Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy.
Veneto Tumour Registry, Azienda Zero, 35131 Padua, Italy.
Viruses. 2021 Mar 16;13(3):486. doi: 10.3390/v13030486.
Efficacy for cervical cancer prevention of opportunistic HPV vaccination in post-pubertal girls is lower than in 11-year-olds.
Women born between 1986 and 1992 vaccinated at 15-25 years of age (at least one dose of 4-valent HPV vaccine) and screened at 24-27 years of age were included. Frequency of opportunistic vaccination, overall and by birth cohort, was calculated; screening outcomes were compared between vaccinated and unvaccinated women.
Overall, 4718 (4.9%) HPV-vaccinated, and 91,512 unvaccinated, women were studied. The frequency of vaccination increased by birth cohort, ranging between 1.8% and 9.8%; age at vaccination decreased progressively by birth cohort ( < 0.0001). Participation in screening was 60.8% among vaccinated, and 56.6% among unvaccinated, women ( < 0.0001). Detection rates (DR) for high-grade lesions were lower in vaccinated women (2.11‰ vs. 3.85‰ in unvaccinated, for CIN3+, = 0.24; 0.0‰ vs. 0.22‰ for cancer). The DR of CIN3+ increased with age at vaccination, scoring respectively 0.0‰, 0.83‰, and 4.68‰ for women vaccinated when they were 15-16, 17-20, and 21-25 years old ( = 0.17).
In comparison to unvaccinated women, higher compliance with cervical cancer screening invitation and lower CIN3+ DR among vaccinated women was observed. Age at vaccination was inversely correlated to vaccination efficacy.
在青春期后女孩中，机会性 HPV 疫苗接种对宫颈癌的预防效果低于 11 岁女孩。
纳入了 1986 年至 1992 年出生、15-25 岁（至少接种过一剂 4 价 HPV 疫苗）接种疫苗并在 24-27 岁接受筛查的女性。计算了机会性接种的频率、总体和按出生队列的频率；比较了接种疫苗和未接种疫苗女性的筛查结果。
总体上，研究了 4718 名（4.9%）HPV 疫苗接种者和 91512 名未接种者。疫苗接种频率随出生队列增加，范围在 1.8%至 9.8%之间；接种年龄随出生队列逐渐降低（<0.0001）。接种疫苗的女性中，参加筛查的比例为 60.8%，未接种疫苗的女性为 56.6%（<0.0001）。接种疫苗的女性中高级别病变的检出率（DR）较低（CIN3+为 2.11‰对未接种者的 3.85‰，=0.24；癌症为 0.0‰对 0.22‰）。随着接种年龄的增加，CIN3+的 DR 增加，分别为 15-16 岁、17-20 岁和 21-25 岁接种疫苗的女性为 0.0‰、0.83‰和 4.68‰（=0.17）。
与未接种疫苗的女性相比，接种疫苗的女性对宫颈癌筛查邀请的依从性更高，CIN3+的检出率较低。接种年龄与疫苗接种效果呈负相关。
