日本未接种疫苗的宫颈上皮内瘤变女性中HPV16/18流行率的变化：HPV疫苗接种计划后群体效应的评估。
Changes in HPV16/18 Prevalence among Unvaccinated Women with Cervical Intraepithelial Neoplasia in Japan: Assessment of Herd Effects following the HPV Vaccination Program.
作者信息
Onuki Mamiko, Yamamoto Kasumi, Yahata Hideaki, Kanao Hiroyuki, Horie Koji, Konnai Katsuyuki, Nio Ai, Takehara Kazuhiro, Kamiura Shoji, Tsuda Naotake, Takei Yuji, Shigeta Shogo, Nakai Hidekatsu, Yoshida Hiroyuki, Motohara Takeshi, Kato Tatsuya, Nakamura Keiichiro, Hamanishi Junzo, Tasaka Nobutaka, Ishikawa Mitsuya, Kado Nobuhiro, Taira Yusuke, Mori Mayuyo, Iwata Takashi, Takahashi Fumiaki, Kukimoto Iwao, Yoshikawa Hiroyuki, Yaegashi Nobuo, Matsumoto Koji
机构信息
Department of Obstetrics and Gynecology, School of Medicine, Showa University, Tokyo 142-8666, Japan.
Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi 673-0021, Japan.
出版信息
Vaccines (Basel). 2022 Jan 25;10(2):188. doi: 10.3390/vaccines10020188.
Since the human papillomavirus (HPV) vaccination program for Japanese girls aged 12-16 years began in 2010, vaccination uptake has been low in women born before 1993 but high (approximately 70%) in those born during 1994-1999. We previously compared the prevalence of vaccine types HPV16 and HPV18 in cervical intraepithelial neoplasia grade 1-3 (CIN1-3) or adenocarcinoma in situ (AIS) between vaccinated and unvaccinated cohorts and found direct protection effects among vaccinated women in Japan. In this study, we focused on changes in HPV16/18 prevalence among "unvaccinated" cohorts with CIN/AIS. We analyzed HPV16/18 prevalence among 5051 unvaccinated women aged <40 years, newly diagnosed with CIN/AIS during 2012-2021 for time trends. Declining trends in HPV16/18 prevalence over 9 years were observed in CIN1 (36.0-10.0%, P = 0.03) and CIN2-3/AIS (62.5-36.4%, P = 0.07) among women aged <25 years. HPV16/18 prevalence in CIN1 and CIN2-3/AIS diagnosed at age 20-24 years was lower in 1994-1999 birth cohorts compared with 1988-1993 birth cohorts (4.5% vs. 25.7% for CIN1 and 40.0% vs. 58.1% for CIN2-3/AIS, both = 0.04). Significant reduction in HPV16/18 prevalence among young unvaccinated women with CIN1 and CIN2-3/AIS suggests herd effects of HPV vaccination in Japan.
自2010年日本针对12至16岁女孩的人乳头瘤病毒（HPV）疫苗接种计划启动以来，1993年以前出生的女性疫苗接种率较低，而1994年至1999年出生的女性接种率较高（约70%）。我们之前比较了接种疫苗和未接种疫苗队列中宫颈上皮内瘤变1至3级（CIN1 - 3）或原位腺癌（AIS）中疫苗型HPV16和HPV18的患病率，发现日本接种疫苗的女性中有直接保护作用。在本研究中，我们关注了患有CIN/AIS的“未接种疫苗”队列中HPV16/18患病率的变化。我们分析了2012年至2021年期间新诊断为CIN/AIS的5051名年龄小于40岁的未接种疫苗女性中HPV16/18的患病率，以观察时间趋势。在25岁以下的女性中，CIN1（从36.0%降至10.0%，P = 0.03）和CIN2 - 3/AIS（从62.5%降至36.4%，P = 0.07）中观察到HPV16/18患病率在9年期间呈下降趋势。与1988 - 1993年出生队列相比，1994 - 1999年出生队列中20至24岁诊断为CIN1和CIN2 - 3/AIS的HPV16/18患病率较低（CIN1分别为4.5%对25.7%，CIN2 - 3/AIS分别为40.0%对58.1%，P均 = 0.04）。年轻未接种疫苗的CIN1和CIN2 - 3/AIS女性中HPV16/18患病率的显著降低表明日本HPV疫苗接种存在群体效应。
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