Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA.
College of Engineering Science and Mechanics, The Pennsylvania State University, State College, PA.
Medicine (Baltimore). 2022 Jul 15;101(28):e29329. doi: 10.1097/MD.0000000000029329.
Prophylactic vaccination and routine screening are effective at preventing most cases of cervical cancer. Globally, cervical cancer is the fourth most frequently diagnosed cancer among women. The aim of this study was to investigate the association between human papillomavirus virus (HPV) vaccination (1, 2, or 3 doses) and cervical cancer screening.
PubMed (MEDLINE), Scopus, Web of Science, and Cochrane Library electronic databases were systematically searched from July 1, 2006, up to September 30, 2021. We pooled estimates using random-effects models. Heterogeneity between studies was quantified using Cochran Q test and I2 statistics. In total, 12 studies involving 2.4 million individuals were included in the meta-analysis.
In the adjusted estimates, uptake of HPV vaccination was associated with increased cervical cancer screening (pooled relative risk [RR]: 1.35; 95% confidence interval [CI]: 1.21, 1.50; n = 12). Between-study heterogeneity was large (I2 = 99%). Compared to unvaccinated, those who received 3 doses of HPV vaccine had the highest uptake of cervical cancer screening (RR: 1.85; 95% CI: 1.58, 2.17), followed by those who received 2 doses (RR: 1.34; 95% CI: 1.21, 1.47). No statistically significant association with screening was found for those who received a single dose of the HPV vaccine.
In this meta-analysis, uptake of HPV vaccination was associated with higher cervical cancer screening. It is plausible that vaccinated individuals are more likely to engage in preventive health behaviors. Healthcare providers should remind patients to continue with routine screening for cervical cancer regardless of their HPV vaccine status since vaccination does not protect against all HPV types.
预防性疫苗接种和常规筛查可有效预防大多数宫颈癌病例。在全球范围内，宫颈癌是女性中第四大常见癌症。本研究旨在调查人乳头瘤病毒（HPV）疫苗（1、2 或 3 剂）接种与宫颈癌筛查之间的关联。
系统检索了 2006 年 7 月 1 日至 2021 年 9 月 30 日期间的 PubMed（MEDLINE）、Scopus、Web of Science 和 Cochrane Library 电子数据库。我们使用随机效应模型汇总估计值。使用 Cochran Q 检验和 I2 统计量来量化研究之间的异质性。共有 12 项涉及 240 万人的研究纳入荟萃分析。
在调整后的估计中，HPV 疫苗接种率与宫颈癌筛查率增加相关（汇总相对风险 [RR]：1.35；95%置信区间 [CI]：1.21，1.50；n = 12）。研究之间存在很大的异质性（I2 = 99%）。与未接种疫苗者相比，接种 3 剂 HPV 疫苗者的宫颈癌筛查率最高（RR：1.85；95%CI：1.58，2.17），其次是接种 2 剂者（RR：1.34；95%CI：1.21，1.47）。接种 1 剂 HPV 疫苗与筛查无统计学显著关联。
在这项荟萃分析中，HPV 疫苗接种率与更高的宫颈癌筛查率相关。接种疫苗的个体更有可能参与预防保健行为，这是合理的。无论 HPV 疫苗接种状态如何，医疗保健提供者都应提醒患者继续进行常规宫颈癌筛查，因为疫苗并不能预防所有 HPV 类型。
