Department National Immunisation Programme, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
PALGA, Houten, The Netherlands.
Cancer Med. 2023 May;12(10):11786-11794. doi: 10.1002/cam4.5842. Epub 2023 Mar 25.
The first HPV-vaccine eligible cohorts in the Netherlands will enter the cervical screening program in 2023. However, a substantial number of young women already have had a cervical sample taken before entry into the regular screening program. This study was initiated to explore early effects of HPV vaccination on detection of cytological abnormalities in cervical samples of women younger than the screening age.
Results of cervical samples were obtained from the Dutch National Pathology Databank (PALGA) and were linked to the women's HPV vaccination status from the national vaccination registry (Praeventis) (N = 42,171). Occurrence of low-grade and high-grade squamous intraepithelial lesions or worse (LSIL and HSIL+) and high-risk HPV positive tests (hrHPV) in the first cervical sample were compared between vaccinated and unvaccinated women by multivariable logistic regression analysis, corrected for age at cervical sampling and age of vaccination (12/13 years, ≥ = 14 years).
For fully vaccinated women (three- or two-dose schedule), statistically significant reductions were seen for all outcomes compared to unvaccinated women (hrHPV: adjusted OR, 0.70, 95% CI, 0.63-0.79; LSIL: 0.70, 0.61-0.80; HSIL+: 0.39, 0.30-0.51).
By linking nation-wide registries on pathology and vaccination, we show significant beneficial early effects of HPV-vaccination on LSIL, HSIL+, CIN3/AIS/carcinoma and hrHPV detection in young women upto 24 years of age who have a cervical sample taken before entry into the cervical cancer screening program.
荷兰第一批符合 HPV 疫苗接种条件的队列将于 2023 年进入宫颈癌筛查计划。然而，相当数量的年轻女性在进入常规筛查计划之前已经接受了宫颈样本采集。本研究旨在探索 HPV 疫苗接种对进入宫颈癌筛查计划前年龄较小的女性宫颈样本细胞学异常检测的早期影响。
从荷兰国家病理学数据库（PALGA）获得宫颈样本结果，并从全国疫苗接种登记处（Praeventis）链接到女性的 HPV 疫苗接种状况（N=42171）。通过多变量逻辑回归分析，比较接种和未接种疫苗的女性在首次宫颈样本中低级别和高级别鳞状上皮内病变或更高级别病变（LSIL 和 HSIL+）和高危型 HPV 阳性检测（hrHPV）的发生率，校正宫颈样本采集时的年龄和疫苗接种年龄（12/13 岁，≥14 岁）。
对于完全接种疫苗的女性（三剂或两剂方案），与未接种疫苗的女性相比，所有结局均显示出统计学显著降低（hrHPV：调整后的 OR，0.70，95%CI，0.63-0.79；LSIL：0.70，0.61-0.80；HSIL+：0.39，0.30-0.51）。
通过将全国范围内的病理学和疫苗接种登记处进行链接，我们显示 HPV 疫苗接种对 LSIL、HSIL+、CIN3/AIS/癌和 hrHPV 检测具有显著的早期有益效果，在进入宫颈癌筛查计划前年龄在 24 岁以下的年轻女性中，这些女性已经接受了宫颈样本采集。
