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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/30792242 below:

Trends in Human Papillomavirus Vaccine Types 16 and 18 in Cervical Precancers, 2008-2014

Affiliations

• ¹ National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. mti6@cdc.gov.
• ² Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
• ³ National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
• ⁴ University of Rochester School of Medicine and Dentistry, Rochester, New York.
• ⁵ Yale School of Public Health, New Haven, Connecticut.
• ⁶ Oregon Health Authority Public Health Division, Portland, Oregon.
• ⁷ Vanderbilt University Medical Center, Nashville, Tennesse.
• ⁸ School of Medicine, University of California at San Francisco, San Francisco, California.
• ⁹ National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

• PMID: 30792242
• PMCID: PMC6526945
• DOI: 10.1158/1055-9965.EPI-18-0885

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Nancy M McClung et al. Cancer Epidemiol Biomarkers Prev. 2019 Mar.

• ¹ National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. mti6@cdc.gov.
• ² Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
• ³ National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
• ⁴ University of Rochester School of Medicine and Dentistry, Rochester, New York.
• ⁵ Yale School of Public Health, New Haven, Connecticut.
• ⁶ Oregon Health Authority Public Health Division, Portland, Oregon.
• ⁷ Vanderbilt University Medical Center, Nashville, Tennesse.
• ⁸ School of Medicine, University of California at San Francisco, San Francisco, California.
• ⁹ National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

• PMID: 30792242
• PMCID: PMC6526945
• DOI: 10.1158/1055-9965.EPI-18-0885

Item in Clipboard

Background: The impact of human papillomavirus (HPV) vaccination has been observed in the United States through declining cervical precancer incidence in young women. To further evaluate vaccine impact, we described trends in HPV vaccine types 16/18 in cervical precancers, 2008-2014.

Methods: We analyzed data from a 5-site, population-based surveillance system. Archived specimens from women age 18-39 years diagnosed with cervical intraepithelial neoplasia grades 2-3 or adenocarcinoma in situ (CIN2+) were tested for 37 HPV types. We described the proportion and estimated number of cases of CIN2+ by HPV-type groups over time. Trends in HPV16/18-positive CIN2+ were examined, overall and by vaccination status, age, histologic grade, and race/ethnicity, using Cochrane-Armitage tests.

Results: In 10,206 cases, the proportion and estimated number of cases of HPV16/18-positive CIN2+ declined from 52.7% (1,235 cases) in 2008 to 44.1% (819 cases) in 2014 (P < 0.001). Declining trends in the proportion of HPV16/18-positive CIN2+ were observed among vaccinated (55.2%-33.3%, P < 0.001) and unvaccinated (51.0%-47.3%, P = 0.03) women; ages 18-20 (48.7%-18.8%, P = 0.02), 21-24 (53.8%-44.0%, P < 0.001), 25-29 (56.9%-42.4%, P < 0.001), and 30-34 (49.8%-45.8%, P = 0.04) years; CIN2 (40.8%-29.9%, P < 0.001) and CIN2/3 (61.8%-46.2%, P < 0.001); non-Hispanic white (59.5%-47.9%, P < 0.001) and non-Hispanic black (40.7%-26.5%, P < 0.001).

Conclusions: From 2008-2014, the proportion of HPV16/18-positive CIN2+ declined, with the greatest declines in vaccinated women; declines in unvaccinated women suggest herd protection.

Impact: The declining proportion of HPV16/18-positive CIN2+ provides additional evidence of vaccine impact in the United States.

©2019 American Association for Cancer Research.

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Disclosure of Potential Conflicts of Interest

L.M. Niccolai is a consultant/advisory board member for Merck. No potential conflicts of interest were disclosed by the other authors.

Total reported CIN2+ cases, proportion…

Total reported CIN2+ cases, proportion and estimated number of cases by HPV type…

Total reported CIN2+ cases, proportion and estimated number of cases by HPV type category, 2008–2014. CIN2+, cervical intraepithelial neoplasia grade 2 or worse; HR, high-risk. Estimated number of CIN2+ cases in each HPV type category = total cases (typed + nontyped) × proportion of typed cases with types in respective type categories.

Proportion of CIN2+ cases among…

Proportion of CIN2+ cases among 18- to 39-year-old women that were HPV 16/18-positive,…

Proportion of CIN2+ cases among 18- to 39-year-old women that were HPV 16/18-positive, 2008–2014, by vaccination status, age group, histologic grade, and race/ethnicity. A, vaccination status, women with unknown timing of vaccination were excluded (n = 306) B, age group, C, histologic grade, and D, race/ethnicity. Gray bars indicate HPV 16/18-positive cases and sequential years from 2008 (darkest gray) to 2014 (lightest gray). CIN: cervical intraepithelial neoplasia; AIS: adenocarcinoma in situ with or without CIN.

• Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors.

  Arbyn M, Xu L, Simoens C, Martin-Hirsch PP. Arbyn M, et al. Cochrane Database Syst Rev. 2018 May 9;5(5):CD009069. doi: 10.1002/14651858.CD009069.pub3. Cochrane Database Syst Rev. 2018. PMID: 29740819 Free PMC article. Review.

• Cervical adenocarcinoma in situ: Human papillomavirus types and incidence trends in five states, 2008-2015.

  Cleveland AA, Gargano JW, Park IU, Griffin MR, Niccolai LM, Powell M, Bennett NM, Saadeh K, Pemmaraju M, Higgins K, Ehlers S, Scahill M, Johnson Jones ML, Querec T, Markowitz LE, Unger ER; HPV-IMPACT Working Group. Cleveland AA, et al. Int J Cancer. 2020 Feb 1;146(3):810-818. doi: 10.1002/ijc.32340. Epub 2019 May 6. Int J Cancer. 2020. PMID: 30980692 Free PMC article.

• HPV type-specific trends in cervical precancers in the United States, 2008 to 2016.

  Gargano JW, McClung N, Lewis RM, Park IU, Whitney E, Castilho JL, Pemmaraju M, Niccolai LM, Brackney M, DeBess E, Ehlers S, Bennett NM, Scahill M, Cleveland AA, Querec TD, Unger ER, Markowitz LE; HPV-IMPACT Working Group. Gargano JW, et al. Int J Cancer. 2023 Jan 15;152(2):137-150. doi: 10.1002/ijc.34231. Epub 2022 Sep 26. Int J Cancer. 2023. PMID: 35904861

• Efficacy of the bivalent HPV vaccine against HPV 16/18-associated precancer: long-term follow-up results from the Costa Rica Vaccine Trial.

  Porras C, Tsang SH, Herrero R, Guillén D, Darragh TM, Stoler MH, Hildesheim A, Wagner S, Boland J, Lowy DR, Schiller JT, Schiffman M, Schussler J, Gail MH, Quint W, Ocampo R, Morales J, Rodríguez AC, Hu S, Sampson JN, Kreimer AR; Costa Rica Vaccine Trial Group. Porras C, et al. Lancet Oncol. 2020 Dec;21(12):1643-1652. doi: 10.1016/S1470-2045(20)30524-6. Lancet Oncol. 2020. PMID: 33271093 Free PMC article. Clinical Trial.

• Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials.

  Arbyn M, Xu L. Arbyn M, et al. Expert Rev Vaccines. 2018 Dec;17(12):1085-1091. doi: 10.1080/14760584.2018.1548282. Epub 2018 Nov 29. Expert Rev Vaccines. 2018. PMID: 30495978 Review.

• HPV Vaccine Delivery Practices by Primary Care Physicians.

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• Knowledge, Attitudes, and Practices towards Cervical Cancer and Screening amongst Female Healthcare Professionals: A Cross-Sectional Study.

  Heena H, Durrani S, AlFayyad I, Riaz M, Tabasim R, Parvez G, Abu-Shaheen A. Heena H, et al. J Oncol. 2019 Oct 17;2019:5423130. doi: 10.1155/2019/5423130. eCollection 2019. J Oncol. 2019. PMID: 31772579 Free PMC article.

• The Burden of Cervical Conization in Privately Insured Young and Mid-Adult Women in the United States.

  Saxena K, Sawhney B, Yande S, Kathe N, Chatterjee S. Saxena K, et al. Vaccines (Basel). 2023 Apr 5;11(4):804. doi: 10.3390/vaccines11040804. Vaccines (Basel). 2023. PMID: 37112716 Free PMC article.

• High RPS27A Expression Predicts Poor Prognosis in Patients With HPV Type 16 Cervical Cancer.

  Wang Q, Cai Y, Fu X, Chen L. Wang Q, et al. Front Oncol. 2021 Nov 2;11:752974. doi: 10.3389/fonc.2021.752974. eCollection 2021. Front Oncol. 2021. PMID: 34796111 Free PMC article.

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