Abstract
Objective: To assess the effectiveness of an HPV vaccination programme in reducing the risk of cervical abnormalities identified at subsequent screening. Design: Retrospective cohort study using administrative health data. Setting: General population of Ferrara Province, Italy. Population: Female residents born in 1986–1993 and participating in the organized cervical screening programme in 2011–2018, who were eligible for HPV vaccination in catch-up cohorts. Methods: Logistic regression to evaluate the potential association between abnormal cervical cytology and one, two, three or at least one dose of HPV vaccine. Main outcome measures: Cervical abnormalities, as predicted by low-grade or high-grade cytology, by number of vaccine doses, stratified by age. Results: The sample consisted of 7785 women (mean age 27.5 years, SD 2.3). Overall, 391 (5.0%) were vaccinated with ≥1 dose and 893 (11.5%) had abnormal cytology. Women receiving at least one vaccine dose were significantly less likely to have an abnormal cytology (adjusted odds ratio 0.52; 95% confidence interval 0.34–0.79). Similar results were observed for women receiving a single dose, for both bivalent and quadrivalent vaccines, and applying buffer periods (excluding cytological outcomes within 1 month, 6 months and 1 year of the first dose). Conclusions: In the context of an organised cervical screening programme in Italy, catch-up HPV vaccination almost halved the risk of cytological abnormalities. Tweetable abstract: Among Ferrara women, vaccination against human papillomavirus halved the risk of screening cervical abnormalities. © 2020 Royal College of Obstetricians and Gynaecologists
Original language | English |
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Pages (from-to) | 532-539 |
Number of pages | 8 |
Journal | BJOG Int. J. Obstet. Gynaecol. |
Volume | 128 |
Issue number | 3 |
DOIs | |
Publication status | E-pub ahead of print - Aug 10 2020 |
Keywords
- Cervical screening
- human papillomavirus
- vaccine
- Wart virus vaccine
- adult
- early cancer diagnosis
- female
- human
- Italy
- middle aged
- papillomavirus infection
- preventive health service
- retrospective study
- statistical model
- treatment outcome
- uterine cervix
- uterine cervix tumor
- virology
- Adult
- Cervix Uteri
- Early Detection of Cancer
- Female
- Humans
- Immunization Programs
- Logistic Models
- Middle Aged
- Papillomavirus Infections
- Papillomavirus Vaccines
- Retrospective Studies
- Treatment Outcome
- Uterine Cervical Neoplasms