HPV疫苗接種可顯著降低浸潤性宮頸癌的風險
作者：
小柯機器人發布時間：2020/10/4 23:26:32
瑞典卡羅林斯卡大學Jiayao Lei團隊研究了HPV疫苗接種與浸潤性宮頸癌風險之間的相關性。2020年10月1日，該研究發表在《新英格蘭醫學雜誌》上。
四價人乳頭瘤病毒（HPV）疫苗在預防高級宮頸病變中已初見成效。但四價HPV疫苗接種與隨後的浸潤性宮頸癌風險之間的相關性尚不明確。
研究組使用了瑞典全國人口統計和健康登記表，來追蹤2006-2017年中年齡在10-30歲間的1672983名女性的數據，用於評估HPV疫苗接種與宮頸癌浸潤風險之間的關聯。
在研究期間，研究組評估了女孩和女性是否患有宮頸癌，直到她們31歲生日為止。最終在接種四價HPV疫苗的19名女性和未接種疫苗的538名女性中診斷出宮頸癌。接種疫苗的女性中，宮頸癌的累積發病率為每十萬人47例，未接種的女性中為每十萬人94例。
校正隨訪年齡後，接種人群與未接種人群宮頸癌的發生率比率為0.51。對其他協變量進行額外校正後，發生率比率為0.37。對所有協變量進行校正後，在17歲之前接種疫苗的女性中，發病率比率為0.12，而在17-30歲間接種疫苗的女性中為0.47。
附：英文原文
Title: HPV Vaccination and the Risk of Invasive Cervical Cancer
Author: Jiayao Lei, Ph.D.,, Alexander Ploner, Ph.D.,, K. Miriam Elfstrm, Ph.D.,, Jiangrong Wang, Ph.D.,, Adam Roth, M.D., Ph.D.,, Fang Fang, M.D., Ph.D.,, Karin Sundstrm, M.D., Ph.D.,, Joakim Dillner, M.D., Ph.D.,, and Pr Sparén, Ph.D.
Issue&Volume: 2020-10-01
Abstract:
Background
The efficacy and effectiveness of the quadrivalent human papillomavirus (HPV) vaccine in preventing high-grade cervical lesions have been shown. However, data to inform the relationship between quadrivalent HPV vaccination and the subsequent risk of invasive cervical cancer are lacking.
Methods
We used nationwide Swedish demographic and health registers to follow an open population of 1,672,983 girls and women who were 10 to 30 years of age from 2006 through 2017. We assessed the association between HPV vaccination and the risk of invasive cervical cancer, controlling for age at follow-up, calendar year, county of residence, and parental characteristics, including education, household income, mother’s country of birth, and maternal disease history.
Results
During the study period, we evaluated girls and women for cervical cancer until their 31st birthday. Cervical cancer was diagnosed in 19 women who had received the quadrivalent HPV vaccine and in 538 women who had not received the vaccine. The cumulative incidence of cervical cancer was 47 cases per 100,000 persons among women who had been vaccinated and 94 cases per 100,000 persons among those who had not been vaccinated. After adjustment for age at follow-up, the incidence rate ratio for the comparison of the vaccinated population with the unvaccinated population was 0.51 (95% confidence interval [CI], 0.32 to 0.82). After additional adjustment for other covariates, the incidence rate ratio was 0.37 (95% CI, 0.21 to 0.57). After adjustment for all covariates, the incidence rate ratio was 0.12 (95% CI, 0.00 to 0.34) among women who had been vaccinated before the age of 17 years and 0.47 (95% CI, 0.27 to 0.75) among women who had been vaccinated at the age of 17 to 30 years.
Conclusions
Among Swedish girls and women 10 to 30 years old, quadrivalent HPV vaccination was associated with a substantially reduced risk of invasive cervical cancer at the population level.
DOI: 10.1056/NEJMoa1917338
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1917338