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▎Cervical cancer, edited by WuXi AppTec's content team, is one of the most common cancers in women worldwide and one of the most common causes of cancer-related deaths in women worldwide
.
Screening and human papillomavirus (HPV) vaccination are important means of cervical cancer prevention.
Thanks to this, the incidence of cervical cancer has been slowly and steadily declining, and young women have particularly benefited
.
However, although the results of a number of randomized controlled trials suggest that HPV vaccines can prevent different HPV subtypes of the general population and the occurrence of cervical intraepithelial neoplasia (CIN), how much influence does HPV vaccine have on the incidence of cervical cancer? There is a relative lack of actual direct evidence around the world
.
This is because the occurrence and development of cancer is a long process, and more long-term data accumulation is usually needed to explain the problem
.
On November 3, 2021, the internationally renowned medical journal The Lancet published a large-scale population cohort study data from the United Kingdom at a national level
.
The study is based on the data of three cohorts of girls of “12-13”, “14-16”, and “16-18” in the UK, confirming that HPV vaccination can reduce cervical cancer by as much as 87% and 97% of cervical intraepithelial neoplasia is grade 3 (CIN3)
.
Among women born after September 1, 1995, HPV vaccination has almost eliminated cervical cancer in local women! The paper pointed out that "this study has confirmed the direct role of HPV vaccine in cervical cancer prevention for the first time", which is of great significance! Screenshot source: The Lancet HPV is an important cause of cervical cancer, genital warts and other diseases.
HPV vaccination provides an important means to prevent HPV infection and the prevention and control of related diseases
.
In 2006, the HPV vaccine was first approved for use in women aged 9-26 to prevent HPV infection and the development of cervical precancerous lesions
.
In November 2020, the WHO issued the "Global Strategy for Accelerating the Elimination of Cervical Cancer".
By 2030, 90% of girls have completed the HPV vaccination before the age of 15, so as to greatly prevent the occurrence of cervical cancer and other HPV-related malignancies
.
Up to now, few research reports on the actual impact of HPV vaccination on the incidence of invasive cervical cancer have been published in the academic community
.
If the direct preventive effect of HPV vaccine on cervical cancer can be confirmed, it will effectively improve the acceptance of HPV vaccination and the efficiency of vaccination promotion among the general population
.
The UK started the HPV vaccination program in 2008, considering that HPV vaccination before exposure to the HPV virus (such as before the start of sex) may be the most effective, so regular HPV bivalent vaccination is implemented for girls aged 12-13.
.
The current observational study uses data from the UK population cancer registry to control confounding factors and bias through modeling.
The three age cohorts (12-13 years old, 14-16 years old and 16- The incidence data of 18-year-old girls and women (4 cohorts) before the start of the HPV vaccination program in the UK were compared
.
During the study period (from January 1, 2006 to June 30, 2019), a total of 27,946 patients were diagnosed with cervical cancer, and 318,058 patients were diagnosed with CIN3
.
In the three vaccination cohorts of "12-13 years old", "14-16 years old" and "16-18 years old", the study follow-up time was up to 13.
7 million-years
.
The results show that the vaccination rate of different age cohorts is different.
The proportion of the "12-13 years old" cohort who completed 3 shots of HPV vaccine was 84.
9%; the "14-16 years old" cohort was 73.
2%; the "16-18 years old" cohort was 73.
2%.
The group is 44.
8%, and with the increase of age, the relative risk of cervical cancer in people with a history of HPV exposure continues to increase
.
It is worth noting that in the three vaccination cohorts of "12-13 years old", "14-16 years old" and "16-18 years old", the incidence of cervical cancer and CIN3 lesions all dropped significantly, especially For girls who completed vaccination at the age of 12-13, the drop was particularly pronounced
.
Specifically, for girls aged 16-18 vaccinated with HPV vaccine, the incidence of cervical cancer was relatively reduced by 34%, and the incidence of CIN3 was relatively reduced by 39%.
Vaccination at the age of 14-16, the risk of cervical cancer was relatively reduced by 62%, and the risk of CIN3 was relatively reduced.
39%; 12-13 years old vaccination, the risk of cervical cancer is relatively reduced by 87%, and the risk of CIN3 is relatively reduced by 97%! ▲Different cohort incidence risk differences: Model 1, Model 2, and Model 3 are the analysis results based on different confounding factors.
The content of this report is the analysis results of Model 3, which can simply and intuitively reflect the differences (picture source: reference [1]).
In general, the HPV vaccination program significantly reduces the incidence of cervical cancer and CIN3 in young women
.
Based on this estimate, as of June 2019, the HPV vaccination program carried out among women across the UK has reduced 448 new cases of cervical cancer and 17,235 new cases of CIN3
.
Considering that the development of high-risk HPV infection to invasive cancer requires a long disease process, which hinders the early evaluation of vaccine effectiveness, so alternative markers such as HPV infection rate, abnormal cervical cytology results, CIN incidence, etc.
have also become assessments A powerful tool for vaccine protection
.
A Cochrane systematic review published in 2018 reviewed 26 randomized controlled clinical trials related to vaccination (18 of which involved bivalent HPV vaccines).
.
The results showed that young women (≤26 years old) who were high-risk HPV-negative at the time of trial entry significantly reduced the incidence of cervical precancerous lesions (including CIN and CGIN) through vaccination
.
At the same time, regardless of the HPV status at the time of enrollment, the incidence of cervical precancerous lesions in HPV vaccine recipients decreased significantly
.
The observational results of the current large population cohort study further fully confirm that the HPV vaccination program has relatively reduced the incidence of cervical cancer, and provides solid evidence of the effectiveness of the vaccine
.
"The Lancet" published a comment at the same time that the actual effect of the immunization program depends on the number of vaccines and the vaccination rate
.
Even so the full implementation of the national HPV vaccination program in the UK, HPV vaccination rate has not yet reached the target set by WHO - "90 percent of girls complete HPV vaccine in the vaccination before the age of 15"
.
Combined with the results of the current research, we still need to further strengthen public health education in the future, and encourage women who have the opportunity to receive HPV vaccine to vaccinate at any age, so as to ensure that the vaccination plan further benefits the younger generation
.
.
Screening and human papillomavirus (HPV) vaccination are important means of cervical cancer prevention.
Thanks to this, the incidence of cervical cancer has been slowly and steadily declining, and young women have particularly benefited
.
However, although the results of a number of randomized controlled trials suggest that HPV vaccines can prevent different HPV subtypes of the general population and the occurrence of cervical intraepithelial neoplasia (CIN), how much influence does HPV vaccine have on the incidence of cervical cancer? There is a relative lack of actual direct evidence around the world
.
This is because the occurrence and development of cancer is a long process, and more long-term data accumulation is usually needed to explain the problem
.
On November 3, 2021, the internationally renowned medical journal The Lancet published a large-scale population cohort study data from the United Kingdom at a national level
.
The study is based on the data of three cohorts of girls of “12-13”, “14-16”, and “16-18” in the UK, confirming that HPV vaccination can reduce cervical cancer by as much as 87% and 97% of cervical intraepithelial neoplasia is grade 3 (CIN3)
.
Among women born after September 1, 1995, HPV vaccination has almost eliminated cervical cancer in local women! The paper pointed out that "this study has confirmed the direct role of HPV vaccine in cervical cancer prevention for the first time", which is of great significance! Screenshot source: The Lancet HPV is an important cause of cervical cancer, genital warts and other diseases.
HPV vaccination provides an important means to prevent HPV infection and the prevention and control of related diseases
.
In 2006, the HPV vaccine was first approved for use in women aged 9-26 to prevent HPV infection and the development of cervical precancerous lesions
.
In November 2020, the WHO issued the "Global Strategy for Accelerating the Elimination of Cervical Cancer".
By 2030, 90% of girls have completed the HPV vaccination before the age of 15, so as to greatly prevent the occurrence of cervical cancer and other HPV-related malignancies
.
Up to now, few research reports on the actual impact of HPV vaccination on the incidence of invasive cervical cancer have been published in the academic community
.
If the direct preventive effect of HPV vaccine on cervical cancer can be confirmed, it will effectively improve the acceptance of HPV vaccination and the efficiency of vaccination promotion among the general population
.
The UK started the HPV vaccination program in 2008, considering that HPV vaccination before exposure to the HPV virus (such as before the start of sex) may be the most effective, so regular HPV bivalent vaccination is implemented for girls aged 12-13.
.
The current observational study uses data from the UK population cancer registry to control confounding factors and bias through modeling.
The three age cohorts (12-13 years old, 14-16 years old and 16- The incidence data of 18-year-old girls and women (4 cohorts) before the start of the HPV vaccination program in the UK were compared
.
During the study period (from January 1, 2006 to June 30, 2019), a total of 27,946 patients were diagnosed with cervical cancer, and 318,058 patients were diagnosed with CIN3
.
In the three vaccination cohorts of "12-13 years old", "14-16 years old" and "16-18 years old", the study follow-up time was up to 13.
7 million-years
.
The results show that the vaccination rate of different age cohorts is different.
The proportion of the "12-13 years old" cohort who completed 3 shots of HPV vaccine was 84.
9%; the "14-16 years old" cohort was 73.
2%; the "16-18 years old" cohort was 73.
2%.
The group is 44.
8%, and with the increase of age, the relative risk of cervical cancer in people with a history of HPV exposure continues to increase
.
It is worth noting that in the three vaccination cohorts of "12-13 years old", "14-16 years old" and "16-18 years old", the incidence of cervical cancer and CIN3 lesions all dropped significantly, especially For girls who completed vaccination at the age of 12-13, the drop was particularly pronounced
.
Specifically, for girls aged 16-18 vaccinated with HPV vaccine, the incidence of cervical cancer was relatively reduced by 34%, and the incidence of CIN3 was relatively reduced by 39%.
Vaccination at the age of 14-16, the risk of cervical cancer was relatively reduced by 62%, and the risk of CIN3 was relatively reduced.
39%; 12-13 years old vaccination, the risk of cervical cancer is relatively reduced by 87%, and the risk of CIN3 is relatively reduced by 97%! ▲Different cohort incidence risk differences: Model 1, Model 2, and Model 3 are the analysis results based on different confounding factors.
The content of this report is the analysis results of Model 3, which can simply and intuitively reflect the differences (picture source: reference [1]).
In general, the HPV vaccination program significantly reduces the incidence of cervical cancer and CIN3 in young women
.
Based on this estimate, as of June 2019, the HPV vaccination program carried out among women across the UK has reduced 448 new cases of cervical cancer and 17,235 new cases of CIN3
.
Considering that the development of high-risk HPV infection to invasive cancer requires a long disease process, which hinders the early evaluation of vaccine effectiveness, so alternative markers such as HPV infection rate, abnormal cervical cytology results, CIN incidence, etc.
have also become assessments A powerful tool for vaccine protection
.
A Cochrane systematic review published in 2018 reviewed 26 randomized controlled clinical trials related to vaccination (18 of which involved bivalent HPV vaccines).
.
The results showed that young women (≤26 years old) who were high-risk HPV-negative at the time of trial entry significantly reduced the incidence of cervical precancerous lesions (including CIN and CGIN) through vaccination
.
At the same time, regardless of the HPV status at the time of enrollment, the incidence of cervical precancerous lesions in HPV vaccine recipients decreased significantly
.
The observational results of the current large population cohort study further fully confirm that the HPV vaccination program has relatively reduced the incidence of cervical cancer, and provides solid evidence of the effectiveness of the vaccine
.
"The Lancet" published a comment at the same time that the actual effect of the immunization program depends on the number of vaccines and the vaccination rate
.
Even so the full implementation of the national HPV vaccination program in the UK, HPV vaccination rate has not yet reached the target set by WHO - "90 percent of girls complete HPV vaccine in the vaccination before the age of 15"
.
Combined with the results of the current research, we still need to further strengthen public health education in the future, and encourage women who have the opportunity to receive HPV vaccine to vaccinate at any age, so as to ensure that the vaccination plan further benefits the younger generation
.
