Cervical cancer; HPV; HPV vaccination; Human papillomavirus; Screening; Surveillance; Papillomavirus Vaccines; Adolescent; Adult; Belgium/epidemiology; Biopsy; Female; Human papillomavirus 16/isolation & purification; Human papillomavirus 18/isolation & purification; Humans; Middle Aged; Papillomavirus Infections/epidemiology; Papillomavirus Infections/prevention & control; Papillomavirus Infections/virology; Papillomavirus Vaccines/administration & dosage; Uterine Cervical Neoplasms/epidemiology; Uterine Cervical Neoplasms/pathology; Vaccination; Young Adult; Belgium; Human papillomavirus 16; Human papillomavirus 18; Papillomavirus Infections; Uterine Cervical Neoplasms; Epidemiology; Oncology; Cancer Research
Abstract :
[en] [en] BACKGROUND: Early effects of HPV (human papillomavirus) vaccination are reflected by changes observable in young women attending cervical cancer screening.
SUBJECT AND METHODS: The SEHIB study included HPV geno-typing of ∼6000 continuous and 650 pathological cervical cell specimen as well as biopsies, collected from women in Belgium in 2010-2014. Data were linked to vaccination status.
RESULTS: HPV vaccination offered protection among women aged <30years against infection with HPV16 (vaccine effectiveness [VE]=67%, 95% CI: 48-79%), HPV18 (VE=93%, 95% CI: 52-99%), and high-risk HPV (VE=16%, 95% CI: 2-29%). Vaccination protected also against cytological lesions. Vaccination protected against histologically confirmed lesions: significantly lower absolute risks of CIN1+ (risk difference [RD]=-1.6%, 95% CI: -2.6% to -0.7%) and CIN3+ associated with HPV16/18 (RD=-0.3%, 95% CI -0.6% to -0.1%). Vaccine effectiveness decreased with age. Protection against HPV16 and 18 infection was significant in all age groups, however no protection was observed against cytological lesions associated with these types in age-group 25-29.
CONCLUSION: The SEHIB study demonstrates the effectiveness of HPV vaccination in Belgian young women in particular in age group 18-19. Declining effectiveness with increasing age may be explained by higher tendency of women already exposed to infection to get the vaccine.
Disciplines :
Oncology
Author, co-author :
Arbyn, Marc; Unit of Cancer Epidemiology/Belgian Cancer Centre, Scientific Institute of Public Health, J. Wytsmanstreet 14, B1050 Brussels, Belgium. Electronic address: marc.arbyn@wiv-isp.be
Broeck, Davy Vanden; International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium, Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium, AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
Benoy, Ina; Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium, AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
Bogers, Johannes; Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium, AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
Depuydt, Christophe; Algemeen Medisch Labo, Sonic Healtcare, Antwerp, Belgium
Praet, Marleen; N. Goormachtigh Institute for Pathology, Ghent University, Ghent, Belgium
Sutter, Philippe De; Department of Gynaecology & Oncology, UZ Brussel, Free University of Brussels, Brussels, Belgium
Hoorens, Anne; Department of Pathology, VUB, Brussels, Belgium
Hauben, Esther; Department of Pathology, UZ Leuven, Leuven, Belgium
Poppe, Willy; Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
Van Ranst, Marc; Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
Delvenne, Philippe ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Gofflot, Stéphanie ; Centre Hospitalier Universitaire de Liège - CHU > > Biothèque Hospitalo-Universitaire de Liège (BHUL)
Pétein, Michel; Institut de Pathologie et de Génétique, Charlerloi, Belgium
Engelen, Frans; Centrum voor Medische Analyse, Herentals, Belgium
Vanneste, Alain; Pathological Anatomy, AZ Groeninge, Kortrijk, Belgium
Beeck, Lode Op De; Pathology Mariaziekenhuis Noord Limburg, Overpelt, Belgium
Damme, Pierre Van; Vaccine & Infectious Disease Institute (VAXINFECTIO), Antwerp University, Antwerp, Belgium
Temmerman, Marleen; International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium, Reproductive Health and Research, World Health Organization, Geneva, Switzerland, Department of Gynaecology and Obstetrics, Ghent University, Ghent, Belgium
Weyers, Steven; Department of Gynaecology and Obstetrics, Ghent University, Ghent, Belgium
M. Arbyn/JP Bogers received support from the 7th Framework Program of DG Research of the European Commission through the CoheaHr Project [Grant number 603019 ], coordinated by the VU University Medical Centre of Amsterdam, the Netherlands and the HPV-AHEAD Project, coordinated by IARC, Lyon, France [Grant number: FP7-HEALTH-2011-282562 ].
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