Human papillomavirus vaccine to prevent CIN3 or worse (CIN3+): A nationwide case-control study in Japan.

IF 5.7 2区 医学 Q1 Medicine
Cancer Science Pub Date : 2024-10-25 DOI:10.1111/cas.16375
Sayaka Ikeda, Yutaka Ueda, Asami Yagi, Taichi Mizushima, Akiko Sukegawa, Risa Kudoh, Manako Yamaguchi, Megumi Kurosawa, Etsuko Miyagi, Masayuki Sekine, Takayuki Enomoto
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Abstract

An increase in cervical cancer incidence has been reported in Japan. The Ministry of Health, Labor, and Welfare of Japan has resumed the active recommendation of regular HPV vaccines in 2022. In Japan, the preventive effect of CIN3+ in the real world has not yet been demonstrated in age-adjusted cohort or case-control studies. This study aimed to estimate the effect of the HPV vaccine against CIN3+ in Japanese women. This nationwide case-control study from April 2013 to March 2020 targeted women aged 20-26 years old at the time of cervical screening. We compared HPV vaccination exposure between those with abnormal and those with normal cytology. Abnormal cytology was classified into cervical intraepithelial neoplasia (CIN)1+, CIN2+, and CIN3+. We calculated the odds ratio (OR) and 95% confidence interval (CI) of the above endpoints and vaccination exposure using the conditional logistic regression model and estimated vaccine effectiveness using the formula (1 -OR) × 100. A total of 2790 cases and 13,990 controls (one-to-five matching) were eligible in 37 municipalities in Japan. In this study, 61 CIN3 (2.2%) and 10 squamous cell carcinomas (SCC) (0.4%) were found. The OR for CIN3+ versus controls was 0.14 (95% CI, 0.03-0.75), equating to a vaccine effectiveness of 86%. Of the 10 patients who had SCC none were vaccinated. This nationwide case-control study in Japan demonstrated a substantial risk reduction in CIN3+ among women who did versus those who did not receive HPV vaccination.

接种人类乳头瘤病毒疫苗预防 CIN3 或更严重(CIN3+):日本全国病例对照研究。
据报道,日本的宫颈癌发病率有所上升。日本厚生劳动省已于 2022 年恢复积极推荐定期接种 HPV 疫苗。在日本,年龄调整后的队列研究或病例对照研究尚未证实 CIN3+ 在现实世界中的预防效果。本研究旨在估算 HPV 疫苗对日本女性 CIN3+ 的预防效果。这项全国性的病例对照研究从 2013 年 4 月开始,到 2020 年 3 月结束,研究对象是接受宫颈筛查时年龄在 20-26 岁之间的女性。我们比较了细胞学异常者和细胞学正常者的 HPV 疫苗接种情况。异常细胞学检查分为宫颈上皮内瘤变(CIN)1+、CIN2+ 和 CIN3+。我们使用条件逻辑回归模型计算了上述终点与疫苗接种暴露的几率比(OR)和 95% 的置信区间(CI),并使用公式 (1 -OR) × 100 估算了疫苗的有效性。日本 37 个市共有 2790 例病例和 13990 例对照(一对五匹配)符合条件。在这项研究中,发现了 61 例 CIN3(2.2%)和 10 例鳞状细胞癌 (SCC)(0.4%)。与对照组相比,CIN3+的OR值为0.14(95% CI,0.03-0.75),相当于疫苗有效率为86%。在 10 名患 SCC 的患者中,没有一人接种过疫苗。日本的这项全国性病例对照研究表明,接种 HPV 疫苗的妇女与未接种疫苗的妇女相比,CIN3+ 的风险大大降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancer Science
Cancer Science ONCOLOGY-
CiteScore
9.90
自引率
3.50%
发文量
406
审稿时长
17 weeks
期刊介绍: Cancer Science (formerly Japanese Journal of Cancer Research) is a monthly publication of the Japanese Cancer Association. First published in 1907, the Journal continues to publish original articles, editorials, and letters to the editor, describing original research in the fields of basic, translational and clinical cancer research. The Journal also accepts reports and case reports. Cancer Science aims to present highly significant and timely findings that have a significant clinical impact on oncologists or that may alter the disease concept of a tumor. The Journal will not publish case reports that describe a rare tumor or condition without new findings to be added to previous reports; combination of different tumors without new suggestive findings for oncological research; remarkable effect of already known treatments without suggestive data to explain the exceptional result. Review articles may also be published.
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