Developing, validating and testing non-vaccine-preventable human papillomavirus to control for differences in sexual behaviour when evaluating HPV vaccination.

IF 3.7 3区医学 Q2 ONCOLOGY

Cancer Epidemiology Biomarkers & Prevention Pub Date : 2025-04-21 DOI:10.1158/1055-9965.EPI-24-1775

Emily Dema, Jaimie Z Shing, Marta Checchi, Simon Beddows, Danping Liu, Monica S Sierra, Cameron B Haas, Kate Soldan, Nigel Field, Aimee R Kreimer, Pam Sonnenberg

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引用次数: 0

Abstract

Background: Evaluating impact/effectiveness of human papillomavirus (HPV) vaccination generally assumes stability in factors driving transmission, which might not be valid. We aimed to develop, validate, and test a grouping of non-vaccine-preventable HPV (NVP-HPV) types as a molecular indicator associated with sexual behaviours to control for changes in HPV transmission risk.

Methods: We used data from the National Surveys of Sexual Attitudes and Lifestyles (Natsal-2, 1999-2001, N=1,849; Natsal-3, 2010-2012, N=2,407) to validate the association of NVP-HPV (26/53/66/70/73) with self-reported sexual behaviours. We calculated NVP-HPV-adjusted HPV16/18 vaccine impact/effectiveness estimates in two real-world scenarios: 1) Natsal-2/Natsal-3 (sexually-experienced women in Britain, 18-44yrs) and 2) England's HPV surveillance (women 16-24yrs) (2008, N=3,539; 2010-2020, N=24,707). Samples (urine/vulvo-vaginal swabs) were tested for 21 HPV genotypes (6/11/16/18/26/31/33/35/39/45/51/52/53/56/58/59/66/68/70/73/82) using an in-house multiplex PCR and Luminex-based genotyping assay.

Results: NVP-HPV infection was strongly associated with sexual behaviours (e.g., younger age sexual debut, partner numbers). In Natsal data, adjusting for NVP-HPV did not change vaccine impact estimates (unadjusted prevalence ratio (PR: 0.50 (0.27-0.95), adjusted PR: 0.45 (0.25-0.82)). In the second scenario, adjusting for NVP-HPV did not change the prevalence ratio for HPV16/18 comparing 2020 to 2010 (0.07 (0.030.15), unadjusted and adjusted PR). In both scenarios, prevalence of NVP-HPV did not change over time.

Conclusions: We have demonstrated proof-of-concept that NVP-HPV is strongly associated with sexual behaviours. Adjusting for NVP-HPV in two datasets found that original estimates were robust.

Impact: NVP-HPV might be used to control for changes in HPV transmission risk over time and between groups when evaluating vaccination impact/effectiveness.

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开发、验证和测试非疫苗可预防的人乳头瘤病毒，以在评估HPV疫苗接种时控制性行为的差异。

背景：评估人乳头瘤病毒（HPV）疫苗接种的影响/有效性通常假设驱动传播的因素是稳定的，这可能是无效的。我们的目的是开发、验证和测试一组非疫苗可预防的HPV （NVP-HPV）类型，作为与性行为相关的分子指标，以控制HPV传播风险的变化。方法：我们使用的数据来自全国性态度和生活方式调查(Natsal-2, 1999-2001， N= 1849；Natsal-3, 2010-2012， N= 2407)验证NVP-HPV（26/53/66/70/73）与自我报告的性行为的关联。我们计算了nvp -HPV调整后的HPV16/18疫苗在两种现实情况下的影响/有效性估计：1)Natsal-2/Natsal-3（英国18-44岁的性经验女性）和2)英格兰HPV监测（16-24岁的女性）(2008年，N=3,539；2010 - 2020年,N = 24707)。使用内部多重PCR和基于luminex的基因分型试验对样本（尿液/外阴阴道拭子）进行21种HPV基因型（6/11/16/18/26/31/33/35/39/45/51/52/53/56/58/59/66/68/70/73/82）的检测。结果：NVP-HPV感染与性行为（例如，较年轻的初次性行为，伴侣数量）密切相关。在Natsal数据中，调整NVP-HPV并没有改变疫苗的影响估计(未调整的患病率(PR: 0.50（0.27-0.95)，调整后的PR: 0.45(0.25-0.82)）。在第二种情况下，调整NVP-HPV并没有改变2020年与2010年相比HPV16/18的患病率（0.07(0.030.15)，未调整和调整的PR）。在这两种情况下，NVP-HPV的患病率都没有随时间变化。结论：我们已经证明了NVP-HPV与性行为密切相关。对两个数据集的NVP-HPV进行调整后发现，最初的估计是稳健的。影响：在评估疫苗接种影响/有效性时，NVP-HPV可用于控制HPV传播风险随时间和组间的变化。

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 Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

2.60%

发文量

538

审稿时长

1.6 months

期刊介绍： Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.