德国人类乳头瘤病毒免疫接种计划对人类乳头瘤病毒相关生殖器疾病的影响:对法定医疗保险理赔数据的回顾性分析。

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Elizabeth Goodman, Miriam Reuschenbach, Tammo Viering, Agnes Luzak, Wolfgang Greiner, Monika Hampl, Christian Jacob
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引用次数: 0

摘要

目的:人类乳头瘤病毒(HPV)是最常见的性传播感染,可导致多种与 HPV 相关的疾病,包括几乎所有的宫颈癌。自 2007 年以来,德国的 HPV 国家免疫计划(NIP)一直建议接种高效的 HPV 疫苗,并由医疗保险报销。然而,疫苗接种率仍然不尽如人意,德国也缺乏有关 HPV 疫苗接种实际影响的数据。本研究旨在证明德国国家免疫计划对年轻女性HPV相关生殖器疾病的人群影响:方法:采用经典的影响研究设计对索赔数据进行回顾性分析,比较德国引入 HPV 免疫接种计划前后 28 至 33 岁女性的疾病患病率。理赔数据约占德国医疗保险的三分之二。与 HPV 相关的疾病结果包括宫颈癌和高级别癌前病变(宫颈上皮内瘤变(CIN)2+)、生殖器疣以及外阴、阴道和肛门癌前病变/癌:结果:CIN2+、生殖器疣和阴道癌前病变/癌症的发病率明显下降。CIN2+ 发病率下降了 51.1%,从 0.92% (95% CI = 0.78%, 1.08%) 降至 0.45% (95% CI = 0.38%, 0.53%)。肛门尖锐湿疣发病率下降了 38.6%,从 0.44% (95% CI = 0.36%, 0.54%) 降至 0.27% (95% CI = 0.22%, 0.32%);阴道癌前病变/癌症发病率下降了 75.0%,从 0.04% (95% CI = 0.02%, 0.07%) 降至 0.01% (95% CI = 0.00%, 0.02%):德国人乳头瘤病毒免疫接种计划使德国年轻女性肛门生殖器疾病的发病率显著下降,凸显了疫苗接种的重要性。此外,数据还表明,在德国提高疫苗接种覆盖率可进一步加强其 HPV 免疫计划对公共卫生的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The impact of Germany’s human papillomavirus immunization program on HPV-related anogenital diseases: a retrospective analysis of claims data from statutory health insurances

The impact of Germany’s human papillomavirus immunization program on HPV-related anogenital diseases: a retrospective analysis of claims data from statutory health insurances

Purpose

Human papillomavirus (HPV) is the most common sexually transmitted infection, responsible for multiple HPV-related diseases, including almost all cervical cancers. The highly effective HPV vaccination has been recommended under the German HPV national immunization program (NIP) since 2007 and is reimbursed by health insurances. Vaccination uptake rates, however, remain suboptimal and data on the real-world impact of HPV vaccination in Germany are lacking. This study aims to demonstrate the population-level impact of Germany’s NIP on HPV-related anogenital diseases among young women.

Methods

Retrospective claims data analysis using a classic impact study design comparing disease prevalence among 28- to 33-year-old women before and after introduction of the HPV-immunization program in Germany. Claims data representing approximately two thirds of German health insurances were used. HPV-related disease outcomes included cervical cancer and high grade precancers (cervical intraepithelial neoplasia (CIN) 2+), anogenital warts, as well as vulvar, vaginal, and anal precancer/cancer.

Results

Significant declines were seen for CIN2+, anogenital warts, and vaginal precancer/cancer. Prevalence of CIN2+ declined 51.1% from 0.92% (95% CI = 0.78%, 1.08%) to 0.45% (95% CI = 0.38%, 0.53%). There was a 38.6% decline in anogenital warts prevalence from 0.44% (95% CI = 0.36%, 0.54%) to 0.27% (95% CI = 0.22%, 0.32%) and 75.0% decline in vaginal precancer/cancer prevalence from 0.04% (95% CI = 0.02%, 0.07%) to 0.01% (95% CI = 0.00%, 0.02%).

Conclusion

The German HPV-immunization program has led to significant declines in female anogenital disease among young women in Germany, highlighting the importance of the vaccination. Moreover, the data suggest that increasing vaccination coverage in Germany could further strengthen the public-health impact of its HPV-immunization program.

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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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