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HPV vaccination program linked to decreases in cervical abnormalities in Australian population
Brotherton JML. Lancet. 2011;377:2085-2092.
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In Australia, the number of high-grade cervical abnormalities has decreased by 0.38% since the introduction of the HPV vaccination program in April 2007, according to data from an ecological analysis. More results are needed, however, to confirm the association between the lower incidence and vaccination status.
Using data from the Victorian Cervical Cytology Registry between 2003 and 2009, researchers compared the incidence of high-grade cervical abnormalities and low-grade cytological abnormalities in five age groups both before and after the introduction of the HPV vaccination program (Jan. 1, 2003, to March 31, 2007, and April 1, 2007, to Dec. 31, 2009). The researchers conducted binary comparisons and compared trends in incidence rates.
According to their analysis, high-grade cervical abnormalities decreased by 0.38% shortly after the introduction of the vaccination program in women aged younger than 18 years (95% CI, 0.61-0.16).
“This decrease was progressive and significantly different to the linear trend in incidence before introduction of the vaccination (incidence rate ratio=1.14; 95% CI, 1.00-1.30),” the researchers wrote.
However, there was no significant change in incidence among women aged 18 to 20 years.
Among women aged 21 to 30 years and those aged at least 31 years, small increases in incidence were recorded (P<.0001 and P=.002, respectively). In girls aged 17 years or younger, there was a significant decrease in high-grade cervical abnormality incidence, according to a quantitative comparison of linear trends. However, there was no significant decrease in girls aged 18 to 20 years.
“Our finding that the decrease in [high-grade cervical abnormality] incidence occurred in the youngest vaccination cohort before it occurred in the older, catch-up cohorts (who were more likely to have been previously sexually experienced) reinforces the appropriateness of the targeting of prophylactic HPV vaccines to pre-adolescent girls,” the researchers wrote.
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