Real-World Effectiveness of Human Papillomavirus Vaccination Against Cervical Cancer

Kjær, Susanne K.; Dehlendorff, Christian; Belmonte, F.; Baandrup, Louise

doi:10.1093/jnci/djab080

Cited by 171 publications

(116 citation statements)

References 34 publications

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“…This is also in line with previous findings which showed a lower risk of genital warts and high-grade cervical lesions with HPV vaccination [19][20][21][22], supporting the recommendation of administering the quadrivalent HPV vaccine prior to exposure to HPV infection in order to achieve the most substantial benefit, since vaccination has no therapeutic effect against pre-existing HPV infection [23,24]. These findings are also confirmed by studies published in Sweden and Denmark in relation to protection against cervical cancer [1,2]. This should not, however, prevent the recommendation of vaccination against HPV for adult women, due to the benefits that the vaccination can bring them [25].…”

Section: Discussionsupporting

confidence: 89%

Quadrivalent Human Papillomavirus Vaccine Effectiveness after 12 Years in Madrid (Spain)

et al. 2022

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A fully government-funded human papillomavirus (HPV) vaccination program started in 2007 in Spain (only 11–14-year-old girls). The first of those vaccinated cohorts, with the quadrivalent vaccine (Gardasil), turned 25 years old in 2018, the age at which cervical cancer screening begins in Spain. The current study could provide the first evidence about the effectiveness of the quadrivalent vaccine against HPV in Spain and the influence of age of vaccination. The present ambispective cohort study, which was conducted on 790 women aged 25 and 26 years old, compares the rate of HPV prevalence and cytologic anomaly according to the vaccination status. The overall infection rate was 40.09% (vaccinated group) vs. 40.6% (non-vaccinated group). There was a significant reduction in the prevalence of HPV 6 (0% vs. 1.3%) and 16 (2.4% vs. 6.1%), and in the prevalence of cytological abnormalities linked to HPV16: Atypical Squamous Cells of Undetermined Significance (ASCUS) (2.04% vs. 14%), Low-grade Squamous Intraepithelial Lesions (LSIL) (2.94% vs. 18.7%) and High-grade Squamous Intraepithelial Lesion (HSIL) (0% vs. 40%), in the vaccinated group vs. the non-vaccinated group. Only one case of HPV11 and two cases of HPV18 were detected. The vaccine effectively reduces the prevalence of vaccine genotypes and cytological anomalies linked to these genotypes.

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Section: Discussionsupporting

confidence: 89%

Quadrivalent Human Papillomavirus Vaccine Effectiveness after 12 Years in Madrid (Spain)

et al. 2022

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“…During 2008–2018, the annual risk factor monitoring in Denmark showed that as in many countries overweight/obesity has increased, while tobacco smoking, alcohol consumption, and UV-radiation proxy measure (sunburn) has decreased slightly 35 . HPV infections are expected to decrease with the introduction of the vaccination program 36 and a corresponding decrease in cervix cancer will follow. This development is likely to be reflected in future PAF calculations.…”

Section: Discussionmentioning

confidence: 99%

Updated fraction of cancer attributable to lifestyle and environmental factors in Denmark in 2018

Tybjerg

Friis

Brown

et al. 2022

Sci Rep

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Environmental exposures and avoidable risk factors account for a large proportion of cancer burden. Exposures and lifestyle vary over time and between populations, which calls for updated and population-specific quantification of how various avoidable risk factors influence cancer risk to plan and design rational and targeted prevention initiatives. The study considered 12 risk-factor groups categorized as class I carcinogens by IARC/WCRF. Exposure data was derived from national studies and surveys and were linked to cancer incidence in 2018 based on the nationwide Danish Cancer Registry. In 2018, 23,078 men and 21,196 women were diagnosed with cancer excluding non-melanoma skin cancer, in Denmark. Of these, 14,235 (32.2%) were estimated to be attributable to avoidable class I carcinogens. Tobacco smoking accounted for 14.6% of total cancers, followed by UV-radiation that accounted for 5.8%. Based on exposure data from 2008, one-third of the cancers in Denmark in 2018 are estimated to be caused by class I carcinogens with tobacco use being the main contributor followed by UV-radiation. Our results should be integrated with public health policies to effectively increase awareness and promote strategies to decrease risk factor exposures at population level.

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“…More than 200 types of HPV have been identified, which are classified into high-risk types (such as types 16,18,31,33,35,39,45,51,52,56,58,59, 66, 68, 73, and 82) that are carcinogenic, and low-risk types (such as types 6, 11, 42, 43, and 44) that cause anogenital warts and benign tumors, such as condyloma acuminata. High-risk HPV types are thought to be responsible for 7-8% of human malignancies, including 96% of cervical cancers, 93% of anal cancers, 64% of vaginal cancers, 51% of vulvar cancers, 36% of penile cancers, and 63% of oropharyngeal cancers.…”

Section: Introductionmentioning

confidence: 99%

“…The preventive effect against invasive cervical cancer has also been clearly proven worldwide. A significant reduction in invasive cervical cancer was reported in Sweden in 2020, followed by Denmark and England in 2021 in real-world data [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effects of Human Papillomavirus Vaccination in Clinical Trials and Real-World Data: A Systematic Review

et al. 2022

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The preventive effect of HPV vaccines against anogenital and oropharyngeal cancers has been proven in both clinical trials and real-world data. We reviewed the published evidence about the long-term efficacy and effectiveness of the HPV vaccine in available papers of clinical trials and real-world data. As far as we searched, the longest period of preventive effect for the bivalent, 4-valent, and 9-valent vaccine were 11 years in the Costa Rica trial, 14 years in the FUTURE II, and 8 years in the LTFU extension study of V503-002 and the Scandinavian study, respectively. The sustained clinical effect during the observation period was longest for the 4-valent vaccine. In real-world data, the longest observation period of the vaccine effectiveness was 12 years in an Australian study for the 4-valent vaccine. On the other hand, the longest period of long-term persistence of HPV vaccine-induced seropositivity was 14 years in FUTURE II for the 4-valent vaccine. For the bivalent vaccine, additional long-term follow-up studies may not have been planned due to the launch of the 4-valent and 9-valent vaccines. In some studies of the 9-valent vaccine, the results have not yet been published because of the short observation period. The additional results are expected in the future. In a national immunization program, most girls and boys are inoculated with HPV vaccine by the time puberty begins; thus, it is important to monitor the vaccine effect at least until the sexually active period in their 20s and 30s.

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Real-World Effectiveness of Human Papillomavirus Vaccination Against Cervical Cancer

Cited by 171 publications

References 34 publications

Quadrivalent Human Papillomavirus Vaccine Effectiveness after 12 Years in Madrid (Spain)

Quadrivalent Human Papillomavirus Vaccine Effectiveness after 12 Years in Madrid (Spain)

Updated fraction of cancer attributable to lifestyle and environmental factors in Denmark in 2018

Long-Term Effects of Human Papillomavirus Vaccination in Clinical Trials and Real-World Data: A Systematic Review

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