Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment

Ana Cecilia Rodríguez; Diane Solomon; Rolando Herrero; Allan Hildesheim; Paula González; Sholom Wacholder; Carolina Porras; Silvia Jiménez; Mark Schiffman; Mario Alfaro; Manuel Barrantes; M. Concepción Bratti; Fernando Cárdenas; Bernal Cortés; Albert Espinoza; Yenory Estrada; Silvia E. Jiménez; Jorge Morales; Luis Villegas; Lidia Ana Morera; Elmer Pérez; Libia Rivas; Enrique Freer; José Bonilla; Alfonso García-Piñeres; Sandra Silva; Ivannia Atmella; Margarita Ramírez; Aimée R. Kreimer; Douglas R. Lowy; Nora Macklin; John T. Schiller; Mark Sherman; Ligia Pinto; Troy Kemp; Claire Eklund; Martha Hutchinson; Mary Sidawy; Wim Quint; Leen Jan Van Doorn

doi:10.1093/aje/kwt047

Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment

Ana Cecilia Rodríguez, Diane Solomon, Rolando Herrero, Allan Hildesheim, Paula González, Sholom Wacholder, Carolina Porras, Silvia Jiménez, Mark Schiffman, Mario Alfaro, Manuel Barrantes, M. Concepción Bratti, Fernando Cárdenas, Bernal Cortés, Albert Espinoza, Yenory Estrada, Silvia E. Jiménez, Jorge Morales, Luis Villegas, Lidia Ana MoreraElmer Pérez, Libia Rivas, Enrique Freer, José Bonilla, Alfonso García-Piñeres, Sandra Silva, Ivannia Atmella, Margarita Ramírez, Aimée R. Kreimer, Douglas R. Lowy, Nora Macklin, John T. Schiller, Mark Sherman, Ligia Pinto, Troy Kemp, Claire Eklund, Martha Hutchinson, Mary Sidawy, Wim Quint, Leen Jan Van Doorn

Quantitative Health Sciences

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Abstract

The impact of human papillomavirus (HPV) vaccination on cervical screening, colposcopy, and treatment is incompletely understood. In 2004-2005, investigators in the Costa Rica Vaccine Trial randomized 7,466 women aged 18-25 years, 1:1, to receive HPV vaccination or hepatitis A vaccination. The worst-ever cytology diagnosis and the 4-year cumulative proportions of colposcopy referral and treatment by vaccination arm were compared for 2 cohorts. The total vaccinated cohort included 6,844 women who provided cervical samples. The naive cohort included 2,284 women with no evidence of previous HPV exposure. In the total vaccinated cohort, HPV-vaccinated women had a significant (P = 0.01) reduction in cytological abnormalities: 12.4% for high-grade lesions and 5.9% for minor lesions. Colposcopy referral was reduced by 7.9% (P = 0.03) and treatment by 11.3% (P = 0.24). Greater relative reductions in abnormal cytology (P < 0.001) were observed for HPV-vaccinated women in the naive cohort: 49.2% for high-grade lesions and 18.1% for minor lesions. Colposcopy referral and treatment were reduced by 21.3% (P = 0.01) and 45.6% (P = 0.08), respectively, in the naive cohort. The overall impact on health services will be modest in the first years after vaccine introduction among young adult women, even in regions with high coverage.

Original language	English (US)
Pages (from-to)	752-760
Number of pages	9
Journal	American journal of epidemiology
Volume	178
Issue number	5
DOIs	https://doi.org/10.1093/aje/kwt047
State	Published - Sep 1 2013

Keywords

HPV
HPV vaccination
cervical cancer
human papillomavirus
screening

ASJC Scopus subject areas

General Medicine

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10.1093/aje/kwt047

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Rodríguez, A. C., Solomon, D., Herrero, R., Hildesheim, A., González, P., Wacholder, S., Porras, C., Jiménez, S., Schiffman, M., Alfaro, M., Barrantes, M., Bratti, M. C., Cárdenas, F., Cortés, B., Espinoza, A., Estrada, Y., Jiménez, S. E., Morales, J., Villegas, L., ... Van Doorn, L. J. (2013). Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment. American journal of epidemiology, 178(5), 752-760. https://doi.org/10.1093/aje/kwt047

Rodríguez, AC, Solomon, D, Herrero, R, Hildesheim, A, González, P, Wacholder, S, Porras, C, Jiménez, S, Schiffman, M, Alfaro, M, Barrantes, M, Bratti, MC, Cárdenas, F, Cortés, B, Espinoza, A, Estrada, Y, Jiménez, SE, Morales, J, Villegas, L, Morera, LA, Pérez, E, Rivas, L, Freer, E, Bonilla, J, García-Piñeres, A, Silva, S, Atmella, I, Ramírez, M, Kreimer, AR, Lowy, DR, Macklin, N, Schiller, JT, Sherman, M, Pinto, L, Kemp, T, Eklund, C, Hutchinson, M, Sidawy, M, Quint, W & Van Doorn, LJ 2013, 'Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment', American journal of epidemiology, vol. 178, no. 5, pp. 752-760. https://doi.org/10.1093/aje/kwt047

@article{aaf8b92982794f26982256d607f637e9,

title = "Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment",

abstract = "The impact of human papillomavirus (HPV) vaccination on cervical screening, colposcopy, and treatment is incompletely understood. In 2004-2005, investigators in the Costa Rica Vaccine Trial randomized 7,466 women aged 18-25 years, 1:1, to receive HPV vaccination or hepatitis A vaccination. The worst-ever cytology diagnosis and the 4-year cumulative proportions of colposcopy referral and treatment by vaccination arm were compared for 2 cohorts. The total vaccinated cohort included 6,844 women who provided cervical samples. The naive cohort included 2,284 women with no evidence of previous HPV exposure. In the total vaccinated cohort, HPV-vaccinated women had a significant (P = 0.01) reduction in cytological abnormalities: 12.4% for high-grade lesions and 5.9% for minor lesions. Colposcopy referral was reduced by 7.9% (P = 0.03) and treatment by 11.3% (P = 0.24). Greater relative reductions in abnormal cytology (P < 0.001) were observed for HPV-vaccinated women in the naive cohort: 49.2% for high-grade lesions and 18.1% for minor lesions. Colposcopy referral and treatment were reduced by 21.3% (P = 0.01) and 45.6% (P = 0.08), respectively, in the naive cohort. The overall impact on health services will be modest in the first years after vaccine introduction among young adult women, even in regions with high coverage.",

keywords = "HPV, HPV vaccination, cervical cancer, human papillomavirus, screening",

author = "Rodr{\'i}guez, {Ana Cecilia} and Diane Solomon and Rolando Herrero and Allan Hildesheim and Paula Gonz{\'a}lez and Sholom Wacholder and Carolina Porras and Silvia Jim{\'e}nez and Mark Schiffman and Mario Alfaro and Manuel Barrantes and Bratti, {M. Concepci{\'o}n} and Fernando C{\'a}rdenas and Bernal Cort{\'e}s and Albert Espinoza and Yenory Estrada and Jim{\'e}nez, {Silvia E.} and Jorge Morales and Luis Villegas and Morera, {Lidia Ana} and Elmer P{\'e}rez and Libia Rivas and Enrique Freer and Jos{\'e} Bonilla and Alfonso Garc{\'i}a-Pi{\~n}eres and Sandra Silva and Ivannia Atmella and Margarita Ram{\'i}rez and Kreimer, {Aim{\'e}e R.} and Lowy, {Douglas R.} and Nora Macklin and Schiller, {John T.} and Mark Sherman and Ligia Pinto and Troy Kemp and Claire Eklund and Martha Hutchinson and Mary Sidawy and Wim Quint and {Van Doorn}, {Leen Jan}",

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doi = "10.1093/aje/kwt047",

language = "English (US)",

volume = "178",

pages = "752--760",

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T1 - Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment

AU - Rodríguez, Ana Cecilia

AU - Solomon, Diane

AU - Herrero, Rolando

AU - Hildesheim, Allan

AU - González, Paula

AU - Wacholder, Sholom

AU - Porras, Carolina

AU - Jiménez, Silvia

AU - Schiffman, Mark

AU - Alfaro, Mario

AU - Barrantes, Manuel

AU - Bratti, M. Concepción

AU - Cárdenas, Fernando

AU - Cortés, Bernal

AU - Espinoza, Albert

AU - Estrada, Yenory

AU - Jiménez, Silvia E.

AU - Morales, Jorge

AU - Villegas, Luis

AU - Morera, Lidia Ana

AU - Pérez, Elmer

AU - Rivas, Libia

AU - Freer, Enrique

AU - Bonilla, José

AU - García-Piñeres, Alfonso

AU - Silva, Sandra

AU - Atmella, Ivannia

AU - Ramírez, Margarita

AU - Kreimer, Aimée R.

AU - Lowy, Douglas R.

AU - Macklin, Nora

AU - Schiller, John T.

AU - Sherman, Mark

AU - Pinto, Ligia

AU - Kemp, Troy

AU - Eklund, Claire

AU - Hutchinson, Martha

AU - Sidawy, Mary

AU - Quint, Wim

AU - Van Doorn, Leen Jan

PY - 2013/9/1

Y1 - 2013/9/1

N2 - The impact of human papillomavirus (HPV) vaccination on cervical screening, colposcopy, and treatment is incompletely understood. In 2004-2005, investigators in the Costa Rica Vaccine Trial randomized 7,466 women aged 18-25 years, 1:1, to receive HPV vaccination or hepatitis A vaccination. The worst-ever cytology diagnosis and the 4-year cumulative proportions of colposcopy referral and treatment by vaccination arm were compared for 2 cohorts. The total vaccinated cohort included 6,844 women who provided cervical samples. The naive cohort included 2,284 women with no evidence of previous HPV exposure. In the total vaccinated cohort, HPV-vaccinated women had a significant (P = 0.01) reduction in cytological abnormalities: 12.4% for high-grade lesions and 5.9% for minor lesions. Colposcopy referral was reduced by 7.9% (P = 0.03) and treatment by 11.3% (P = 0.24). Greater relative reductions in abnormal cytology (P < 0.001) were observed for HPV-vaccinated women in the naive cohort: 49.2% for high-grade lesions and 18.1% for minor lesions. Colposcopy referral and treatment were reduced by 21.3% (P = 0.01) and 45.6% (P = 0.08), respectively, in the naive cohort. The overall impact on health services will be modest in the first years after vaccine introduction among young adult women, even in regions with high coverage.

AB - The impact of human papillomavirus (HPV) vaccination on cervical screening, colposcopy, and treatment is incompletely understood. In 2004-2005, investigators in the Costa Rica Vaccine Trial randomized 7,466 women aged 18-25 years, 1:1, to receive HPV vaccination or hepatitis A vaccination. The worst-ever cytology diagnosis and the 4-year cumulative proportions of colposcopy referral and treatment by vaccination arm were compared for 2 cohorts. The total vaccinated cohort included 6,844 women who provided cervical samples. The naive cohort included 2,284 women with no evidence of previous HPV exposure. In the total vaccinated cohort, HPV-vaccinated women had a significant (P = 0.01) reduction in cytological abnormalities: 12.4% for high-grade lesions and 5.9% for minor lesions. Colposcopy referral was reduced by 7.9% (P = 0.03) and treatment by 11.3% (P = 0.24). Greater relative reductions in abnormal cytology (P < 0.001) were observed for HPV-vaccinated women in the naive cohort: 49.2% for high-grade lesions and 18.1% for minor lesions. Colposcopy referral and treatment were reduced by 21.3% (P = 0.01) and 45.6% (P = 0.08), respectively, in the naive cohort. The overall impact on health services will be modest in the first years after vaccine introduction among young adult women, even in regions with high coverage.

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KW - HPV vaccination

KW - cervical cancer

KW - human papillomavirus

KW - screening

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Impact of human papillomavirus vaccination on cervical cytology screening, colposcopy, and treatment

Abstract

Keywords

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