Surveillance of effects of HPV vaccination in Belgium

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Abstract

Background: Early effects of HPV (human papillomavirus) vaccination are reflected by changes observable in young women attending cervical cancer screening.

Subject and methods: The SEHIB study included HPV geno-typing of similar to 6000 continuous and 650 pathological cervical cell specimen as well as biopsies, collected from women in Belgium in 2010-2014. Data were linked to vaccination status.

Results: HPV vaccination offered protection among women aged <30 years against infection with HPV16 (vaccine effectiveness [VE] = 67%, 95% CI: 48-79%), HPV18 (VE = 93%, 95% CI: 52-99%), and high-risk HPV (VE = 16%, 95% CI: 2-29%). Vaccination protected also against cytological lesions. Vaccination protected against histologically confirmed lesions: significantly lower absolute risks of CIN1+ (risk difference [RD] = -1.6%, 95% CI: -2.6% to -0.7%) and CIN3+ associated with HPV16/18 (RD = -0.3%, 95% CI -0.6% to -0.1%). Vaccine effectiveness decreased with age. Protection against HPV16 and 18 infection was significant in all age groups, however no protection was observed against cytological lesions associated with these types in age-group 25-29.

Conclusion: The SEHIB study demonstrates the effectiveness of HPV vaccination in Belgian young women in particular in age group 18-19. Declining effectiveness with increasing age may be explained by higher tendency of women already exposed to infection to get the vaccine. (C) 2016 Elsevier Ltd. All rights reserved.
Keywords

Author Keywords:Cervical cancer; Screening; Surveillance; HPV; Human papillomavirus; HPV vaccination

KeyWords Plus:HUMAN-PAPILLOMAVIRUS VACCINATION; CERVICAL-CANCER; YOUNG-WOMEN; EFFICACY; CYTOLOGY; PROGRAM; TRIAL; PREVALENCE; INFECTION; PCR
 

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Authors & affiliation: 
By:Arbyn, M [ 1 ] ; Vanden Broeck, D [ 2,3,4 ] ; Benoy, I [ 3,4 ] ; Bogers, J [ 3,4 ] ; Depuydt, C [ 3 ] ; Praet, M [ 5 ] ; De Sutter, P [ 6 ] ; Hoorens, A [ 7 ] ; Hauben, E [ 8 ] ; Poppe, W [ 9 ] ; Van Ranst, M [ 10 ] ; Delvenne, P [ 11 ] ; Gofflot, S [ 11 ] ; Petein, M [ 12 ] ; Engelen, F [ 13 ] ; Vanneste, A [ 14 ] ; Op De Beeck, L [ 15 ] ; Van Damme, P [16 ] ; Temmerman, M [ 2,17,18 ] ; Weyers, S [ 18] Addresses: [ 1 ] Belgian Canc Ctr, Unit Canc Epidemiol, Sci Inst Publ Hlth, J Wytsmanst 14, B-1050 Brussels, Belgium [ 2 ] Univ Ghent, ICRH, B-9000 Ghent, Belgium [ 3 ] Sonic Healtcare, Algemeen Medisch Labo, Antwerp, Belgium [[ 4 ] Univ Antwerp, Lab Cell Biol & Histol, AMBIOR, B-2020 Antwerp, Belgium [[ 5 ] Univ Ghent, N Goormachtigh Inst Pathol, B-9000 Ghent, Belgium [ 6 ] Free Univ Brussels, Dept Gynaecol & Oncol, UZ Brussel, Brussels, Belgium [[ 7 ] VUB, Dept Pathol, Brussels, Belgium [ 8 ] UZ Leuven, Dept Pathol, Leuven, Belgium [ 9 ] UZ Leuven, Dept Obstet & Gynaecol, Leuven, Belgium [ 10 ] Katholieke Univ Leuven, Dept Microbiol & Immunol, Rega Inst, Leuven, Belgium [ 11 ] ULg, Dept Pathol, Liege, Belgium [ 12 ] Inst Pathol & Genet, Charlerloi, Belgium [ 13 ] Ctr Med Analyse, Herental, Belgium [ 14 ] AZ Groeninge, Pathol Anat, Kortrijk, Belgium [ 15 ] Pathol Mariaziekenhuis Noord Limburg, Overpelt, Belgium [ 16 ] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, B-2020 Antwerp, Belgium [ 17 ] WHO, Reprod Hlth & Res, CH-1211 Geneva, Switzerland [ 18 ] Univ Ghent, Dept Obstet & Gynaecol, B-9000 Ghent, Belgium E-mail Addresses:marc.arbyn@wiv-isp.be
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Published In: 
CANCER EPIDEMIOLOGY Volume: 41 Pages: 152-158 DOI: 10.1016/j.canep.2015.12.011
Publication date: 
Wednesday, April 6, 2016