Assessing Impact of HPV Vaccination on Cervical Cancer Incidence in Women 15-29 years in the United States, 1999-2017: An Ecologic Study
Menée aux Etats-Unis à partir de données 1999-2017 de plusieurs registres portant sur 97,8% de la population américaine, cette étude analyse l'évolution de l'incidence des cancers invasifs du col de l'utérus depuis l'introduction du vaccin contre le papillomavirus humain, en fonction de l'âge
Résumé en anglais
Background: To date, the human papillomavirus (HPV) vaccine impact on invasive cervical cancers in the United States has not been documented due, in part, to the time needed for cancer to develop, and to recent changes to cervical cancer screening guidelines and recommendations which complicate data interpretation.
Methods: We examined incidence rates of cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC)among women aged 15-29 years diagnosed during 1999-2017 using population-based cancer registry data covering 97.8% of the US population. Trends were stratified by age and histology. The annual percent change in cervical cancer incidence per year was calculated using Joinpoint regression.
Results: During 1999-2017, SCC rates decreased 7.9% per year among women aged 15-20 years, 5.5% among women aged 21-24 years, and 2.3% among women aged 25-29 years. The declines in SCC rates were largest among women aged 15-20 years from 2011 to 2017, with a decrease of 22.5% per year. Overall, AC rates decreased 4.1% per year among women aged 15-20 years, 3.6% per year among women aged 21-24 years, and 1.6% per year among women 25-29 years. AC rates declined the most among women aged 15-20 years during 2005 to 2017, decreasing 11.2% per year.
Conclusions: Since HPV vaccine introduction, both SCC and AC incidence rates declined among women aged 15-20 years, a group not typically screened for cervical cancer, suggesting HPV vaccine impact.
Impact: Timely vaccination and improved screening and follow-up among recommended age groups could result in further reductions in invasive cervical cancer.
