Reduction in HPV16/18 prevalence among young women with high-grade cervical lesions following the Japanese HPV vaccination program

for the MINT Study Group

Research output: Contribution to journalArticle

Abstract

The Japanese government began a human papillomavirus (HPV) vaccination program for girls aged 12-16 years in 2010 but withdrew its recommendation in 2013 because of potential adverse effects, leading to drastically reduced vaccination uptake. To evaluate population-level effects of HPV vaccination, women younger than 40 years of age newly diagnosed with cervical intraepithelial neoplasia grade 1-3 (CIN1-3), adenocarcinoma in situ (AIS), or invasive cervical cancer (ICC) have been registered at 21 participating institutes each year since 2012. A total of 7709 women were registered during 2012-2017, of which 5045 were HPV genotyped. Declining trends in prevalence of vaccine types HPV16 and HPV18 during a 6-year period were observed in CIN1 (50.0% to 0.0%, Ptrend <.0001) and CIN2-3/AIS (83.3% to 45.0%, Ptrend =.07) only among women younger than 25 years of age. Overall, HPV vaccination reduced the proportion of HPV16/18-attributable CIN2-3/AIS from 47.7% to 33.0% (P =.003): from 43.5% to 12.5% as routine vaccination (P =.08) and from 47.8% to 36.7% as catch-up vaccination (P =.04). The HPV16/18 prevalence in CIN2-3/AIS cases was significantly reduced among female individuals who received their first vaccination at age 20 years or younger (P =.02). We could not evaluate vaccination effects on ICC owing to low incidence of ICC among women aged less than 25 years. We found HPV vaccination to be effective in protecting against HPV16/18-positive CIN/AIS in Japan; however, our data did not support catch-up vaccination for women older than 20 years. Older adolescents who skipped routine vaccination due to the government’s suspension of its vaccine recommendation could benefit from receiving catch-up vaccination before age 20 years.

Original languageEnglish
JournalCancer science
DOIs
Publication statusAccepted/In press - 2019 Jan 1

Fingerprint

Vaccination
Uterine Cervical Neoplasms
Vaccines
Cervical Intraepithelial Neoplasia
Suspensions
Japan
Adenocarcinoma in Situ
Incidence

Keywords

  • adenocarcinoma in situ
  • cervical cancer
  • cervical intraepithelial neoplasia
  • human papillomavirus
  • vaccination

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Reduction in HPV16/18 prevalence among young women with high-grade cervical lesions following the Japanese HPV vaccination program. / for the MINT Study Group.

In: Cancer science, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Reduction in HPV16/18 prevalence among young women with high-grade cervical lesions following the Japanese HPV vaccination program",
abstract = "The Japanese government began a human papillomavirus (HPV) vaccination program for girls aged 12-16 years in 2010 but withdrew its recommendation in 2013 because of potential adverse effects, leading to drastically reduced vaccination uptake. To evaluate population-level effects of HPV vaccination, women younger than 40 years of age newly diagnosed with cervical intraepithelial neoplasia grade 1-3 (CIN1-3), adenocarcinoma in situ (AIS), or invasive cervical cancer (ICC) have been registered at 21 participating institutes each year since 2012. A total of 7709 women were registered during 2012-2017, of which 5045 were HPV genotyped. Declining trends in prevalence of vaccine types HPV16 and HPV18 during a 6-year period were observed in CIN1 (50.0{\%} to 0.0{\%}, Ptrend <.0001) and CIN2-3/AIS (83.3{\%} to 45.0{\%}, Ptrend =.07) only among women younger than 25 years of age. Overall, HPV vaccination reduced the proportion of HPV16/18-attributable CIN2-3/AIS from 47.7{\%} to 33.0{\%} (P =.003): from 43.5{\%} to 12.5{\%} as routine vaccination (P =.08) and from 47.8{\%} to 36.7{\%} as catch-up vaccination (P =.04). The HPV16/18 prevalence in CIN2-3/AIS cases was significantly reduced among female individuals who received their first vaccination at age 20 years or younger (P =.02). We could not evaluate vaccination effects on ICC owing to low incidence of ICC among women aged less than 25 years. We found HPV vaccination to be effective in protecting against HPV16/18-positive CIN/AIS in Japan; however, our data did not support catch-up vaccination for women older than 20 years. Older adolescents who skipped routine vaccination due to the government’s suspension of its vaccine recommendation could benefit from receiving catch-up vaccination before age 20 years.",
keywords = "adenocarcinoma in situ, cervical cancer, cervical intraepithelial neoplasia, human papillomavirus, vaccination",
author = "{for the MINT Study Group} and Koji Matsumoto and Nobuo Yaegashi and Takashi Iwata and Kasumi Yamamoto and Yoichi Aoki and Masao Okadome and Kimio Ushijima and Shoji Kamiura and Kazuhiro Takehara and Koji Horie and Nobutaka Tasaka and Kenzo Sonoda and Yuji Takei and Yoichi Aoki and Katsuyuki Konnai and Hidetaka Katabuchi and Keiichiro Nakamura and Mitsuya Ishikawa and Hidemichi Watari and Hiroyuki Yoshida and Noriomi Matsumura and Hidekatsu Nakai and Shogo Shigeta and Fumiaki Takahashi and Kiichiro Noda and Hiroyuki Yoshikawa",
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month = "1",
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language = "English",
journal = "Cancer Science",
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AU - for the MINT Study Group

AU - Matsumoto, Koji

AU - Yaegashi, Nobuo

AU - Iwata, Takashi

AU - Yamamoto, Kasumi

AU - Aoki, Yoichi

AU - Okadome, Masao

AU - Ushijima, Kimio

AU - Kamiura, Shoji

AU - Takehara, Kazuhiro

AU - Horie, Koji

AU - Tasaka, Nobutaka

AU - Sonoda, Kenzo

AU - Takei, Yuji

AU - Aoki, Yoichi

AU - Konnai, Katsuyuki

AU - Katabuchi, Hidetaka

AU - Nakamura, Keiichiro

AU - Ishikawa, Mitsuya

AU - Watari, Hidemichi

AU - Yoshida, Hiroyuki

AU - Matsumura, Noriomi

AU - Nakai, Hidekatsu

AU - Shigeta, Shogo

AU - Takahashi, Fumiaki

AU - Noda, Kiichiro

AU - Yoshikawa, Hiroyuki

PY - 2019/1/1

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N2 - The Japanese government began a human papillomavirus (HPV) vaccination program for girls aged 12-16 years in 2010 but withdrew its recommendation in 2013 because of potential adverse effects, leading to drastically reduced vaccination uptake. To evaluate population-level effects of HPV vaccination, women younger than 40 years of age newly diagnosed with cervical intraepithelial neoplasia grade 1-3 (CIN1-3), adenocarcinoma in situ (AIS), or invasive cervical cancer (ICC) have been registered at 21 participating institutes each year since 2012. A total of 7709 women were registered during 2012-2017, of which 5045 were HPV genotyped. Declining trends in prevalence of vaccine types HPV16 and HPV18 during a 6-year period were observed in CIN1 (50.0% to 0.0%, Ptrend <.0001) and CIN2-3/AIS (83.3% to 45.0%, Ptrend =.07) only among women younger than 25 years of age. Overall, HPV vaccination reduced the proportion of HPV16/18-attributable CIN2-3/AIS from 47.7% to 33.0% (P =.003): from 43.5% to 12.5% as routine vaccination (P =.08) and from 47.8% to 36.7% as catch-up vaccination (P =.04). The HPV16/18 prevalence in CIN2-3/AIS cases was significantly reduced among female individuals who received their first vaccination at age 20 years or younger (P =.02). We could not evaluate vaccination effects on ICC owing to low incidence of ICC among women aged less than 25 years. We found HPV vaccination to be effective in protecting against HPV16/18-positive CIN/AIS in Japan; however, our data did not support catch-up vaccination for women older than 20 years. Older adolescents who skipped routine vaccination due to the government’s suspension of its vaccine recommendation could benefit from receiving catch-up vaccination before age 20 years.

AB - The Japanese government began a human papillomavirus (HPV) vaccination program for girls aged 12-16 years in 2010 but withdrew its recommendation in 2013 because of potential adverse effects, leading to drastically reduced vaccination uptake. To evaluate population-level effects of HPV vaccination, women younger than 40 years of age newly diagnosed with cervical intraepithelial neoplasia grade 1-3 (CIN1-3), adenocarcinoma in situ (AIS), or invasive cervical cancer (ICC) have been registered at 21 participating institutes each year since 2012. A total of 7709 women were registered during 2012-2017, of which 5045 were HPV genotyped. Declining trends in prevalence of vaccine types HPV16 and HPV18 during a 6-year period were observed in CIN1 (50.0% to 0.0%, Ptrend <.0001) and CIN2-3/AIS (83.3% to 45.0%, Ptrend =.07) only among women younger than 25 years of age. Overall, HPV vaccination reduced the proportion of HPV16/18-attributable CIN2-3/AIS from 47.7% to 33.0% (P =.003): from 43.5% to 12.5% as routine vaccination (P =.08) and from 47.8% to 36.7% as catch-up vaccination (P =.04). The HPV16/18 prevalence in CIN2-3/AIS cases was significantly reduced among female individuals who received their first vaccination at age 20 years or younger (P =.02). We could not evaluate vaccination effects on ICC owing to low incidence of ICC among women aged less than 25 years. We found HPV vaccination to be effective in protecting against HPV16/18-positive CIN/AIS in Japan; however, our data did not support catch-up vaccination for women older than 20 years. Older adolescents who skipped routine vaccination due to the government’s suspension of its vaccine recommendation could benefit from receiving catch-up vaccination before age 20 years.

KW - adenocarcinoma in situ

KW - cervical cancer

KW - cervical intraepithelial neoplasia

KW - human papillomavirus

KW - vaccination

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