| Titre : | Impact of Human Papillomavirus Vaccination on Cervical Cytology Screening, Colposcopy, and Treatment (2013) |
| Auteurs : | Ana-Cecilia Rodriguez ; Guanacaste Epidemiology Project, Inciensa Instituto Costarricense de Investigacion y Ensenanza en Nutricion y Salud Foundation (San José, Costa rica) ; Diane SOLOMON ; Division of Cancer Epidemiology and Genetics, National Cancer Institute (Bethesda MD, Etats-Unis) ; Rolando HERRERO ; Allan HILDESHEIM ; Prevention and Implementation Group, International Agency for Research on Cancer (Lyon, France) ; Paula GONZALEZ ; Sholom WACHOLDER ; Carolina PORRAS ; Silvia JIMENEZ |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 178, n° 5, 2013) |
| Pagination : | 752-760 |
| Langues: | Anglais |
| Mots-clés : | Homme ; Vaccination ; Prévention santé ; Cytologie ; Dépistage ; Thérapeutique ; Epidémiologie ; Virus ; Cancer |
| Résumé : | [BDSP. Notice produite par INIST-CNRS pBJlIR0x. Diffusion soumise à autorisation]. 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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