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接种HPV疫苗与浸润性宫颈癌风险之间的关系
HPV Vaccination and the Risk of Invasive Cervical Cancer


Jiayao Lei ... 肿瘤 妇产科和儿科 • 2020.10.01
相关阅读
• 接种HPV疫苗的确可降低宫颈癌风险 • 少女和年轻女性接种四价HPV疫苗的结果令人安心 • 接种HPV疫苗使全民获益 • 人乳头瘤病毒疫苗有效,且可诱导群体免疫 • 理解关于HPV疫苗接种的无意识偏见

摘要


背景

四价人乳头瘤病毒(HPV)疫苗预防宫颈高级别病变的有效性和效果已得到证实。但目前仍缺乏接种四价HPV疫苗与之后浸润性宫颈癌风险之间关系的数据。

 

方法

我们利用瑞典全国人口统计和健康登记系统随访了2006—2017年的1,672,983名10~30岁女童和成年女性构成的开放人群。针对随访时的年龄、日历年、居住省份及父母特征(包括教育程度、家庭收入、母亲的出生国家和母亲病史)进行校正后,我们评估了接种HPV疫苗与浸润性宫颈癌风险之间的关系。

 

结果

在本研究期间,我们评估了女童和成年女性截至年满31周岁时的宫颈癌患病情况。19名接种四价HPV疫苗的成年女性和538名未接种疫苗的成年女性被诊断为宫颈癌。在接种疫苗的成年女性和未接种疫苗的成年女性中,宫颈癌的累积发病率分别为47例/100,000人和94例/100,000人。针对随访时的年龄进行校正后,接种疫苗人群与未接种疫苗人群的宫颈癌发病率比为0.51(95% CI,0.32~0.82)。针对其他协变量进行校正后,两个人群的发病率比为0.37(95% CI,0.21~0.57)。针对所有协变量进行校正后,在17岁前接种疫苗的成年女性和17~30岁接种疫苗的成年女性中,两个人群的发病率比分别为0.12(95% CI,0.00~0.34)和0.47(95% CI,0.27~0.75)。

 

结论

在瑞典10~30岁的女童和成年女性中,接种四价HPV疫苗与人群水平的浸润性宫颈癌风险显著降低相关(由瑞典策略研究基金会[Swedish Foundation for Strategic Research]等资助)。





作者信息

Jiayao Lei, Ph.D., Alexander Ploner, Ph.D., K. Miriam Elfström, Ph.D., Jiangrong Wang, Ph.D., Adam Roth, M.D., Ph.D., Fang Fang, M.D., Ph.D., Karin Sundström, M.D., Ph.D., Joakim Dillner, M.D., Ph.D., and Pär Sparén, Ph.D.
From the Departments of Medical Epidemiology and Biostatistics (J.L., A.P., P.S.) and Laboratory Medicine (K.M.E., J.W., K.S., J.D.) and the Institute of Environmental Medicine (F.F.), Karolinska Institutet, the Regional Cancer Center Stockholm Gotland (K.M.E.), and the Karolinska University Laboratory, Karolinska University Hospital (J.D.), Stockholm, the Department of Communicable Disease Control and Health Protection, Public Health Agency of Sweden, Solna (A.R.), and the Department of Translational Medicine, Lund University, Lund (A.R.) — all in Sweden. Address reprint requests to Dr. Lei at Nobels väg 12A, 171 65 Solna, Sweden, or at jiayao.lei@ki.se.

 

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