Stephanie D Boone1, Christina M Pinkston2, Kathy B Baumgartner3, Richard N Baumgartner3, Sean M Harper4, Aaron J Bonham5, Christopher A Paynter5, Diane M Harper6. 1. University of Louisville, School of Public Health & Information Sciences, Department of Epidemiology & Population Health, James Graham Brown Cancer Center, Louisville, KY, USA. Electronic address: stephanie.boone@louisville.edu. 2. University of Louisville, School of Public Health & Information Sciences, Department of Bioinformatics and Biostatistics, Louisville, KY, USA. 3. University of Louisville, School of Public Health & Information Sciences, Department of Epidemiology & Population Health, James Graham Brown Cancer Center, Louisville, KY, USA. 4. University of Louisville, Department of Mathematics, Louisville, KY, USA. 5. University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. 6. University of Louisville, School of Medicine, Departments of Community and Geriatric Medicine, Obstetrics & Gynecology, Louisville, KY, USA; University of Louisville, School of Public Health and Information Sciences, Departments of Epidemiology & Population Health and Health Promotion & Behavioral Health Sciences, Louisville, KY, USA; University of Louisville, School of Engineering, Department of Bioengineering, Louisville, KY, USA.
Abstract
BACKGROUND: Cervical cancer screening, regardless of HPV vaccination, is a cornerstone of cancer prevention. This study evaluated associations between prior HPV vaccine doses and initiation and continued participation of screening by age at vaccination. METHODS: Using electronic medical records for a safety net healthcare system (Truman Medical Center), women aged 14-26y vaccinated (n=1123) between 07/01/2006 and 10/1/2009 were randomly selected and matched on birth year and health campus to unvaccinated (n=1123) women. Frequency of screening was determined through 07/01/2013. Hazard ratios (HR) for screening were estimated using Cox proportional hazards regression. RESULTS: Screening rates were higher after vaccination: unvaccinated (53%), first (62%), second (59%) or third (61%) doses. Women who initiated screening were less likely to complete the vaccine series, regardless of age. Women receiving one dose were more likely than unvaccinated women to initiate screening (HR=2.98 95% Confidence Interval (CI):2.45-3.61) and were more likely to screen than those receiving two (1 vs. 2, HR=2.94 95% CI:2.09-4.14) or three doses (1 vs. 3, HR=3.15 95% CI:2.21-4.48). Compared to unvaccinated women, women <21y who completed 3-doses were 1.8-times more likely to screen at ≥21y, whereas vaccinated women ≥21y were more likely to screen regardless of number of doses (p<0.0001). CONCLUSIONS: Women who were vaccinated were more likely to screen than unvaccinated women; screening rate was highest after and occurred closest to the first vaccine dose. Research evaluating the efficacy of a one-dose vaccine is warranted and may provide both higher vaccination and screening rates.
BACKGROUND: Cervical cancer screening, regardless of HPV vaccination, is a cornerstone of cancer prevention. This study evaluated associations between prior HPV vaccine doses and initiation and continued participation of screening by age at vaccination. METHODS: Using electronic medical records for a safety net healthcare system (Truman Medical Center), women aged 14-26y vaccinated (n=1123) between 07/01/2006 and 10/1/2009 were randomly selected and matched on birth year and health campus to unvaccinated (n=1123) women. Frequency of screening was determined through 07/01/2013. Hazard ratios (HR) for screening were estimated using Cox proportional hazards regression. RESULTS: Screening rates were higher after vaccination: unvaccinated (53%), first (62%), second (59%) or third (61%) doses. Women who initiated screening were less likely to complete the vaccine series, regardless of age. Women receiving one dose were more likely than unvaccinated women to initiate screening (HR=2.98 95% Confidence Interval (CI):2.45-3.61) and were more likely to screen than those receiving two (1 vs. 2, HR=2.94 95% CI:2.09-4.14) or three doses (1 vs. 3, HR=3.15 95% CI:2.21-4.48). Compared to unvaccinated women, women <21y who completed 3-doses were 1.8-times more likely to screen at ≥21y, whereas vaccinated women ≥21y were more likely to screen regardless of number of doses (p<0.0001). CONCLUSIONS:Women who were vaccinated were more likely to screen than unvaccinated women; screening rate was highest after and occurred closest to the first vaccine dose. Research evaluating the efficacy of a one-dose vaccine is warranted and may provide both higher vaccination and screening rates.
Authors: Monica L Kasting; Shannon Wilson; Terrell W Zollinger; Brian E Dixon; Nathan W Stupiansky; Gregory D Zimet Journal: Prev Med Rep Date: 2016-12-21
Authors: Francesco Venturelli; Flavia Baldacchini; Cinzia Campari; Cinzia Perilli; Maria Grazia Pascucci; Alba Carola Finarelli; Luigi Moscara; Paolo Giorgi Rossi Journal: BMJ Open Date: 2017-09-25 Impact factor: 2.692
Authors: Djibril M Ba; Jennifer S McCall-Hosenfeld; Paddy Ssentongo; Vernon M Chinchilli; Edeanya Agbese; Guodong Liu; Douglas L Leslie; Ping Du Journal: Medicine (Baltimore) Date: 2021-10-15 Impact factor: 1.889