Surveillance of effects of HPV vaccination in Belgium
Menée en Belgique à partir de l'analyse de 6 650 échantillons cervicaux prélevés entre 2010 et 2014, cette étude évalue, en fonction de catégories d'âge, l'efficacité d'une vaccination contre le papillomavirus humain (HPV) pour réduire le risque d'infection par le HPV de type 16 ou 18 et le risque de lésion cervicale pré-cancéreuse ou cancéreuse
Background : Early effects of HPV (human papillomavirus) vaccination are reflected by changes observable in young women attending cervical cancer screening. Subject and methods : The SEHIB study included HPV geno-typing of 6000 continuous and 650 pathological cervical cell specimen as well as biopsies, collected from women in Belgium in 2010–2014. Data were linked to vaccination status. Results : HPV vaccination offered protection among women aged <30 years against infection with HPV16 (vaccine effectiveness [VE] = 67%, 95% CI: 48–79%), HPV18 (VE = 93%, 95% CI: 52–99%), and high-risk HPV (VE = 16%, 95% CI: 2–29%). Vaccination protected also against cytological lesions. Vaccination protected against histologically confirmed lesions: significantly lower absolute risks of CIN1+ (risk difference [RD] = −1.6%, 95% CI: −2.6% to −0.7%) and CIN3+ associated with HPV16/18 (RD = −0.3%, 95% CI −0.6% to −0.1%). Vaccine effectiveness decreased with age. Protection against HPV16 and 18 infection was significant in all age groups, however no protection was observed against cytological lesions associated with these types in age-group 25–29. Conclusion : The SEHIB study demonstrates the effectiveness of HPV vaccination in Belgian young women in particular in age group 18–19. Declining effectiveness with increasing age may be explained by higher tendency of women already exposed to infection to get the vaccine. Keywords : Cervical cancer; Screening; Surveillance; HPV; Human papillomavirus; HPV vaccination
Cancer Epidemiology 2016