PDF(Pubmed)
Abstract：
HPV vaccination with concomitant HPV-based screening of young women has been proposed for faster cervical cancer elimination. We describe the baseline results of a population-based trial of this strategy to reduce the incidence of HPV. All 89,547 women born 1994-1999 and resident in the capital region of Sweden were personally invited to concomitant HPV vaccination and HPV screening with 26,125 women (29.2%) enrolled between 2021-05-03 and 2022-12-31. Baseline HPV genotyping of cervical samples from the study participants finds, compared to pre-vaccination prevalences, a strong decline of HPV16 and 18 in birth cohorts previously offered vaccination, some decline for cross-protected HPV types but no decline for HPV types not targeted by vaccines. Our dynamic transmission modelling predicts that the trial could reduce the incidence of high-risk HPV infections among the 1994-1998 cohorts by 62-64% in 3 years. Baseline results are prevalences of HPV infection, validated transmission model projections, and power estimates for evaluating HPV incidence reductions at follow-up (+/-0.1% with 99.9% confidence). In conclusion, concomitant HPV vaccination and HPV screening appears to be a realistic option for faster cervical cancer elimination. Clinicaltrials.gov identifier: NCT04910802; EudraCT number: 2020-001169-34.
摘要：
已提出HPV疫苗接种与伴随的基于HPV的年轻女性筛查，以更快地消除宫颈癌。我们描述了该策略的基于人群的试验的基线结果，以降低HPV的发病率。1994-1999年出生并居住在瑞典首都地区的所有89,547名妇女都被邀请参加HPV疫苗接种和HPV筛查，其中26,125名妇女（29.2％）在2021-05-03和2022-12-31之间注册。来自研究参与者的宫颈样本的基线HPV基因分型发现，与疫苗接种前的流行相比，在先前提供疫苗接种的出生队列中，HPV16和18的人数大幅下降，交叉保护的HPV类型有所下降,但非疫苗靶向的HPV类型没有下降.我们的动态传播模型预测，该试验可以在3年内将1994-1998年队列中高风险HPV感染的发生率降低62-64％。基线结果是HPV感染的患病率，经过验证的传输模型预测，和评估随访时HPV发病率降低的功效估计（+/-0.1％，置信度为99.9％）。总之,伴随HPV疫苗接种和HPV筛查似乎是更快消除宫颈癌的现实选择.Clinicaltrials.gov标识符：NCT04910802；EudraCT编号：2020-001169-34。
