Dataset Information

Effect of number of human papillomavirus vaccine doses on guideline adherent cervical cytology screening among 19-26year old females.

ABSTRACT: Little is known about how the number of HPV vaccine doses affect adherence to screening guidelines. This study compared adherence to cervical cancer screening by the number of HPV vaccine doses received by young women and assessed whether the specialty of vaccinating providers affected behavior.This retrospective cohort study using administrative insurance claims records included 24,964 19-26year old women who received at least 1 injection of the HPV vaccine between January 2006 and November 2009. Vaccinated young women continuously enrolled in a nationally-representative private insurance plan for 6months prior to and 37months after HPV vaccine administration were included. Logistic regression was used to compare the odds of Papanicolaou (Pap) testing 3years after vaccine initiation by number of vaccine doses and provider type.In this sample, 79.3% had a Pap test 3years following vaccine initiation. Receiving 1 (aOR: 0.60, 95% CI 0.55-0.65) or 2 (aOR: 0.80, 95% CI 0.74-0.87) doses was associated with decreased odds of Pap testing compared to 3 doses. Many young women in our sample (16.5%) were diagnosed with cervical dysplasia prior to HPV vaccination. Patients vaccinated by non-obstetrician/gynecologists were less likely to get a Pap test following vaccination.Women who received 1 or 2 doses of the HPV vaccine were less likely than those who received 3 doses to be screened for cervical cancer 3years following vaccine initiation. Pediatricians and primary care physicians should convey the importance of initiating and continuing screening to HPV vaccinated patients.

SUBMITTER: Hirth JM

PROVIDER: S-EPMC4902738 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Effect of number of human papillomavirus vaccine doses on guideline adherent cervical cytology screening among 19-26year old females.

Hirth Jacqueline M JM Lin Yu-Li YL Kuo Yong-Fang YF Berenson Abbey B AB

Preventive medicine 20160413

<h4>Purpose</h4>Little is known about how the number of HPV vaccine doses affect adherence to screening guidelines. This study compared adherence to cervical cancer screening by the number of HPV vaccine doses received by young women and assessed whether the specialty of vaccinating providers affected behavior.<h4>Methods</h4>This retrospective cohort study using administrative insurance claims records included 24,964 19-26year old women who received at least 1 injection of the HPV vaccine betwe ...[more]

PMID: 27085993

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Project description:BACKGROUND:Low human papillomavirus (HPV) vaccination rates early after introduction, particularly among low income and minority adolescents, may have resulted in disparities in vaccine-type HPV prevalence (types 6, 11, 16, 18). The purpose of this study was to examine racial/ethnic variations in HPV prevalence, and evaluate how HPV vaccination has affected vaccine-type HPV prevalence across time. METHODS:This study was a retrospective analysis of 6 cycles of the National Health and Nutrition Examination Survey (NHANES) data (2003-2014). Results on HPV status from vaginal samples of 14-26?year old females who responded about HPV vaccination were used to determine HPV prevalence. Prevaccine HPV prevalence was compared to post-licensure prevalence. Racial/ethnic comparisons were made across time, and models were developed to examine the role of HPV vaccination in observed variations for vaccine-type HPV prevalence. RESULTS:Among 4080 females, 29.7% were black, 25.6% were Mexican American, 8.9% were Hispanic, and 35.8% were white. Compared to prevaccine years (2003-2006), vaccine-type HPV did not decrease until late post-licensure years (2011-2014; 14.2% vs. 5.2%, p?<?0.001). Most of the decrease occurred among white females between prevaccine and late post-licensure periods (15.2% vs. 4.1%, p?<?0.001). Although a decrease in prevalence was observed among black females during the same periods (16.9% vs. 9.8%, p?<?0.05), it was not as large as among white females. Prevalence decreased among Mexican Americans (8.2 vs. 4.0, p?>?0.05) during the same periods, but the difference was not significant. Interactions between race and time were significant (p?<?0.001), with uneven vaccination between black and white females contributing to the disparities observed. CONCLUSIONS:HPV vaccination was low in among black and Mexican American females, which contributed to disparities in HPV prevalence. Increasing vaccination among all adolescents, particularly 11-12?year olds, is important because most children this age will not have been exposed.

Project description:In women aged ≥ 30 years, Human Papillomavirus testing will replace cytology for primary cervical screening. We compared Hybrid Capture 2 (HC2), cobas, CLART, and APTIMA HPV assays with cytology on 2869 SurePath samples from women undergoing routine screening at 30-65 years in Copenhagen, Denmark. Women with cytological abnormalities were managed according to routine recommendations, with 92% completeness. Those with cytology-normal/HPV-positive samples (on any of the four assays) were invited for repeated cytology and HPV testing in 1.5 year, and 58% had additional testing. HPV testing detected more ≥ CIN3 than cytology (HC2: 35, cobas, CLART: 37, APTIMA: 34, cytology: 31), although statistically the differences were not significant. Cobas and CLART detected significantly more ≥ CIN2 than cytology (cobas, CLART: 49, cytology: 39). The proportion of women with false-positive test results (positive test results without ≥ CIN3) varied between 3.3% with cytology and 14.9% with cobas. All HPV assays led to significantly more false-positive tests, whereas compared to HC2 cobas and CLART were associated with a significantly higher and APTIMA with a significantly lower proportion. Detection of CIN1 was particularly increased for the three DNA assays. With APTIMA combined with cytological triage, about 20% more women were referred for colposcopy than with cytology screening. With the three DNA assays, the increase was ≥ 50%. The number of women with repeated testing was twice as high with APTIMA and almost five times as high with cobas compared to cytology. To our knowledge, Horizon was the only study set in routine practice that compared more than two HPV assays in the same women while also ascertaining the histological status of women with normal cytology/HPV-positive test results. HPV-based screening of Danish women aged 30-65 detected more high-grade CIN but decreased the screening specificity, and increased the demand for additional testing.

Dataset Information

Effect of number of human papillomavirus vaccine doses on guideline adherent cervical cytology screening among 19-26year old females.

Publications

Effect of number of human papillomavirus vaccine doses on guideline adherent cervical cytology screening among 19-26year old females.

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