瑞典卡罗林斯卡大学Jiayao Lei团队研究了HPV疫苗接种与浸润性宫颈癌风险之间的相关性。2020年10月1日，该研究发表在《新英格兰医学杂志》上。

四价人乳头瘤病毒（HPV）疫苗在预防高级宫颈病变中已初见成效。但四价HPV疫苗接种与随后的浸润性宫颈癌风险之间的相关性尚不明确。

研究组使用了瑞典全国人口统计和健康登记表，来追踪2006-2017年中年龄在10-30岁间的1672983名女性的数据，用于评估HPV疫苗接种与宫颈癌浸润风险之间的关联。

在研究期间，研究组评估了女孩和女性是否患有宫颈癌，直到她们31岁生日为止。最终在接种四价HPV疫苗的19名女性和未接种疫苗的538名女性中诊断出宫颈癌。接种疫苗的女性中，宫颈癌的累积发病率为每十万人47例，未接种的女性中为每十万人94例。

校正随访年龄后，接种人群与未接种人群宫颈癌的发生率比率为0.51。对其他协变量进行额外校正后，发生率比率为0.37。对所有协变量进行校正后，在17岁之前接种疫苗的女性中，发病率比率为0.12，而在17-30岁间接种疫苗的女性中为0.47。

总之，10-30岁的女性进行四价HPV疫苗接种可大大降低浸润性宫颈癌的风险。

附：英文原文

Title: HPV Vaccination and the Risk of Invasive Cervical Cancer

Author: Jiayao Lei, Ph.D.,, Alexander Ploner, Ph.D.,, K. Miriam Elfstrm, Ph.D.,, Jiangrong Wang, Ph.D.,, Adam Roth, M.D., Ph.D.,, Fang Fang, M.D., Ph.D.,, Karin Sundstrm, M.D., Ph.D.,, Joakim Dillner, M.D., Ph.D.,, and Pr Sparén, Ph.D.

Issue&Volume: 2020-10-01

Abstract:

Background

The efficacy and effectiveness of the quadrivalent human papillomavirus (HPV) vaccine in preventing high-grade cervical lesions have been shown. However, data to inform the relationship between quadrivalent HPV vaccination and the subsequent risk of invasive cervical cancer are lacking.

Methods

We used nationwide Swedish demographic and health registers to follow an open population of 1,672,983 girls and women who were 10 to 30 years of age from 2006 through 2017. We assessed the association between HPV vaccination and the risk of invasive cervical cancer, controlling for age at follow-up, calendar year, county of residence, and parental characteristics, including education, household income, mother’s country of birth, and maternal disease history.

Results

During the study period, we evaluated girls and women for cervical cancer until their 31st birthday. Cervical cancer was diagnosed in 19 women who had received the quadrivalent HPV vaccine and in 538 women who had not received the vaccine. The cumulative incidence of cervical cancer was 47 cases per 100,000 persons among women who had been vaccinated and 94 cases per 100,000 persons among those who had not been vaccinated. After adjustment for age at follow-up, the incidence rate ratio for the comparison of the vaccinated population with the unvaccinated population was 0.51 (95% confidence interval [CI], 0.32 to 0.82). After additional adjustment for other covariates, the incidence rate ratio was 0.37 (95% CI, 0.21 to 0.57). After adjustment for all covariates, the incidence rate ratio was 0.12 (95% CI, 0.00 to 0.34) among women who had been vaccinated before the age of 17 years and 0.47 (95% CI, 0.27 to 0.75) among women who had been vaccinated at the age of 17 to 30 years.

Conclusions

Among Swedish girls and women 10 to 30 years old, quadrivalent HPV vaccination was associated with a substantially reduced risk of invasive cervical cancer at the population level.

DOI: 10.1056/NEJMoa1917338

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1917338