Does the HPV vaccination programme have implications for cervical screening programmes in the UK?

Helen Beer, Samantha Hibbitts, Sinead Brophy, M.A. Rahman, Jo Waller, Shantini Paranjothy

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Abstract

In the UK, a national HPV immunisation programme was implemented in 2008 for girls aged 12?13 years. In addition a catch-up programme was implemented for older girls up to 18 years of age from 2009 to 2011, with an uptake rate of 49.4%. Information about future uptake of cervical screening according to vaccination statistics is important in order to understand the impact of the vaccination programme and implications for a national cervical screening programme. We analysed data on a cohort of women who had been offered the HPV vaccine in the catch-up programme and were invited for cervical screening between 2010 and 2012 in Wales (n = 30,882), in a record-linked database study, to describe the cervical screening uptake and clinical outcome according to HPV vaccination status. In our cohort, 48.5% (n = 14,966) women had had HPV vaccination and 45.9% (n = 14,164) women attended for cervical screening. Women who were unvaccinated were less likely to attend cervical screening (adjusted OR 0.58; 95% CI (0.55, 0.61)). Of those who attended for screening, 13.9% of vaccinated women had abnormal cytology reported compared to 16.7% of women who were unvaccinated. Women who lived in areas with high levels of social deprivation were less likely to be vaccinated (Quintile 5 OR 0.48 95% CI (0.45, 0.52)) or attend cervical screening (Quintile 5 OR 0.70; 95% CI (0.65, 0.75)) compared to those who lived in the least deprived areas. These data highlight the need for new strategies to address inequalities in cervical screening uptake and can inform further mathematical modelling work to clarify the impact of the HPV vaccination programme on future cervical cancer incidence.
Original languageEnglish
Pages (from-to)1828-1833
Number of pages6
JournalVaccine
Volume32
Issue number16
DOIs
Publication statusPublished - 1 Apr 2014

Bibliographical note

Acknowledgements: This study was funded by Cancer Research UK and sponsored by Cardiff University. The research was also supported by The Centre for the Improvement of Population Health through E-records Research (CIPHER). CIPHER is one of four UK e-health Informatics Research Centres funded by a joint investment from: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Chief Scientist Office (Scottish Government Health Directorates), the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute for Health Research, the National Institute for Social Care and Health Research (Welsh Government) and the Wellcome Trust (Grant reference: MR/K006525/1).

Author contributions: SP and SH conceived of the study. HB, SB and MAR collected the data for the study. HB, SH and SP contributed to the analyses of the study and all authors contributed to the interpretation of results and the writing of this paper and have approved the final draft.

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