Population‐based trends in high‐grade cervical lesions in the early human papillomavirus vaccine era in the United States

BACKGROUND Cervical intraepithelial neoplasia grade 2, 3, and adenocarcinoma in situ (CIN2+) lesions can be monitored as early indicators of human papillomavirus (HPV) vaccine impact. Changes to screening utilization will affect observed reductions in CIN2+ rates and complicate the interpretation of...

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Bibliographic Details
Published in:Cancer 2015-08, Vol.121 (16), p.2775-2781
Main Authors: Hariri, Susan, Johnson, Michelle L., Bennett, Nancy M., Bauer, Heidi M., Park, Ina U., Schafer, Sean, Niccolai, Linda M., Unger, Elizabeth R., Markowitz, Lauri E.
Format: Article
Language:English
Subjects:
Adolescent
Adult
cervical cancer screening
cervical intraepithelial neoplasia (CIN)
Cervical Intraepithelial Neoplasia - epidemiology
Cervical Intraepithelial Neoplasia - prevention & control
cervical precancers
Early Detection of Cancer
Female
high‐grade cervical lesions
Human papillomavirus
human papillomavirus (HPV)
human papillomavirus vaccine effectiveness
human papillomavirus vaccines
Humans
Incidence
Papillomavirus Vaccines - immunology
United States - epidemiology
Uterine Cervical Neoplasms - epidemiology
Uterine Cervical Neoplasms - prevention & control
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Summary:BACKGROUND Cervical intraepithelial neoplasia grade 2, 3, and adenocarcinoma in situ (CIN2+) lesions can be monitored as early indicators of human papillomavirus (HPV) vaccine impact. Changes to screening utilization will affect observed reductions in CIN2+ rates and complicate the interpretation of vaccine impact. METHODS From 2008 to 2012, 9119 cases of CIN2+ among 18‐ to 39‐year‐old residents of catchment areas in California, Connecticut, New York, and Oregon were reported to the HPV‐IMPACT Project, a sentinel system for monitoring the population impact of HPV vaccine. Age‐stratified CIN2+ incidence rates were calculated for each catchment. Annual cervical screening was estimated for California, New York, and Oregon catchments with administrative and survey data. The Cochran‐Armitage test was used to examine trends. RESULTS From 2008 to 2012, the incidence of CIN2+ significantly decreased among 18‐ to 20‐year‐olds (California, from 94 to 5 per 100,000 women; Connecticut, from 450 to 57 per 100,000 women; New York, from 299 to 43 per 100,000 women; and Oregon, from 202 to 37 per 100,000 women; Ptrend 
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.29266