Disparity of Cervical Cancer Risk in Young Japanese Women: Bipolarized Status of HPV Vaccination and Cancer Screening.

Mariko Taniguchi,Kei Hirai,Masayuki Endo,Ai Miyoshi,Asami Yagi,Tomio Nakayama,Ryoko Minekawa,Yusuke Tanaka,Tadashi Kimura,Takuji Tomimatsu,Yutaka Ueda

doi:10.3390/vaccines9030280

Mariko Taniguchi, Kei Hirai + Show 9 more

Open Access

https://doi.org/10.3390/vaccines9030280

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Journal: Vaccines	Publication Date: Mar 19, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: Osaka University, Osaka Rosai Hospital

Abstract

Women born between 1994 and 1999 achieved high vaccination rates for human papillomavirus (HPV); they are now reaching the age of cervical cancer screening programs in Japan. In this study, we aimed to investigate the health awareness of HPV-vaccinated and unvaccinated women and to create tailored leaflets recommending cervical cancer screening for each. Surveys on the cancer screening rates for HPV-vaccinated and unvaccinated women aged 20 and 21 have demonstrated that the rate was significantly higher (p < 0.01) in vaccinated (6.2%) than in unvaccinated women (3.1%). Next, interviews and Internet questionnaires clarified that there was a trend that vaccinated women have a better health consciousness than the unvaccinated ones, and that in unvaccinated women, their willingness to receive cervical cancer screening was significantly enhanced by the fear of developing cancer. Finally, in a prospective study, the increase in the screening rate for both vaccinated and unvaccinated groups after they read tailored leaflets, from 6.4% to 7.4% and from 3.9% to 5.1%, respectively, was not statistically significant compared to the groups provided with a standard reminder letter. Cervical cancer control measures might be enhanced by recommending cervical cancer screening in ways better tailored to HPV vaccination status.

Highlights

It is widely accepted that the vast majority of cervical cancers can be prevented by timely human papillomavirus (HPV) vaccination and regular cervical cancer screening
Internet-based questionnaires were sent to women who satisfied our criteria; respondents continued to be accepted until the number of responses from both vaccinated and unvaccinated women reached over 200 per group. Questionnaires covered their health consciousness, knowledge of cervical cancer and how to protect against it, and attitudes toward cervical cancer screening. We asked whether their willingness to participate in cancer screening was changed by the recommendation messages we provided, depending on their HPV vaccination status
Among 5587 women born in fiscal year (FY) 1995 and FY 1996, and targeted for cervical cancer screening at age 20 and 21 in FY 2015 and FY 2016, in Toyonaka and Iwaki, the overall HPV vaccination rate was 66.2% (3697/5587)

Summary

Introduction

It is widely accepted that the vast majority of cervical cancers can be prevented by timely human papillomavirus (HPV) vaccination and regular cervical cancer screening. There is a statistical prediction in Australia that if current high-coverage vaccination and screening rates are maintained, cervical cancer can be eliminated by 2028, at an elimination threshold of four new cases per 100,000 women annually [4]. Japan’s Ministry of Health, Labor, and Welfare (MHLW) recommends that all women aged 20 and older should be receiving screening every two years to achieve the earliest possible detection of cervical cancer. Despite this recommendation, the overall screening rate in Japan currently remains at roughly 40%, and it is extremely lower in the youngest generations: 10%, 10–20%, and 10–30%, at age 20–24, 25–29, and 30–39, respectively [5]

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