Abstract
To evaluate the impact of catch-up human papillomavirus (HPV) vaccination on conization rates in France in a large population-based study. We conducted a retrospective real-life cohort study on data collected prospectively by French National Health Insurance. Echantillon généralistes des bénéficiaires (EGB) is a database composed of demographic and health care utilization data for a 1/97th sample of the French population. We extracted data about all women born between 1983 and 1991, corresponding to the catch-up population (vaccination after 14 years old) at the time of implementation of HPV vaccination. The primary outcome was the occurrence of conization (all types of procedures) compared between vaccinated and non-vaccinated women. The cohort consisted of 42,452 women. Vaccination coverage (at least one dose) was low (9.8%, n = 4,129), but increased with time from vaccine implementation, from 0% in the 1983 cohort to 31% in the 1991 cohort. The conization rate was 1% for the overall population. The risk of conization for women between the ages of 19 and 30 years was reduced in the vaccinated group with a Hazard Ratio (HR) of 0.59 (95% CI[0.39-0.90]; p = 0.043). With a 10-year follow-up, catch-up HPV vaccination is associated with risk reduction of conization between the ages of 19 and 30.
Highlights
Cervical cancer remains a public health issue in France, as it affects young women with a peak incidence at the age of 42 years [1, 2]
The risk of conization for women between the ages of 19 and 30 years was reduced in the vaccinated group with a Hazard Ratio (HR) of 0.59
With a 10-year follow-up, catch-up human papillomavirus (HPV) vaccination is associated with risk reduction of conization between the ages of 19 and 30
Summary
Cervical cancer remains a public health issue in France, as it affects young women with a peak incidence at the age of 42 years [1, 2]. The severity of cervical cancer is related to the high morbidity associated with treatment, including chemotherapy, radiation therapy and surgery. Conization is part of the treatment of cervical dysplasia and early stage cancer. In women who have not always completed their pregnancy plans, this procedure is associated with obstetrical morbidity. Almost all cervical cancers are induced by human papillomavirus (HPV). The genotypes most frequently involved are genotypes 16 and 18, responsible for about 70% of all cervical cancers. Sexual transmission mainly occurs during the first year of sexual activity. The natural history of HPV infection consists of slow progression either to spontaneous cure or possible dysplasia and subsequent cervical cancer
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
