Impact of the COVID-19 pandemic on cancer incidence and mortality

Impact of human papillomavirus vaccine in reducing genital warts: A Google Trends analysis

ABSTRACTIntroductionHuman papillomavirus (HPV) is a leading cause of both cervical and non-cervical cancers, including anal, oropharyngeal, vaginal, and vulvar cancers. While most HPV vaccination impact assessments have focused on preventing cervical cancer among women, the broader benefits of vaccination against other HPV-attributable cancers in low- and middle-income countries (LMICs) remain less explored.MethodsWe used a static cohort model to assess the potential health impact of bivalent HPV vaccination on HPV-attributable female non-cervical cancers in 117 LMICs from 2030 to 2100. The model incorporated country-specific data on cancer mortality, HPV type distribution, demographic projections, and vaccine coverage. Sensitivity analyses were performed to account for uncertainties in cancer incidence and mortality, HPV type distribution, and cancer stage distribution.ResultsOur projections suggest that HPV vaccination could contribute to prevention of approximately 0.59 million cases of anal, 0.88 million oropharyngeal, 1.27 million vaginal, and 2.18 million vulvar cancers over the analytic period. In total, 3.0 million deaths from these non-cervical cancers could be averted by 2100. The African Region is expected to see the largest relative reductions in both cases and deaths, while the European region showed the smallest gains. By the end of the century, 58 countries are projected to reach at least a 25% reduction in anal cancer mortality, compared to just 25 countries for oropharyngeal cancer. These findings reflect substantial regional disparities in both burden and vaccination impact.ConclusionHPV vaccination holds considerable promise in reducing the burden of non-cervical cancers among women in LMICs, especially in regions with high incidence and limited access to care. Recognizing and harnessing these broader benefits can strengthen the public health case for scaling up vaccine access, implementing region-specific strategies, and investing in equitable healthcare systems to decrease global disparities.KEY MESSAGESWhat is Already Known About This Topic?Health-impact modelling has been used to project the impact of human papillomavirus (HPV) vaccination on prevention of cervical cancer.HPV is a leading cause of non-cervical cancers, including anal, oropharyngeal, vaginal, and vulvar cancers.What Does This Study Add?This study estimated the impact of HPV vaccination on non-cervical female cancers, projecting the largest reductions in the African region.How Might This Study Affect Research, Practice, or Policy?In order to improve coverage of HPV vaccination programs, it will be important to estimate additional cancer prevention benefits that can mitigate disease burden in low- and middle-income countries.

Vaccinating Adolescents—New Evidence of Challenges and Opportunities

Far too few adults getting recommended vaccines

Maximizing the Potential Public Health Impact of HPV Vaccines: A Focus on Parents

Global HPV vaccination programs and coverage rates: a systematic review.

Cancer incidence and mortality in Australia from 2020 to 2044 and an exploratory analysis of the potential effect of treatment delays during the COVID-19 pandemic: a statistical modelling study

The COVID-19 Pandemic and Eating Disorders: A Wake-Up Call for the Future of Eating Disorders Among Adolescents and Young Adults

US jurisdictions have enacted a wide range of policies to address low human papillomavirus (HPV) vaccination coverage among adolescents, but it is unclear which policies are effective. To systematically review the impact of governmental policies on adolescent HPV vaccination coverage. PubMed, Embase, and Scopus databases. Eligible studies, published from 2009 to 2022, evaluated the impact of governmental policies on HPV vaccination coverage among adolescents ages 9 to 18. Two investigators independently extracted data on study sample, study design and quality, policy characteristics, and HPV vaccination outcomes. We summarized findings by policy type: school-entry requirements (SERs), federally-funded policies related to the Vaccines for Children program and Medicaid, educational requirements, and others. Our search yielded 36 eligible studies. A majority of studies evaluating HPV vaccine SERs found positive associations between SERs and HPV vaccination coverage (8 of 14), particularly for SERs in Rhode Island and Washington, DC. All studies evaluating SERs for other adolescent vaccines observed positive spillover effects for HPV vaccination (7 of 7). Federally-funded policies related to Vaccines for Children and Medicaid were consistently associated with higher HPV vaccination coverage (7 of 9). Relatively few studies found associations between educational requirements and HPV vaccination coverage (2 of 8). Studies used limited vaccination data sources and non- or quasi-experimental designs. Some studies had no or poorly matched comparison groups. Our findings suggest promise for SERs and federally-funded policies, but not educational requirements, for increasing HPV vaccination coverage among adolescents.

Introduction: Human papillomavirus (HPV) vaccine coverage in Australia is 80% for females and 76% for males. Attitudes may influence coverage but surveys measuring attitudes are resource-intensive. The aim of this study was to determine whether Twitter-derived estimates of HPV vaccine information exposure were associated with differences in coverage across regions in Australia. Methods: Regional differences in information exposure were estimated from 1,103,448 Australian Twitter users and 655,690 HPV vaccine related tweets posted between 6 September 2013 and 1 September 2017. Tweets about HPV vaccines were grouped using topic modelling; an algorithm for clustering text-based data. Proportional exposure to topics across 25 regions in Australia were used as factors to model HPV vaccine coverage in females and males, and compared to models using employment and education as factors. Results: Models using topic exposure measures were more closely correlated with HPV vaccine coverage (female: Pearson’s R = 0.75 [0.49 to 0.88]; male: R = 0.76 [0.51 to 0.89]) than models using employment and education as factors (female: 0.39 [−0.02 to 0.68]; male: 0.36 [−0.04 to 0.66]). In Australia, positively-framed news tended to reach more Twitter users overall, but vaccine-critical information made up higher proportions of exposures among Twitter users in low coverage regions, where distorted characterisations of safety research and vaccine-critical blogs were popular. Conclusions: Twitter-derived models of information exposure were correlated with HPV vaccine coverage in Australia. Topic exposure measures may be useful for providing timely and localised reports of the information people access and share to inform the design of targeted vaccine promotion interventions.

Background: Human papillomavirus (HPV) vaccine can prevent several types of cancer, including cervical, anal, vaginal, and vulvar cancer. Widespread coverage with HPV vaccine could reduce disparities in the incidence and mortality rates of these cancers. However, preliminary evidence has shown that HPV vaccination among girls is highest in U.S. states with the lowest rates of cervical cancer mortality. We expanded on this finding and tested the hypothesis that states with higher risks of HPV-associated cancers would have lower HPV vaccine coverage levels. Methods: We gathered state-level data on HPV-related cancer risk and HPV vaccine initiation coverage for girls and boys, separately, and HPV vaccine follow-through (i.e., receipt of 3 doses among those initiating the series) for girls only. In addition, we gathered data on states' demographic composition and contact with the healthcare system. Data came from high-quality, national sources, and most data were from 2012. We calculated Pearson correlations for ecological relationships between (a) vaccination levels and (b) cancer rates, demographic composition, and contact with the healthcare system. Results: HPV vaccine initiation among girls was lower in states with higher levels of cervical cancer incidence and mortality (r=-.29 and -.46, respectively). In addition, girls' initiation was lower in states with higher proportions of non-Hispanic black residents (r=-.28) and lower proportions of higher income residents (r=.32). HPV vaccine follow-through among girls was lower in states with higher levels of cervical cancer mortality (r=-.30) and higher in states with greater levels of adolescents' contact with the healthcare system. HPV vaccine initiation among boys was lower in states with higher proportions of non-Hispanic white residents and lower proportions of residents of “other” race/ethnicity. HPV vaccine initiation among boys was not associated with states' HPV-related cancer incidence or mortality. Conclusions: HPV vaccine coverage for girls was lower in states with higher HPV-related cancer risk. As initiation among boys and girls was highly correlated, it is possible that the pattern seen among girls could develop as vaccination among boys becomes more widely accepted and coverage increases. Public health efforts should concentrate on geographic areas with higher cancer burden. Strengthening adolescent preventive healthcare use may be particularly important to increase vaccine follow-through. Cost-effectiveness analyses may overestimate the benefits of current vaccination coverage and underestimate the benefits of increasing coverage. The current patterns of HPV vaccination, especially among girls, may not be adequate to reverse the current geographic and racial/ethnic disparities in HPV-related cancer incidence and mortality. Citation Format: Jennifer L. Moss, Paul L. Reiter, Noel T. Brewer. What do current vaccination patterns tell us about the future of geographic and racial disparities in human papillomavirus (HPV)-related cancers? [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B90.

Isolation and school closure during the COVID-19 pandemic could decrease human papillomavirus (HPV) vaccination uptake and potentially increase future HPV-related morbidity among unvaccinated populations. The aim of our study was to investigate HPV vaccination rates in Israel during the pandemic. The HPV vaccination rates were compared before and during the COVID-19 pandemic years (2020-2021). Data regarding HPV vaccination between 2015 and 2021 were extracted from the Israeli Ministry of Health online reports. Vaccination rates were compared with other childhood vaccines, given at similar ages. Israeli HPV vaccination rates were further compared with England and Australia, which have an established vaccination infrastructure. The average Israeli coverage of first-dose HPV vaccine was 60.2%, with significant variations from 2015 to 2021. During the pandemic years, first-dose vaccine coverage increased compared with the 3 previous years. The pandemic had also no apparent influence on other childhood vaccine uptake, even though adolescents in Israel missed many school days during this time. Average vaccine uptake in England and Australia was significantly higher than Israel ( p = .009); however, first-dose vaccination rates decreased considerably in England during 2020, to a nadir of 59%. The pandemic had little effect on HPV vaccination rates in Australia. Despite many school days missed, the COVID-19 pandemic did not result in a decrease in HPV vaccine uptake in Israel. The pandemic could prove a good opportunity to further educate the public regarding the importance of whole-population vaccination programs. Implementing catch-up vaccination programs may bridge "vaccination gaps" that may be caused by future pandemics.

BackgroundCervical cancer is one of the most common cancers in women and could be prevented by human papilloma virus (HPV) vaccination. Cervarix, the first available HPV vaccine, has been widely administrated to Chinese women, while little was known about its effect on the prevention and control for HPV related diseases in China. The study aims to assess the impact of Cervarix on HPV infection and cervical related diseases in real world.MethodsThis is a prospective, multi-age birth cohort study to investigate the incidence and continuous status of HPV infection, and relevant cervical diseases by exposure status (with Cervarix vaccination history or without any HPV vaccination history). It is planned to recruit 12,118 eligible women at age of 9 to 45 years from vaccination clinics or hospital outpatient clinics, and then follow up them for three years. The standard questionnaire will be used to collect information such as demographic characteristics, menstruation and obstetrical histories, history of sexual behavior, personal behavior history, history of disease and pathogen infection, medication history, and family history at baseline. After three years, the changes of these behaviors will be investigated again, and other related health status information will be retrieved from the electronic health records during the follow-up period. If available physically and legally, the cervical cancer screening will be performed, including type-specific HPV deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) testing and contingent thinprep cytologic test (TCT) and colposcopy. The free cervical cancer screening will be captured and uploaded timely to the Yinzhou Regional Health Information Platform (YRHIP); therefore, the long-term outcomes of participants will be monitored.DiscussionThis prospective cohort study will assess the impact of HPV vaccine on HPV infection and related cervical diseases in women aged 9–45 years, which makes up for the lack of evidence in Chinese women. The results of this study will provide support for understanding the impact of HPV vaccination in China, and make a contribution to increasing HPV vaccination and cervical cancer screening coverage in China.Trial registrationThis study has been retrospectively registered on clinicaltrials.gov (NCT05341284) on April 22, 2022.

Impact of the human papillomavirus vaccine in low-resource settings

Appalachia is a geographic region with high cervical cancer incidence and mortality rates, yet little is known about human papillomavirus (HPV) vaccination in this region. We determined HPV vaccine coverage among adolescent females from Appalachia, made comparisons to non-Appalachian females, and examined how coverage differs across subregions within Appalachia. We analyzed data from the National Immunization Survey-Teen 2008-2010 for adolescent females ages 13-17 (n = 1,951, Appalachian females and n = 25,468, non-Appalachian females). We examined HPV vaccine initiation (receipt of at least one dose), completion (receipt of at least three doses), and follow-through (completion among initiators). Analyses used weighted logistic regression. HPV vaccine initiation [Appalachian = 40.8% vs. non-Appalachian = 43.6%; OR, 0.92; 95% confidence interval (CI), 0.79-1.07] and completion (Appalachian = 27.7% vs. non-Appalachian = 25.3%; OR, 1.12; 95% CI, 0.95-1.32) were similar between Appalachian and non-Appalachian females. HPV vaccine follow-through was higher among Appalachian females than non-Appalachian females (67.8% vs. 58.1%; OR, 1.36; 95% CI, 1.07-1.72). Vaccination outcomes tended to be higher in the Northern (completion and follow-through) and South Central (follow-through) subregions of Appalachia compared with non-Appalachian United States. Conversely, vaccination outcomes tended to be lower in the Central (initiation and completion) and Southern (initiation and completion) subregions. In general, HPV vaccination in Appalachia is mostly similar to the rest of the United States. However, vaccination is lagging in regions of Appalachia where cervical cancer incidence and mortality rates are highest. Current cervical cancer disparities could potentially worsen if HPV vaccine coverage is not improved in regions of Appalachia with low HPV vaccine coverage.