Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women

Manako Yamaguchi,Takayuki Enomoto,Sharon J B Hanley,Megumi Hara,Sosuke Adachi,Risa Kudo,Yutaka Ueda,Etsuko Miyagi,Masayuki Sekine

doi:10.1038/s41598-021-82354-6

Abstract

In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. Although vaccine opponents claim modifying sexual behavior can prevent cervical cancer, no comprehensive data exist on sexual behavior and the risk of high-grade cervical disease in a Japanese population. This study investigates sexual behavior and the risk of HPV infection and cervical disease in 3968 women aged 20–41 yrs undergoing cervical screening between April 2014 and March 2016. Mean age at first intercourse was 18.4 yrs ± 2.8 and 32% of women reported ≥ 6 lifetime sexual partners. In regression analyses, number of partners was a significant risk factor for HPV infection. However, for high-grade disease (CIN2+), when HPV genotype was adjusted for, number of partners was not statistically significant. The greatest risk factor was an HPV16/18 infection (adjusted odds ratio 113.7, 95% CI: 40.8–316.9). In conclusion, we found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately.

Highlights

In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears
Public funding became available from 2010 and from April 2013, the HPV vaccine was included in the National Immunization Program (NIP) for girls aged 12–16 yrs
We investigated the correlation between sexual behavior, HPV infection, including genotype-specific infection and high-grade cervical disease in sexually active Japanese women of reproductive age for a better comprehensive approach to cervical cancer prevention in Japan

Summary

Introduction

In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. We found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately. Following the global call to action for the elimination of cervical by the World Health Organization’ s (WHO) Director General in 2018, a global strategy to accelerate cervical cancer elimination was drafted with clear targets for the period 2020–2030 These include that 80–100% of girls get vaccinated against HPV by the age of 15 yrs[9]. Schoolchildren recommend cancer screening for cervical cancer prevention in Japan, HPV vaccination are not described in the materials[17]

Methods

Results

Conclusion