title: Does the HPV vaccination programme have implications for cervical screening programmes in the UK?
abstract: In the UK, a national HPV immunisation programme was implemented in 2008 for girls aged 12-13 years. In addition a catch-up programme was implemented for older girls up to 18 years of age from 2009 to 2011, with an uptake rate of 49.4%. Information about future uptake of cervical screening according to vaccination statistics is important in order to understand the impact of the vaccination programme and implications for a national cervical screening programme. We analysed data on a cohort of women who had been offered the HPV vaccine in the catch-up programme and were invited for cervical screening between 2010 and 2012 in Wales (n=30,882), in a record-linked database study, to describe the cervical screening uptake and clinical outcome according to HPV vaccination status. In our cohort, 48.5% (n=14,966) women had had HPV vaccination and 45.9% (n=14,164) women attended for cervical screening. Women who were unvaccinated were less likely to attend cervical screening (adjusted OR 0.58; 95% CI (0.55, 0.61)). Of those who attended for screening, 13.9% of vaccinated women had abnormal cytology reported compared to 16.7% of women who were unvaccinated. Women who lived in areas with high levels of social deprivation were less likely to be vaccinated (Quintile 5 OR 0.48 95% CI (0.45, 0.52)) or attend cervical screening (Quintile 5 OR 0.70; 95% CI (0.65, 0.75)) compared to those who lived in the least deprived areas. These data highlight the need for new strategies to address inequalities in cervical screening uptake and can inform further mathematical modelling work to clarify the impact of the HPV vaccination programme on future cervical cancer incidence.
authors: Public Health Wales, Screening Division, Cervical Screening Wales, 18 Cathedral Road, Cardiff CF11 9LJ, Wales, UK.
authors: Helen
authors: H
authors: Beer
authors: School of Medicine, Cardiff University, Cardiff CF14 4XN, Wales, UK. Electronic address: hibbittssj@cardiff.ac.uk.
authors: Sam
authors: S
authors: Hibbitts
authors: Health Information Research Unit, Swansea University, College of Medicine, Swansea SA2 8PP, Wales, UK; Centre for Improvement in Population Health through E-records Research, Swansea University, College of Medicine, Swansea SA2 8PP, Wales, UK.
authors: Sinead
authors: S
authors: Brophy
authors: Health Information Research Unit, Swansea University, College of Medicine, Swansea SA2 8PP, Wales, UK.
authors: M A
authors: MA
authors: Rahman
authors: Cancer Research UK Health Behaviour Research Centre, Research Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, UK.
authors: Jo
authors: J
authors: Waller
authors: School of Medicine, Cardiff University, Cardiff CF14 4XN, Wales, UK; Centre for Improvement in Population Health through E-records Research, Swansea University, College of Medicine, Swansea SA2 8PP, Wales, UK.
authors: Shantini
authors: S
authors: Paranjothy
mesh_terms: D000328:Adult; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs; D008403:Mass Screening / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014611:Vaccination / Q000706:statistics & numerical data*; D014852:Wales; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines