title: Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland.
abstract: BACKGROUND
  In Scotland, a national HPV immunisation programme began in 2008 for 12- to 13-year olds, with a catch-up campaign from 2008 to 2011 for those under the age of 18. To monitor the impact of HPV immunisation on cervical disease at the population level, a programme of national surveillance was established.
  
  
  METHODS
  We analysed colposcopy data from a cohort of women born between 1988 and 1992 who entered the Scottish Cervical Screening Programme (SCSP) and were aged 20-21 in 2008-2012.
  
  
  RESULTS
  By linking datasets from the SCSP and colposcopy services, we observed a significant reduction in diagnoses of cervical intraepithelial neoplasia 1 (CIN 1; RR 0.71, 95% CI 0.58 to 0.87; P=0.0008), CIN 2 (RR 0.5, 95% CI 0.4 to 0.63; P<0.0001) and CIN 3 (RR 0.45, 95% CI 0.35 to 0.58; P<0.0001) for women who received three doses of vaccine compared with unvaccinated women.
  
  
  CONCLUSIONS
  To our knowledge, this is one of the first studies to show a reduction of low- and high-grade CIN associated with high uptake of the HPV bivalent vaccine at the population level. These data are very encouraging for countries that have achieved high HPV vaccine uptake.
authors.affiliation: Health Protection Scotland, 5 Cadogan Street, Glasgow G2 6QE, Scotland.
authors.forename: K G J
authors.initials: KG
authors.lastname: Pollock
authors.affiliation: Department of Mathematics and Statistics, University of Strathclyde, Level 8, Livingstone Tower, 26 Richmond St, Glasgow G1 1XH, Scotland.
authors.forename: K
authors.initials: K
authors.lastname: Kavanagh
authors.affiliation: Health Protection Scotland, 5 Cadogan Street, Glasgow G2 6QE, Scotland.
authors.forename: A
authors.initials: A
authors.lastname: Potts
authors.affiliation: Health Protection Scotland, 5 Cadogan Street, Glasgow G2 6QE, Scotland.
authors.forename: J
authors.initials: J
authors.lastname: Love
authors.affiliation: Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland.
authors.forename: K
authors.initials: K
authors.lastname: Cuschieri
authors.affiliation: Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland.
authors.forename: H
authors.initials: H
authors.lastname: Cubie
authors.affiliation: Health Protection Scotland, 5 Cadogan Street, Glasgow G2 6QE, Scotland.
authors.forename: C
authors.initials: C
authors.lastname: Robertson
authors.affiliation: University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland.
authors.forename: M
authors.initials: M
authors.lastname: Cruickshank
authors.affiliation: Raigmore Department of Pathology, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, Scotland.
authors.forename: T J
authors.initials: TJ
authors.lastname: Palmer
authors.affiliation: Department of Cytology, Ninewells Hospital, Dundee DD1 9SY, Scotland.
authors.forename: S
authors.initials: S
authors.lastname: Nicoll
authors.affiliation: Health Protection Scotland, 5 Cadogan Street, Glasgow G2 6QE, Scotland.
authors.forename: M
authors.initials: M
authors.lastname: Donaghy
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003127:Colposcopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening; D009313:National Health Programs; D060787:Neoplasm Grading; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D015995:Prevalence; D011379:Prognosis; D012606:Scotland / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D014611:Vaccination; D064166:Vaccine Potency; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines