title: Pre-vaccination type-specific HPV prevalence in confirmed cervical high grade lesions in the Māori and non-Māori populations in New Zealand.
abstract: BACKGROUND
  New Zealand initiated HPV vaccination in 2008, and has attained 3-dose coverage of ~50 % in 12-13 year old girls. Due to the success of program initiatives in Māori girls, higher coverage rates of ~60 % have been achieved in this group. We have previously reported a benchmark overall pre-vaccination prevalence of oncogenic HPV infection in high grade cervical lesions in New Zealand. The current extended analysis provides separate pre-vaccination benchmark prevalence for Māori and non-Māori women.
  
  
  METHODS
  The National Cervical Screening Programme Register (NCSP-R) was used to identify any woman aged 20-69 years of age with an index high grade cytology report from 2009-2011. Extended recruitment was performed until 2012 in clinics with a high proportion of Māori women. Ethnicity status was based on self-reported information by participating women through phone contact supplemented by recordings on the study questionnaire (the NCSP-R was not used to extract ethnicity status). A total of 730 women consented to participate and had a valid HPV test result; 418 of these had histologically-confirmed cervical intraepithelial neoplasia (CIN) 2/3 lesions (149 Māori, 269 non-Māori). The prevalence of any cervical oncogenic HPV infection, HPV16, and HPV18 was calculated in women with CIN2/3.
  
  
  RESULTS
  In confirmed CIN2/3, the prevalence of any oncogenic HPV, HPV16 and HPV18 was 96 % (95 % CI:91-99 %), 54 % (95 % CI:46-63 %), 11 % (95 % CI:7-18 %) in Māori and 96 % (95 % CI:93-98 %), 54 % (95 % CI:48-60 %), 11 % (95 % CI:7-15 %) in non-Māori women, respectively. Age-specific patterns of infection for HPV16/18 in confirmed CIN2/3 differed between the two groups (Pinteraction = 0.02), with a lower prevalence in younger vs. older Māori women (57 % in 20-29 years vs 75 % in 40-69 years) but a higher prevalence in younger vs. older non-Māori women (70 % in 20-29 years vs 49 % in 40-69 years); the difference in the age-specific patterns of infection for HPV16/18 was not significant either when considering confirmed CIN2 alone (p = 0.09) or CIN3 alone (p = 0.22).
  
  
  CONCLUSIONS
  The overall prevalence of vaccine-included types in CIN2/3 was similar in Māori and non-Māori women, implying that the long-term effects of vaccination will be similar in the two groups.
authors: Prince of Wales Clinical School, UNSW, Sydney, NSW, 2052, Australia. yoonjung.kang@nswcc.org.au.|Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia. yoonjung.kang@nswcc.org.au.
authors: Yoon-Jung
authors: YJ
authors: Kang
authors: National Cervical Screening Programme, Ministry of Health, Wellington, New Zealand. Hazel.Lewis@paradise.net.nz.|, Current address: 59 Normandale Rd, Lower Hutt, New Zealand. Hazel.Lewis@paradise.net.nz.
authors: Hazel
authors: H
authors: Lewis
authors: Prince of Wales Clinical School, UNSW, Sydney, NSW, 2052, Australia. megan.smith@nswcc.org.au.|Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia. megan.smith@nswcc.org.au.
authors: Megan A
authors: MA
authors: Smith
authors: Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia. leonardo_marco.simonella@roche.com.|Current address: MORSE (modelling outcomes research, statistics and epidemiology) group, Roche, Basel, Switzerland. leonardo_marco.simonella@roche.com.
authors: Leonardo
authors: L
authors: Simonella
authors: National Cervical Screening Programme, Ministry of Health, Wellington, New Zealand. Harold_Neal@moh.govt.nz.
authors: Harold
authors: H
authors: Neal
authors: Molecular Biology, Aotea Pathology, CMC Building 89 Courtenay Place, Wellington, New Zealand. CBromhead@apath.co.nz.|Current address: Institute of Food and Nutrition, College of Health, Massey University Wellington, Wellington, New Zealand. CBromhead@apath.co.nz.
authors: Collette
authors: C
authors: Bromhead
authors: Prince of Wales Clinical School, UNSW, Sydney, NSW, 2052, Australia. karen.canfell@nswcc.org.au.|Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia. karen.canfell@nswcc.org.au.
authors: Karen
authors: K
authors: Canfell
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D053918:Papillomavirus Vaccines; D015995:Prevalence; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D014611:Vaccination; D044465:White People; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines