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Does the HPV vaccination programme have implications for cervical screening programmes in the UK?

Beer, H; Hibbitts, S; Brophy, S; Rahman, MA; Waller, J; Paranjothy, S; (2014) Does the HPV vaccination programme have implications for cervical screening programmes in the UK? Vaccine , 32 (16) pp. 1828-1833. 10.1016/j.vaccine.2014.01.087. Green open access

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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.

Type: Article
Title: Does the HPV vaccination programme have implications for cervical screening programmes in the UK?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.vaccine.2014.01.087
Publisher version: http://dx.doi.org/10.1016/j.vaccine.2014.01.087
Additional information: © 2014 The Authors. Published by Elsevier Ltd. All rights reserved. This is an open-access article distributed under the terms of the CreativeCommons Attribution License, which permits unrestricted use, distribution andreproduction in any medium, provided the original author and source are credited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1409963
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