人乳头瘤病毒（HPV）疫苗对日本宫颈癌的影响：基于癌症统计数据和MINT研究的初步结果。
Human papillomavirus vaccine impact on invasive cervical cancer in Japan: Preliminary results from cancer statistics and the MINT study.
发表日期：2023 Sep 08
作者：
Mamiko Onuki, Fumiaki Takahashi, Takashi Iwata, Hiroshi Nakazawa, Hideaki Yahata, Hiroyuki Kanao, Koji Horie, Katsuyuki Konnai, Ai Nio, Kazuhiro Takehara, Shoji Kamiura, Naotake Tsuda, Yuji Takei, Shogo Shigeta, Noriomi Matsumura, Hiroyuki Yoshida, Takeshi Motohara, Hiroyuki Yamazaki, Keiichiro Nakamura, Junzo Hamanishi, Nobutaka Tasaka, Mitsuya Ishikawa, Yasuyuki Hirashima, Wataru Kudaka, Mayuyo Mori-Uchino, Iwao Kukimoto, Takuma Fujii, Yoh Watanabe, Kiichiro Noda, Hiroyuki Yoshikawa, Nobuo Yaegashi, Koji Matsumoto,
来源：
Immunity & Ageing
摘要：
2009年，日本获得了针对人乳头瘤病毒（HPV）16型和HPV18型的第一个预防性疫苗的批准许可。该疫苗已在日本年轻女性中证明对高级别宫颈病变具有有效性，但其对浸润性宫颈癌（ICC）的影响的证据尚缺乏。本研究使用两个不同的癌症登记册的数据，通过泊松回归分析比较了近期不同年龄组新发ICC病例的趋势。我们还分析了过去十年中1414名年龄<40岁的日本女性被新诊断为ICC的人中，HPV16/18感染率的时间趋势。根据基于人口的癌症登记册，年轻女性（20-29岁）ICC的发病率在2016-2019年期间从每10万女性年3.6下降到2.8，显示出显著下降，但其他年龄组没有类似下降的趋势（p<0.01）。类似地，根据日本妇产科学会妇科癌症登记册的数据，20-29岁女性的年度ICC病例数也在2011-2020年期间从256个减少到135个（p<0.0001）。此外，在2017-2022年期间只有20-29岁女性ICC中的HPV16/18感染率呈下降趋势（90.5%-64.7%，p=0.05；Cochran-Armitage趋势检验）。这是首次提出了HPV疫苗在日本对ICC的人群层面效应。尽管年轻女性ICC中HPV16/18感染率的下降趋势支持了疫苗接种与癌症登记结果之间的因果关联，但仍需要进一步研究来确认我们的发现是否可以归因于接种疫苗。© 2023 The Authors. 《癌症科学》由澳大利亚约翰威利有限公司代表日本癌症协会出版。
The first prophylactic vaccine against human papillomavirus (HPV) 16 and HPV18 was licensed in Japan in 2009. HPV vaccine effectiveness against high-grade cervical lesions has been demonstrated among young Japanese women, but evidence of its effects on invasive cervical cancer (ICC) is lacking. Using data from two different cancer registries, we compared recent trends of new ICC cases by age group using Poisson regression analysis. We also analyzed time trends in HPV16/18 prevalence among 1414 Japanese women aged <40 years newly diagnosed with ICC in the past decade. Based on the population-based cancer registry, the incidence of ICC among young women aged 20-29 years showed a significant decline from 3.6 to 2.8 per 100 000 women-years during 2016-2019, but no similar decline was observed for older age groups (p < 0.01). Similarly, using data from the gynecological cancer registry of the Japan Society of Obstetrics and Gynecology, the annual number of ICCs among women aged 20-29 years also decreased from 256 cases to 135 cases during 2011-2020 (p < 0.0001). Furthermore, a declining trend in HPV16/18 prevalence in ICC was observed only among women aged 20-29 years during 2017-2022 (90.5%-64.7%, p = 0.05; Cochran-Armitage trend test). This is the first report to suggest population-level effects of HPV vaccination on ICC in Japan. Although the declining trend in HPV16/18 prevalence among young women with ICC supports a causal linkage between vaccination and results from cancer registries, further studies are warranted to confirm that our findings are attributable to vaccination.© 2023 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.