Measuring effectiveness of the cervical cancer vaccine in an Australian setting (the VACCINE study)

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• 作者：Elisa J Young (1) (7)
  Sepehr N Tabrizi (1) (7) (8)
  Julia ML Brotherton (2) (9)
  John D Wark (5)
  Jan Pyman (6)
  Marion Saville (2)
  C David Wrede (4)
  Yasmin Jayasinghe (4) (8)
  Jeffrey Tan (4)
  Dorota M Gertig (2) (9)
  Marian Pitts (3)
  Suzanne M Garland (1) (7) (8)
  
• 关键词：Human papillomavirus ; Cervical cancer ; CIN3 ; LCM ; Pap smears
• 刊名：BMC Cancer
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：184 KB
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  46. The pre-publication history for this paper can be accessed here:medcentral.com/1471-2407/13/296/prepub" class="a-plus-plus">http://www.biomedcentral.com/1471-2407/13/296/prepub
  
• 作者单位：Elisa J Young (1) (7)
  Sepehr N Tabrizi (1) (7) (8)
  Julia ML Brotherton (2) (9)
  John D Wark (5)
  Jan Pyman (6)
  Marion Saville (2)
  C David Wrede (4)
  Yasmin Jayasinghe (4) (8)
  Jeffrey Tan (4)
  Dorota M Gertig (2) (9)
  Marian Pitts (3)
  Suzanne M Garland (1) (7) (8)
  
  1. Department of Microbiology and Infectious Diseases, Royal Women’s Hospital, Level 1, Building 404, Bio 21 Institute, 30 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia
  7. Department of Microbiology and Infectious Diseases, Murdoch Childrens Research Institute, Anatomical Pathology, The Royal Women’s Hospital, Level 1, Building 404, Bio 21 Institute, 20 Flemington Road Parkville, Melbourne, VIC, 3052, Australia
  8. Department of Obstetrics and, Gynaecology University of Melbourne, Kragujevac, Australia
  2. VCS Incorporated, 265 Faraday St, Carlton, Melbourne, VIC, 3053, Australia
  9. School of Population and Global Health, University of Melbourne, Melbourne, Australia
  5. Dept of Medicine, Bone and Mineral Medicine, The University of Melbourne and The Royal Melbourne Hospital, Level 4, Clinical Sciences Building, Royal Pde, Parkville, Melbourne, VIC, 3050, Australia
  6. Anatomical Pathology, The Royal Women’s Hospital, 20 Flemington Road Parkville, Kragujevac, Vic, 3052, Australia
  4. Dept of Oncology/Dysplasia RWH, 20 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia
  3. Australian Research Centre for Sex, Health & Society, La Trobe University, Level 1, 215 Franklin Street, Melbourne, VIC, 3000, Australia
  
• ISSN：1471-2407

文摘

Background The quadrivalent human papillomavirus vaccine has been provided in Australia through the National Human Papillomavirus Vaccination Program since April 2007. National registry data demonstrates good coverage of the vaccine, with 73% of school-aged girls having received all three doses. To evaluate the effectiveness of the program, we propose a two-pronged approach. In one (sub study A), the prevalence of the vaccine-targeted human papillomavirus genotypes in a population cohort is being estimated, and will be analysed in relation to vaccination status, cervical cytology screening status, demographic, social, behavioural, medical and clinical factors. In sub study B, the distribution of human papillomavirus genotypes detected in high grade cervical intraepithelial neoplastic lesions from vaccine eligible women is being assessed. Methods/Design Sub Study A involves the recruitment of 1569 women aged 18-5, residing in Victoria, Australia, through Facebook advertising. Women who are sexually active are being asked to provide a self-collected vaginal swab, collected at home and posted into the study centre, where human papillomavirus DNA detection and genotyping is performed. Participants also complete an online questionnaire regarding sexual history, experience with, knowledge of, and attitudes towards human papillomavirus, the human papillomavirus vaccine, and cervical screening. Sub Study B will involve the collection of 500 cervical biopsies, positively identified as containing high grade cervical intraepithelial neoplastic lesions and/or adenocarcinoma in situ. Five serial sections are being taken from each case: sections 1 and 5 are being assessed to confirm the presence of the high grade cervical intraepithelial neoplastic lesions or adenocarcinoma in situ; human papillomavirus genotyping is performed on sections 2 and 3; single lesions are excised from section 4 using laser capture microdissection to specifically define causality of a human papillomavirus genotyping of each specific lesion. Discussion Australia is well placed to gain a clear and early insight into the effectiveness of the human papillomavirus vaccine in reducing the prevalence of human papillomavirus infection in young women, and any subsequent reduction in the prevalence of pre-cancerous cervical lesions, specifically high grade cervical intraepithelial neoplasia lesions, particularly of vaccine related types. The findings of a successful population based human papillomavirus program will have wide-reaching translational benefits across the globe.