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- Title
Trends in High-grade Cervical Lesions and Cervical Cancer Screening in 5 States, 2008–2015.
- Authors
Gargano, Julia Warner; Park, Ina U; Griffin, Marie R; Niccolai, Linda M; Powell, Melissa; Bennett, Nancy M; Jones, Michelle L Johnson; Whitney, Erin; Pemmaraju, Manideepthi; Brackney, Monica; Abdullah, Nasreen; Scahill, Mary; Dahl, Rebecca M; Cleveland, Angela A; Unger, Elizabeth R; Markowitz, Lauri E
- Abstract
Background We describe changes in rates of cervical intraepithelial neoplasia grades 2, 3 and adenocarcinoma in situ (CIN2+) during a period of human papillomavirus (HPV) vaccine uptake and changing cervical cancer screening recommendations. Methods We conducted population-based laboratory surveillance for CIN2+ in catchment areas in 5 states, 2008–2015. We calculated age-specific CIN2+ rates per 100000 women by age groups. We estimated incidence rate ratios (IRR) of CIN2+ for 2-year periods among all women and among screened women to evaluate changes over time. Results A total of 16572 CIN2+ cases were reported. Among women aged 18–20 and 21–24 years, CIN2+ rates declined in all sites, whereas in women aged 25–29, 30–34, and 35–39 years, trends differed across sites. The percent of women screened annually declined in all sites and age groups. Compared to 2008–2009, rates among screened women were significantly lower for all 3 periods in women aged 18–20 years (2010–2011: IRR 0.82, 95% confidence interval [CI] 0.67–0.99; 2012–2013: IRR 0.63, 95% CI 0.47–0.85; 2014–2015: IRR 0.44, 95% CI 0.28–0.68) and lower for the latter 2 time periods in women aged 21–24 years (2012–2013: IRR 0.86, 95% CI 0.79–0.94; 2014–2015: IRR 0.61, 95% CI 0.55–0.67). Conclusions From 2008–2015, both CIN2+ rates and cervical cancer screening declined in women aged 18–24 years. The significant decreases in CIN2+ rates among screened women aged 18–24 years are consistent with a population-level impact of HPV vaccination.
- Subjects
CONFIDENCE intervals; PAPILLOMAVIRUSES; PUBLIC health surveillance; WOMEN; CERVIX uteri tumors; EARLY detection of cancer; TUMOR grading
- Publication
Clinical Infectious Diseases, 2019, Vol 68, Issue 8, p1282
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciy707