Associations between prior HPV4 vaccine doses and cervical cancer screening participation

Publication date: June 2016
Source:Cancer Epidemiology, Volume 42
Author(s): Stephanie D. Boone, Christina M. Pinkston, Kathy B. Baumgartner, Richard N. Baumgartner, Sean M. Harper, Aaron J. Bonham, Christopher A. Paynter, Diane M. Harper
BackgroundCervical cancer screening, regardless of HPV vaccination, is a cornerstone of cancer prevention. This study evaluated associations between prior HPV vaccine doses and initiation and continued participation of screening by age at vaccination.MethodsUsing electronic medical records for a safety net healthcare system (Truman Medical Center), women aged 14–26y vaccinated (n=1123) between 07/01/2006 and 10/1/2009 were randomly selected and matched on birth year and health campus to unvaccinated (n=1123) women. Frequency of screening was determined through 07/01/2013. Hazard ratios (HR) for screening were estimated using Cox proportional hazards regression.ResultsScreening rates were higher after vaccination: unvaccinated (53%), first (62%), second (59%) or third (61%) doses. Women who initiated screening were less likely to complete the vaccine series, regardless of age. Women receiving one dose were more likely than unvaccinated women to initiate screening (HR=2.98 95% Confidence Interval (CI):2.45–3.61) and were more likely to screen than those receiving two (1 vs. 2, HR=2.94 95% CI:2.09–4.14) or three doses (1 vs. 3, HR=3.15 95% CI:2.21–4.48). Compared to unvaccinated women, women <21y who completed 3-doses were 1.8-times more likely to screen at ≥21y, whereas vaccinated women ≥21y were more likely to screen regardless of number of doses (p<0.0001).ConclusionsWomen who were vaccinated were more likely to screen than unvaccinated women; screening rate was highest after and occurred closest to the first vaccine dose. Research evaluating the efficacy of a one-dose vaccine is warranted and may provide both higher vaccination and screening rates.



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