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Ecological Association of Human Papillomavirus Vaccination with Cervical Dysplasia Prevalence in the United States, 2007-2014.

Ecological Association of Human Papillomavirus Vaccination with Cervical Dysplasia Prevalence in the United States, 2007-2014.
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Flagg EW, Torrone EA, Weinstock H,


Flagg EW, Torrone EA, Weinstock H, (click to view)

Flagg EW, Torrone EA, Weinstock H,

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American journal of public health 2016 Oct 13() e1-e8

Abstract
OBJECTIVES
To examine prevalence of low- and high-grade cervical lesions over time in a large cohort of US female adolescents and women.

METHODS
We used health care claims data from 9 million privately insured female patients aged 15 to 39 years to estimate annual prevalence of cytologically detected cervical low-grade (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and high-grade histologically detected cervical intraepithelial neoplasia grades 2 and 3 (CIN2+) during 2007 through 2014. We restricted analyses to those who received cervical cancer screening in a given calendar year.

RESULTS
Prevalence of HSIL and CIN2+ decreased significantly for those aged 15 to 19 years. Average annual percent change in prevalence in this group during 2007 through 2014 for HSIL and CIN2+ was -8.3% and -14.4%, respectively (P < .001 for both estimates). Prevalence of HSIL and CIN2+ also decreased significantly for women aged 20 to 24 years. No decreases were seen in women aged 30 to 39 years. CONCLUSIONS
Decreases in high-grade lesions reflected their greater association with human papillomavirus types 16 and 18, compared with low-grade lesions, providing ecological evidence of population effectiveness of human papillomavirus vaccination among young, privately insured women. (Am J Public Health. Published online ahead of print October 13, 2016: e1-e8. doi:10.2105/AJPH.2016.303472).

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