HPV vaccine uptake among overweight and obese US adolescents: An analysis of the National Health and Nutrition Examination Survey (NHANES) 2009-2014

Dietary Vitamin K Intake and HPV-Infection Status Among American Women: A Secondary Analysis From National Health and Nutrition Examination Survey Data From 2003 to 2016

Objective: Cervical cancer is a serious potential risk to women’s health, and is closely related to persistent HPV infection. Vitamin K mainly existed in green vegetables, fruit, and dairy products. This research aims to observe the association between vitamin K and HPV-infection.

Methods: 13,447 participants from the NHANES were selected. Dietary vitamin K intake was used as the objective independent variable and continuous variable, HPV-infection status was used as the outcome variable, and characteristics of selected participants were used as the covariates.

Results: There was a nonlinearity between vitamin K intake and HPV-infection, and the inflection point is 3.81 of log2 vitamin K intake. In a range of 0–3.81, Each one-unit increase in log2 vitamin K intake was associated with a 43% reduction in the risk of HPV infection. When log2 vitamin K intake excess of 3.81, the risk of HPV infection did not continue to decline. The HPV-subtype was not associated with vitamin K intake.

Conclusion: There is a nonlinearity between vitamin K intake and HPV-infection status. But HPV-subtype was not associated with vitamin K intake.

HPV Vaccination and the Risk of Invasive Cervical Cancer

BACKGROUND

The efficacy and effectiveness of the quadrivalent human papillomavirus (HPV) vaccine in preventing high-grade cervical lesions have been shown. However, data to inform the relationship between quadrivalent HPV vaccination and the subsequent risk of invasive cervical cancer are lacking.

METHODS

We used nationwide Swedish demographic and health registers to follow an open population of 1,672,983 girls and women who were 10 to 30 years of age from 2006 through 2017. We assessed the association between HPV vaccination and the risk of invasive cervical cancer, controlling for age at follow-up, calendar year, county of residence, and parental characteristics, including education, household income, mother's country of birth, and maternal disease history.

RESULTS

During the study period, we evaluated girls and women for cervical cancer until their 31st birthday. Cervical cancer was diagnosed in 19 women who had received the quadrivalent HPV vaccine and in 538 women who had not received the vaccine. The cumulative incidence of cervical cancer was 47 cases per 100,000 persons among women who had been vaccinated and 94 cases per 100,000 persons among those who had not been vaccinated. After adjustment for age at follow-up, the incidence rate ratio for the comparison of the vaccinated population with the unvaccinated population was 0.51 (95% confidence interval [CI], 0.32 to 0.82). After additional adjustment for other covariates, the incidence rate ratio was 0.37 (95% CI, 0.21 to 0.57). After adjustment for all covariates, the incidence rate ratio was 0.12 (95% CI, 0.00 to 0.34) among women who had been vaccinated before the age of 17 years and 0.47 (95% CI, 0.27 to 0.75) among women who had been vaccinated at the age of 17 to 30 years.

CONCLUSIONS

Among Swedish girls and women 10 to 30 years old, quadrivalent HPV vaccination was associated with a substantially reduced risk of invasive cervical cancer at the population level. (Funded by the Swedish Foundation for Strategic Research and others.).

Dietary Calcium Intake and HPV Infection Status Among American Women: A Secondary Analysis from National Health and Nutrition Examination Survey (NHANES) Data Set of 2003 - 2016

Background

The evidence on the link of dietary calcium (DCa) to human papillomavirus (HPV) infection is limited. Thus, this research was conducted to explore whether DCa is independently associated with HPV infection status in American women with age of 18 to 59 years old.

Material/Methods

We performed a secondary analysis from the National Health and Nutrition Examination Survey (NHANES) data set including 7 cycles from 2003 to 2016. A total of 13 475 selected participants were used for data analysis. The interested independent and the outcome variable were DCa and HPV infection status (HPV infection; HPV subtype). Sociodemographic, dietary, laboratory, questionnaire, and physical examination data were covariates. Weighted binary logistic regression and generalized additive model (GAM) were used for the investigation of both linear and non-linear relationships between DCa and HPV infection status.

Results

Weighted multivariable binary logistic regression indicated DCa was not associated with HPV infection and subtype (OR: 0.93; 95% CI: 0.82–1.05 for HPV infection; OR: 1.09; 95% CI: 0.93–1.28 for HPV subtype). For HPV infection, a non-linear correlation was detected, whose inflection points were 9.78 of log2 DCa. The OR values and the confidence intervals on both sides of inflection point were 0.83 (95% CI: 0.70–0.98) and 1.18 (95% CI: 0.91–1.52), respectively.

Conclusions

At the range of 3.32–9.78 of log2 calcium intake, DCa intake was negatively correlated with HPV infection. After this interval, DCa intake was not associated with the risk of HPV infection.

Obesity and Disparities in Human Papillomavirus Vaccination for U.S. Adolescent Girls and Young Women

BACKGROUND

Obesity is recognized as a barrier to receiving women's preventive health services, including cervical and breast cancer screening. Little is known about whether obesity is associated with a lower incidence of human papillomavirus (HPV) vaccination, another important preventive care service for adolescent girls and young women. The objective of this study was to determine if adolescent girls and young women with obesity are less likely to receive HPV vaccination compared with individuals with normal weight.

METHODS

We examined whether HPV vaccination was associated with obesity status in women aged 9-30 years surveyed from 2009 to 2016 by the U.S. National Health and Nutrition Examination Survey. Results from logistic and linear regression models were adjusted for age, race, income, insurance status, self-reported health, and health care use, accounting for the weighted survey design.

RESULTS

The final cohort included 5,517 women. Overall, 32.9% of participants reported vaccination, with a mean age at vaccination of 15.8 years. Adolescent girls and young women with obesity were less likely to report vaccination; the adjusted odds ratio of vaccination was 0.79 (p = .01) compared with normal weight women. Among those vaccinated, the age at vaccination was significantly older for women with obesity, 16.3 years compared with 15.2 years (p = .002), but there was no difference in the completion of the vaccination series rate by obesity.

CONCLUSIONS

Adolescent girls and young women with obesity were less likely to report HPV vaccination and, if they were vaccinated, received the vaccination at a later age.