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Tampakoudis G, Anastasiou OE. Burden of HPV-Related Hospitalization in Germany from 2000 to 2021. Viruses 2023; 15:1857. [PMID: 37766265 PMCID: PMC10538031 DOI: 10.3390/v15091857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
HPV has been linked to the development of precancerous and cancerous lesions. The aim of this study was to evaluate the burden of HPV-related hospitalization in Germany from 2000 to 2021 and the potential impact of the COVID-19 pandemic on it. METHODS We performed a retrospective query using data from the German Statistical Office from 2000 to 2021, including hospital admission, inpatient mortality and hospital stay length data on cervical cancer/dysplasia, female genitourinary tract, anal, penile, head and neck cancers. RESULTS The HPV-attributable hospitalization rate per 100,000 inhabitants in Germany has decreased over time, from 89 cases in 2000 to 60 in 2021, with an average annual percent change (AAPC) of -1.93 (CI -2.08--1.79, p < 0.05). The same trend was observed for the average hospital stay, which declined from 9 to 7 days, with an AAPC of -1.33 (CI -1.52--1.21, p < 0.05). An undulating but overall slightly declining pattern was observed for the inpatient mortality (AAPC -0.92, CI -1.21--0.64, p < 0.05). We observed a reduction in the hospitalization rates for invasive and non-invasive cervical cancer, which was observed in almost all age groups and in all German federal states. CONCLUSION Our study provides a comprehensive analysis of the trends in HPV-related hospitalizations over the past two decades. The decline in hospitalization rates for cervical cancer and dysplasia suggests the potential efficacy of the HPV vaccination and screening programs.
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Affiliation(s)
- Georgios Tampakoudis
- Maternal-Fetal Medicine and Obstetrics Saint Luke’s Hospital, 55236 Thessaloniki, Greece;
- First Department of Obstetrics and Gynaecology Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Olympia E. Anastasiou
- Institute for Virology, Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
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Di Martino G, Cedrone F, Di Giovanni P, Tognaccini L, Trebbi E, Romano F, Staniscia T. The Burden of HPV-Related Hospitalizations: Analysis of Hospital Discharge Records from the Years 2015-2021 from a Southern Italian Region. Pathogens 2023; 12:pathogens12050725. [PMID: 37242395 DOI: 10.3390/pathogens12050725] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: The human papillomavirus (HPV) is the most common agent related to sexually transmitted infections in the general population. Its genotypes are classified into two main classes, high-risk genotypes and low-risk genotypes, according to their capacity to induce cancers. The low-risk class (types 6 and 11) is associated with anogenital and genital lesions. The high-risk class is responsible for up to 4.5% of all new cancer cases yearly. The aim of this study was to evaluate the incidence of HPV-related hospitalizations and its trend in a southern Italian region for the years 2015-2021. (2) Methods: This was a retrospective study performed in the Abruzzo region, Italy. All admissions for the period 2015-2021 were extracted from the hospital discharge record (HDR). (3) Results: During the study period (2015-2021), a total of 5492 hospitalizations attributable to HPV infection occurred in the Abruzzo region, Italy. A significant number of admissions were related to cervical cancer (3386 cases) and genital warts (638 cases). The trend declined for all diagnoses except for penile cancer admissions. Considering the first year of the pandemic (year 2020), a decrease in the standardized incidence of the majority of the diseases considered was reported, particularly among cases of cervical cancer. (4) Conclusions: HPV-related hospitalizations decreased in Abruzzo during study period. These results could be useful to LHAs and policy-makers in improving vaccination coverage and screening adherence.
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Affiliation(s)
- Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy
| | - Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy
| | - Pamela Di Giovanni
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Livia Tognaccini
- School of Public Health, "La Sapienza" University of Rome, 00100 Rome, Italy
| | - Edoardo Trebbi
- School of Public Health, "La Sapienza" University of Rome, 00100 Rome, Italy
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, "La Sapienza" University of Rome, 00100 Rome, Italy
| | - Tommaso Staniscia
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
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3
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Viottini E, Albanesi B, Casabona E, Onorati R, Campagna S, Borraccino A. Ten-Year Trend in Emergency Department Visits for Sexually Transmitted Infections among Adolescents: A Retrospective Cross-Sectional Study in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14207. [PMID: 36361087 PMCID: PMC9656796 DOI: 10.3390/ijerph192114207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Sexually transmitted infections (STIs) are frequently underdiagnosed, representing a serious public health concern, especially during adolescence and in more vulnerable communities. AIM to describe the last ten years of emergency department (ED) visits for STIs among adolescents. METHODS a retrospective cross-sectional observation was carried out in the Piedmont region in Italy. Data were retrieved through the Italian National Information System database. ED visits related to specific ICD-9-CM codes carried out on 11 to 19-year-old youths between 2011 and 2020 were investigated. Age-specific, crude, and standardized rates and admission ratios, with 95% confidence intervals (CIs), were calculated to estimate the STI trend. RESULTS from a total of 1,219,075 ED visits, 339 were related to STIs, representing an increasing ratio of 28 per 100,000 visits, primarily in females. Most infections occurred in girls (83.5%) and among 17 to 19-year-olds (71.5%). A drop in both ED visits and STI cases was observed in 2020. Genital Herpes and Genital Warts were more frequent in girls while Gonorrhea was more frequent in boys. CONCLUSIONS the increasing trend of ED visits for STIs, particularly in girls, represents an emerging relevant public health issue that needs to be urgently tackled.
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Affiliation(s)
- Elena Viottini
- Department of Public Health and Paediatrics, University of Torino, 10126 Torino, Italy
| | - Beatrice Albanesi
- Department of Public Health and Paediatrics, University of Torino, 10126 Torino, Italy
| | - Elena Casabona
- Department of Public Health and Paediatrics, University of Torino, 10126 Torino, Italy
| | - Roberta Onorati
- Epidemiology Unit, Local Health Unit TO3, 10095 Grugliasco, Italy
| | - Sara Campagna
- Department of Public Health and Paediatrics, University of Torino, 10126 Torino, Italy
| | - Alberto Borraccino
- Department of Public Health and Paediatrics, University of Torino, 10126 Torino, Italy
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Restivo V, Costantino C, Amato L, Candiloro S, Casuccio A, Maranto M, Marrella A, Palmeri S, Pizzo S, Vitale F, Amodio E. Evaluation of the Burden of HPV-Related Hospitalizations as a Useful Tool to Increase Awareness: 2007-2017 Data from the Sicilian Hospital Discharge Records. Vaccines (Basel) 2020; 8:vaccines8010047. [PMID: 31991909 PMCID: PMC7157634 DOI: 10.3390/vaccines8010047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/15/2020] [Accepted: 01/22/2020] [Indexed: 12/29/2022] Open
Abstract
In light of the implementation of human papillomavirus (HPV) prevention strategies, epidemiological studies in different geographical areas are required in order to assess the impact of HPV-related diseases. The purpose of the present study was to describe the burden of HPV-related hospitalizations in Sicily. A retrospective observational study estimated 43,531 hospitalizations attributable to HPV from 2007 to 2017. During the observed period, there was a decrease for all HPV-related conditions with a higher reduction, among neoplasms, for cervical cancer (annual percent change (APC) = −9.9%, p < 0.001). The median age for cervical cancer was 45 years old, with an increasing value from 43 to 47 years (p < 0.001). The age classes with greater decreases in hospital admissions for invasive cancers were women aged 35 years or more (APC range from −5.5 to −9.86) and 25–34 years old (APC = −11.87, p < 0.001) for women with cervical carcinoma in situ. After ten years for vaccine introduction and sixteen years for cervical cancer screening availability, a relatively large decrease in hospital admissions for cervical cancer and other HPV-related diseases in Sicily was observed. Some clinical characteristics of hospitalization, such as increasing age, are suggestive clues for the impact of preventive strategies, but further research is needed to confirm this relationship.
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Kuhdari P, Previato S, Giordani M, Biavati P, Ferretti S, Gabutti G. The burden of HPV-related diseases in Italy, 2001-12. J Public Health (Oxf) 2019; 39:730-737. [PMID: 28334854 DOI: 10.1093/pubmed/fdx025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Indexed: 01/18/2023] Open
Abstract
Background Human papillomavirus (HPV) infection is the main cause of cervical cancer and plays a relevant role in the development of genital warts and of the cancer of penis and anus, head/neck, oropharynx and genitourinary system. The aim of this study is the evaluation of hospitalizations due to HPV-related pathologies in 2001-12 in Italy. Methods The national hospital discharge forms were provided by the Ministry of Health. The HPV-related hospitalizations were identified using specific diagnostic codes, accordingly to the ICD-9-CM coding system. The proportion of hospitalizations of potentially HPV-related pathologies, obtained from the literature, was evaluated as well as the hospitalization rates (hr) and their trend over time. Results Uterine cervical cancer and CIN III accounted for 40% of hospitalizations (hr: 15.6/100 000 and 17.6/100 000, respectively). Head/neck and oropharynx pathologies accounted for 24.5% of cases (hr: 16/100 000 and 3.9/100 000, in males and females, respectively), followed by genital warts (17.3% of hospitalizations; hr: 7.5/100 000 in males and 8.52/100 000 in females), anal (8.1% of hospitalizations), genitourinary (7.7%) and penis cancers (2.2%). Conclusions The study, even if limited to the evaluation of hospitalizations, points out how HPV-related pathologies continue to be a relevant public health issue in Italy with a high impact on population.
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Affiliation(s)
- P Kuhdari
- Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - S Previato
- Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - M Giordani
- Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - P Biavati
- Azienda USL Bologna, Registro Tumori Area Vasta Emilia Centrale, 40124 Bologna, Italy
| | - S Ferretti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy.,Azienda USL Ferrara, Registro Tumori Area Vasta Emilia Centrale, 44121 Ferrara, Italy
| | - G Gabutti
- Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy.,Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
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Mennini FS, Fabiano G, Marcellusi A, Sciattella P, Saia M, Cocchio S, Baldo V. Burden of Disease of Human Papillomavirus (HPV): Hospitalizations in the Marche and Veneto Regions. An observational study. Clin Drug Investig 2018; 38:173-180. [PMID: 29081028 DOI: 10.1007/s40261-017-0597-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES HPV (human papillomavirus) is the virus most often responsible for sexually transmitted infections. The burden of HPV-related diseases on hospital resources represents a major public health problem. The aim of this study was to assess the economic burden of HPV-related diseases (anal cancer, genital cancer, genital warts, oropharyngeal cancer) on hospital resources in two Italian regions. METHODS A retrospective, non-randomized, observational study was developed in the Marche and Veneto Regions, based on patients receiving hospitalization between 2008 and 2011. All hospitalizations were identified through administrative archives, according to the International Classification of Diseases (ICD-9 CM) to which a defined tariff was assigned. RESULTS We identified 5299 hospitalized patients in Veneto and 1735 in the Marche Region. The mean annual hospitalization rate was 49.44 per 100,000 individuals in Veneto and 48.41 in Marche. The total mean annual cost attributable to HPV-related diseases was €5.78 (SD 0.80) million in Veneto and €2.24 (SD 0.17) million in Marche. Costs associated with genital cancer amounted to €1.61 million in Veneto and €1.06 million in Marche (28% and 47% of the total mean annual cost, respectively). Oropharyngeal cancer accounted for 36% in Veneto (€2.08 million) and 28% in Marche (€632,645). Hospitalization costs related to anal cancer were €882,567 in Veneto and €377,719 in Marche; genital warts accounted for €1.19 million in Veneto and €171,406 in Marche. Finally, the mean cost per patient was €4364 in Veneto and €5176 in Marche. CONCLUSIONS The present work estimated the cost of HPV-related diseases for hospitalized patients in two Italian regions. The considerable estimated annual economic burden is a powerful driver for the governance of the public health sector.
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Affiliation(s)
- Francesco Saverio Mennini
- Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome 'Tor Vergata', Via Columbia, 2, Roma, RM, Italy.,Institute of Leadership and Management in Health, Kingston University, London, UK
| | - Gianluca Fabiano
- Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome 'Tor Vergata', Via Columbia, 2, Roma, RM, Italy.,Institute of Leadership and Management in Health, Kingston University, London, UK
| | - Andrea Marcellusi
- Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome 'Tor Vergata', Via Columbia, 2, Roma, RM, Italy. .,Institute of Leadership and Management in Health, Kingston University, London, UK. .,Consiglio Nazionale delle Ricerche (CNR), Istituto di Richerche sulla Popolazione e le Politiche Sociali (IRPPS), Rome, Italy.
| | - Paolo Sciattella
- Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome 'Tor Vergata', Via Columbia, 2, Roma, RM, Italy
| | - Mario Saia
- Net, Veneto Region Health Directorate, Venezia, Italy
| | - Silvia Cocchio
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, Institute of Hygiene, University of Padua, Via Loredan, 18, 35121, Padova, Italy
| | - Vincenzo Baldo
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, Institute of Hygiene, University of Padua, Via Loredan, 18, 35121, Padova, Italy
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Cocchio S, Baldovin T, Bertoncello C, Buja A, Furlan P, Saia M, Baldo V. Decline in hospitalization for genital warts in the Veneto region after an HPV vaccination program: an observational study. BMC Infect Dis 2017; 17:249. [PMID: 28381294 PMCID: PMC5382454 DOI: 10.1186/s12879-017-2361-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. This observational study was conducted to estimate the trend of hospitalization for genital warts (GWs) in the Veneto region (Italy) from 2004 to 2015. METHODS All patients with GWs were identified in the hospital discharge records of all public and accredited private hospitals that related to Veneto residents and contained the ICD9-CM code 078.11 associated with a genital surgical procedure (vulval/vaginal warts, penile warts and anal warts). Annual total and sex- and age-specific hospitalization rates and trends were calculated and correlated with the different HPV vaccine coverage over the study period. RESULTS An annual rate of 11.8 per 100,000 population (8.6 per 100,000 males, and 14.8 per 100,000 females) was found, corresponding to 6076 hospitalizations for condyloma (53.3% vulval/vaginal, 35.8% anal, 8.3% penile, and 2.6% both penile or vulval/vaginal and anal). Among females, the rate of overall GWs remained stable to 2007 (19.1 per 100,000), then dropped significantly, reaching a rate of 11.3 per 100,000 in 2015 (average annual percent changes [AAPC]: -6.1%; 95% CI: -8.4; -3.7). For males, the overall rate increased over the study period (from 6.4 per 100,000 in 2004 to 10.8 per 100,000 in 2015; AAPC: 3.8%; 95% CI: 1.2; 6.4). Among the potentially vaccinated females (12- to 20-year-olds) there was a 62.1% decrease in the number of vulval/vaginal warts from the years 2010-2012 to the years 2013-2015 due to an increase in the HPV coverage rate. A similar reduction among males was observed in the same period and the same age group for penile warts (-68.2%). CONCLUSION GWs have an important impact on the health services and data suggest that GW-related hospitalization rates rapidly decline in a population with a high HPV vaccination coverage (about 75%). Further efforts should be made to better clarify the epidemiological picture regarding HPV-related diseases, with particular regard to sexual behavior.
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Affiliation(s)
- Silvia Cocchio
- Institute of Hygiene, Laboratory of Public Health and Population Studies, University of Padua, Via Loredan 18, 35121, Padua, Italy
| | - Tatjana Baldovin
- Institute of Hygiene, Laboratory of Public Health and Population Studies, University of Padua, Via Loredan 18, 35121, Padua, Italy
| | - Chiara Bertoncello
- Institute of Hygiene, Laboratory of Public Health and Population Studies, University of Padua, Via Loredan 18, 35121, Padua, Italy
| | - Alessandra Buja
- Institute of Hygiene, Laboratory of Public Health and Population Studies, University of Padua, Via Loredan 18, 35121, Padua, Italy
| | - Patrizia Furlan
- Institute of Hygiene, Laboratory of Public Health and Population Studies, University of Padua, Via Loredan 18, 35121, Padua, Italy
| | - Mario Saia
- EuroHealth Net, Venice, Veneto Region Health Directorate, Venice, Italy
| | - Vincenzo Baldo
- Institute of Hygiene, Laboratory of Public Health and Population Studies, University of Padua, Via Loredan 18, 35121, Padua, Italy.
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Levi M, Bellini I, Sinisgalli E, Sala A, Indiani L, Bonanni P. The burden of hospitalization due to HPV infections in Tuscany, Central Italy. Public Health 2016; 141:194-197. [PMID: 27932000 DOI: 10.1016/j.puhe.2016.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/20/2016] [Accepted: 09/26/2016] [Indexed: 11/17/2022]
Affiliation(s)
- M Levi
- Department of Health Sciences, University of Florence, Florence, Italy.
| | - I Bellini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - E Sinisgalli
- Department of Health Sciences, University of Florence, Florence, Italy
| | - A Sala
- Department of Health Sciences, University of Florence, Florence, Italy
| | - L Indiani
- Department of Health Sciences, University of Florence, Florence, Italy
| | - P Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
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Mariani L, Vici P, Suligoi B, Checcucci-Lisi G, Drury R. Early direct and indirect impact of quadrivalent HPV (4HPV) vaccine on genital warts: a systematic review. Adv Ther 2015; 32:10-30. [PMID: 25620536 PMCID: PMC4311067 DOI: 10.1007/s12325-015-0178-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Since 2007, many countries have implemented national human papillomavirus (HPV) vaccination programs with the quadrivalent HPV (4HPV) vaccine that has been shown to be efficacious in clinical trials involving 25,000 subjects. Two vaccine serotypes, HPV16 and 18, are responsible for cervical cancer and other HPV-related cancers, but the impact of the 4HPV vaccine on these cancers cannot be seen immediately as there is a considerable lag between infection with HPV and cancer development. The other two serotypes, HPV6 and 11, are responsible for genital warts (GWs), which develop within a few months after infection, making GWs an early clinical endpoint for the assessment of the impact of 4HPV vaccination. METHODS We performed a systematic literature search in PubMed to identify all published studies on 4HPV vaccination, including those that assessed the impact of 4HPV vaccination programs on the incidence of GWs at a population level around the world. RESULTS A total of 354 records were identified in the PubMed search. After screening and obtaining full papers for 56 publications, 16 publications presenting data on the impact or effectiveness of 4HPV vaccination on GWs were identified. These reported data on the impact or effectiveness of 4HPV in six countries [Australia (n = 6), New Zealand (n = 2), United States (n = 3), Denmark (n = 2), Germany (n = 1), and Sweden (n = 2)]. In Australia, no GWs were diagnosed in women aged <21 years who reported being vaccinated. A 92.6% reduction in GWs incidence was reported for all women in this age group, where the vaccine uptake rate (VUR) was 70% for 3 doses. The highest reductions were reported in countries with high VURs, mostly through school-based vaccination programs, although high VURs were obtained with some non-school-based programs. CONCLUSION The results are coherent with the GWs incidence reduction reported in clinical trials and are an early indicator of what can be expected for the long-term clinical impact on vaccine-type HPV-related cancers.
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Affiliation(s)
- Luciano Mariani
- HPV-UNIT, Department of Gynecologic Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Department of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy
| | - Barbara Suligoi
- AIDS Unit, Department of Infectious, Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy
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