Declines in Human Papillomavirus (HPV)-Associated High-Grade Cervical Lesions After Introduction of HPV Vaccines in Connecticut, United States, 2008-2015.

摘要: Background Trends in human papillomavirus (HPV)-associated cervical lesions can provide an indication of vaccine impact. Our purpose was to measure trends during 2008-2015 and consider possible explanations including vaccination coverage, changes screening for cancer, risk behaviors acquiring HPV. Methods Connecticut (CT) implemented mandatory reporting intraepithelial neoplasia grades 2/3 adenocarcinoma situ (cervical grade 2 or higher [CIN2+]) 2008. by age birth cohort were modeled using negative binomial regression change-point methods. To evaluate changes, these compared HPV cancer screening, antecedent event detection a high-grade lesion, sexual Chlamydia trachomatis, infection with similar epidemiology shared factors Results A significant decline CIN2+ first evident among women aged 21 years 2010, followed successive declines 22-26 2011-2012. During 2008-2015, the rates declined 30%-74% 21-26 years, greater observed younger women. Birth cohorts between 1985 1994 all experienced surveillance period, ranging from 25% 82%. Ecological comparisons revealed substantial increases this time more modest reductions behaviors. Conclusions The patterns our data suggest that are likely driven vaccination, introduced 2006, than behavior.