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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Estimation of the individual residual risk of cervical cancer after vaccination with the nonavalent HPV vaccine

Research output: Contribution to journalJournal articleResearchpeer-review

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  1. Human papillomavirus genotype-specific risks for cervical intraepithelial lesions

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  3. Borderline ovarian tumors in Denmark 1997-2018: Time trends in incidence by histology, age and educational level

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  5. Endometrial cancer risk after fertility treatment: a population-based cohort study

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  • Karl-Ulrich Petry
  • Kaatje Bollaerts
  • Paolo Bonanni
  • Margaret Stanley
  • Rosybel Drury
  • Elmar Joura
  • Susanne K Kjaer
  • Chris J L M Meijer
  • Didier Riethmuller
  • Benoit Soubeyrand
  • Pierre Van Damme
  • Xavier Bosch
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BACKGROUND: The nonavalent HPV (9vHPV) vaccine is indicated for active immunisation of individuals from the age of 9 years against cervical, vulvar, vaginal and anal premalignant lesions and cancers causally related to vaccine HPV high risk types 16, 18, 31, 33, 45, 52 and 58, and to the HPV low risk types 6 and 11, causing genital warts.

OBJECTIVE: To estimate the lifetime risk (up to the age of 75 years) for developing cervical cancer after vaccinating a HPV naïve girl (e.g. 9 to 12 years old) with the 9vHPV vaccine in the hypothetical absence of cervical cancer screening.

METHODS: We built Monte Carlo simulation models using historical pre-screening age-specific cancer incidence data and current mortality data from Denmark, Finland, Norway, Sweden and the UK. Estimates of genotype contribution fractions and vaccine efficacy were used to estimate the residual lifetime risk after vaccination assuming lifelong protection.

RESULTS: We estimated that, in the hypothetical absence of cervical screening and assuming lifelong protection, 9vHPV vaccination reduced the lifetime cervical cancer and mortality risks 7-fold with a residual lifetime cancer risks ranging from 1/572 (UK) to 1/238 (Denmark) and mortality risks ranging from 1/1488 (UK) to 1/851 (Denmark). After decades of repetitive cervical screenings, the lifetime cervical cancer and mortality risks was reduced between 2- and 4-fold depending on the country.

CONCLUSION: Our simulations demonstrate how evidence can be generated to support decision-making by individual healthcare seekers regarding cervical cancer prevention.

Original languageEnglish
JournalHuman vaccines & immunotherapeutics
Volume14
Issue number7
Pages (from-to)1800-1806
Number of pages7
ISSN2164-5515
DOIs
Publication statusPublished - 3 Jul 2018

ID: 56090870