Thomas Wright (United States of America)

Columbia University Pathology

Presenter of 2 Presentations

 Conference Calendar
Oral Session 4: Triage Approaches for HPV-Positive Women Hall C

CUMULATIVE INCIDENCE RATES OF CERVICAL NEOPLASIA STRATIFIED BY EXTENDED GENOTYPING DURING THE THREE-YEAR LONGITUDINAL PHASE OF THE ONCLARITY TRIAL (ID 559)

Session Date
07/22/2020
Session Time
08:45 - 10:00
Room
Hall C
Session Type
Clinical Science Oral Session
Session Name
Oral Session 4: Triage Approaches for HPV-Positive Women
Lecture Time
08:45 - 09:00
Presenter
Authors

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Public Health / Epidemiology / Vaccination: Implementation, Evaluation and Impact ePoster

HPV INFECTIONS AND CYTOLOGIC ABNORMALITIES IN VACCINATED WOMEN 21-34 YEARS OF AGE: THREE-YEAR LONGITUDINAL RESULTS OF THE ONCLARITY TRIAL (ID 908)

Session Date
07/21/2020
Session Time
10:00 - 17:00
Room
ePoster
Session Type
Poster Viewing - 20-24 July
Session Name
Public Health / Epidemiology / Vaccination: Implementation, Evaluation and Impact
Lecture Time
10:56 - 10:57
Presenter
Authors

Abstract

Introduction

Human papillomavirus (HPV) vaccination programs have led to reduced HPV infections and high-grade cervical disease in many countries. Comparatively, vaccination rates in the United States (where vaccination is largely opportunistic) are lower and vaccination often occurs at an older age. However, baseline data from the Onclarity trial suggest that “catch-up” vaccination is effective in reducing HPV infection. Here we provide three-year cumulative prevalence values for HPV genotypes and cervical intraepithelial neoplasia grade 2 or worse (≥CIN2) in vaccinated and unvaccinated women enrolled in the trial.

Methods

33,858 subjects, ≥21 years, were screened by cytology and the Onclarity HPV Assay. Those with abnormal results underwent colposcopy/biopsy. Women who had colposcopy and a random selection of others were invited for yearly follow-up for three years. HPV and ≥CIN2 cumulative prevalence values were compared in a subset (N=14,153) of women 21-34 years of age stratified by vaccination status and age group (21-24 yrs, 25-29 yrs, and 30-34 yrs). Mantel-Haenszel analysis was performed to determine the association between vaccination status and prevalence/odds ratio (OR), adjusting for age.

Results

The three-year cumulative prevalences of overall HPV, HPV16, 18, 31, and 33/58 were all lower in vaccinated women across age groups; significant (all p<0.005) lower prevalences were observed with 16 (OR: 0.28), 18 (OR: 0.15), 31 (0.54), and 33/58 (0.67) in vaccinated compared to unvaccinated women (all ages combined). In addition, reduced HPV 16/18-associated ≥CIN2 prevalence was observed in vaccinated women compare to unvaccinated women (OR: 0.38; p<0.001).

Conclusions

Consistent with the baseline results, the three-year follow-up data show that HPV vaccinated women have a lower prevalence of any high-risk HPV, HPV 16, 18, 31, and 33/58; and of HPV 16/18-associated ≥CIN2 compared to unvaccinated women. A lower HPV prevalence in older, vaccinated women suggests that “catch-up” vaccination provides benefit.

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