J Gynecol Oncol.  2020 Jan;31(1):e4. 10.3802/jgo.2020.31.e4.

Status of HPV vaccination among HPV-infected women aged 20–60 years with abnormal cervical cytology in South Korea: a multicenter, retrospective study

Affiliations
  • 1Division of Viral Diseases Research, Center for Infectious Diseases Research, Korea National Institute of Health, Cheongju, Korea
  • 2Center for Infectious Diseases Research, Korea National Institute of Health, Cheongju, Korea
  • 3Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Daegu, Korea
  • 4Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea
  • 5Department of Pathology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
  • 6Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, University College of Medicine, Busan, Korea
  • 7Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
  • 8Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
  • 9Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University, Seoul, Korea

Abstract


Objectives
Since 2007, human papillomavirus (HPV) vaccines have been administered for the prevention of cervical cancer in Korea. We investigated the status of HPV vaccination among HPV-infected adult women with abnormal cervical cytology before the introduction of National Immunization Program.
Methods
From 2010 to 2016, HPV-positive women (age, 20–60 years) with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion (LSIL) were enrolled from five hospitals across Korea. Their HPV genotype, epidemiologic, and clinical data, including HPV vaccination history, were obtained. We compared the epidemiological characteristics and prevalence of HPV-16/18 genotypes between vaccinated and unvaccinated women.
Results
Among the 1,300 women, approximately 26% had a history of vaccination. Vaccinated patients were significantly younger, unmarried, and had a higher education level than unvaccinated women. For HPV-vaccinated individuals by vaccine dose, there was a significant younger age at vaccination initiation (p=0.025), longer duration from HPV vaccination to Pap test date (p=0.001), and lower proportion of HPV-16/18 (p=0.028) in the women with three doses. There was a significantly lower prevalence of HPV-16/18 genotypes in women who were vaccinated at least 12 months prior than in unvaccinated women (adjusted prevalence ratio [aPR]=0.51; 95% confidence interval [CI]=0.29–0.88). For women with LSIL, the prevalence of the HPV-16/18 genotypes was significantly lower in women who were vaccinated more than 12 months prior than in unvaccinated women (aPR=0.35; 95% CI=0.13–0.96).
Conclusion
This study highlighted the status of HPV vaccination and the prevalence of HPV-16/18 genotypes among HPV-infected women with abnormal cervical cytology according to HPV vaccination. It provides preliminary information regarding the status of HPV vaccination among Korean adult women.

Keyword

HPV; Vaccination; Adult; Korea; Genotype
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