2021年 · 第101卷第24期

At present, the coverage of immunization programs for human papillomavirus (HPV) vaccines for girls of school age in most countries around the world is still far below the 90% threshold recommended in the global cervical cancer elimination strategy. In order to promote the implementation of HPV vaccination programs in various regions, the study estimated the expected incidence of cervical cancer among women born between 2005 and 2014 without HPV vaccination based on data released by GLOBOCAN 2018 and the United Nations, and quantitatively evaluated the impact of HPV vaccine on improving the global burden of cervical cancer disease. By 2094, 11.6 million cervical cancer patients are expected to occur worldwide among women born in the 2005-2014 cohort. Africa and Asia have the highest burden of disease with approximately 10.13 million (87.4%) cases of cervical cancer, followed by Latin America with approximately 870,000 (7.4%) cases. North America, Europe and Oceania are expected to be 600,000 cases (5.2%). Countries with a high burden of cervical cancer disease at present also have a higher expected incidence of cervical cancer among women born in the cohort from 2005 to 2014. The burden of cervical cancer disease in this population also increased with the decrease of the national human development index (HDI). The expected burden of cervical cancer disease in low-medium HDI countries (8 million) is almost 10 times that in very high HDI countries (800,000). Nearly 8.7 million cases of cervical cancer can be prevented if HPV vaccination (for HPV16 and 18, with partial cross-protection for 31, 33, and 45) is administered to women born in the cohort from 2005 to 2014. This means that about 95% of cases in Africa, Asia and Latin America and about 70% of cases in low-medium HDI countries can be prevented by vaccination. This study data highlights the health benefits of carrying out HPV vaccine immunization programs and helps to improve the vaccine hesitancy in advancing HPV vaccination and improving coverage at this stage.

In 2020, the World Health Assembly approved the Global Strategy for Accelerating the Elimination of Cervical Cancer formulated by WHO, and China said it would fully support the strategy. By integrating China's current medical and health resources and possible new technologies for cervical cancer prevention and treatment in the future, this study adopted a validated hybrid model of cervical cancer epidemiology, and took all the people living in China from 2015 to 2100 as the research object, and comprehensively evaluated the costs and benefits of cervical cancer screening strategies for routine HPV vaccination of appropriate-age girls (9-14 years old), HPV vaccination of other women (over 15 years old) and women with different immunization histories (unvaccinated, bivalent vaccine and nine-valent vaccine), and selected an optimal path for cervical cancer elimination.

Human papillomavirus (HPV) vaccination is one of the most effective measures to prevent cervical cancer, but public concerns about adverse events of vaccination hinder the promotion and application of HPV vaccine. In June 2016, South Korea included HPV vaccine in the national immunization program, and implemented two doses of bivalent or quadrivalent HPV vaccine among girls aged 12 to 13. To enhance public confidence in HPV vaccines and supplement the safety data of HPV vaccines in Korea, Sungkyunkwan University in Korea conducted a nationwide cohort study using the Immunization Registry Information System and the National Health Information System to assess the association between HPV vaccination and serious adverse events.