HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data

T. J. Palmer (Lead / Corresponding author), M. McFadden, K. G. J. Pollock, K. Kavanagh, K. Cuschieri, M. Cruickshank, S. Nicoll, C. Robertson

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    BACKGROUND: To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign.

    METHODS: A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years.

    RESULTS: There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95% CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95% CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation.

    CONCLUSIONS: HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.

    Original languageEnglish
    Pages (from-to)576-581
    Number of pages6
    JournalBritish Journal of Cancer
    Volume114
    Issue number5
    DOIs
    Publication statusPublished - 1 Mar 2016

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    Observational Studies
    Immunization
    Immunization Programs
    Registries
    Vaccines
    Retrospective Studies
    Health
    Population

    Keywords

    • Case-control studies
    • Early detection of cancer
    • Female
    • Humans
    • Papillomavirus infections
    • Papillomavirus vaccines
    • Retrospective studies
    • Scotland
    • Uterine cervical neoplasms
    • Young adult
    • Journal article
    • Observational study
    • Research support, Non-U.S. Gov't

    Cite this

    Palmer, T. J., McFadden, M., Pollock, K. G. J., Kavanagh, K., Cuschieri, K., Cruickshank, M., ... Robertson, C. (2016). HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data. British Journal of Cancer, 114(5), 576-581. https://doi.org/10.1038/bjc.2015.473
    Palmer, T. J. ; McFadden, M. ; Pollock, K. G. J. ; Kavanagh, K. ; Cuschieri, K. ; Cruickshank, M. ; Nicoll, S. ; Robertson, C. / HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data. In: British Journal of Cancer. 2016 ; Vol. 114, No. 5. pp. 576-581.
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    abstract = "BACKGROUND: To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign.METHODS: A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years.RESULTS: There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95{\%} CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95{\%} CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation.CONCLUSIONS: HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.",
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    Palmer, TJ, McFadden, M, Pollock, KGJ, Kavanagh, K, Cuschieri, K, Cruickshank, M, Nicoll, S & Robertson, C 2016, 'HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data', British Journal of Cancer, vol. 114, no. 5, pp. 576-581. https://doi.org/10.1038/bjc.2015.473

    HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data. / Palmer, T. J. (Lead / Corresponding author); McFadden, M.; Pollock, K. G. J.; Kavanagh, K.; Cuschieri, K.; Cruickshank, M.; Nicoll, S.; Robertson, C.

    In: British Journal of Cancer, Vol. 114, No. 5, 01.03.2016, p. 576-581.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data

    AU - Palmer, T. J.

    AU - McFadden, M.

    AU - Pollock, K. G. J.

    AU - Kavanagh, K.

    AU - Cuschieri, K.

    AU - Cruickshank, M.

    AU - Nicoll, S.

    AU - Robertson, C.

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    Y1 - 2016/3/1

    N2 - BACKGROUND: To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign.METHODS: A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years.RESULTS: There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95% CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95% CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation.CONCLUSIONS: HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.

    AB - BACKGROUND: To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign.METHODS: A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years.RESULTS: There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95% CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95% CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation.CONCLUSIONS: HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.

    KW - Case-control studies

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    KW - Female

    KW - Humans

    KW - Papillomavirus infections

    KW - Papillomavirus vaccines

    KW - Retrospective studies

    KW - Scotland

    KW - Uterine cervical neoplasms

    KW - Young adult

    KW - Journal article

    KW - Observational study

    KW - Research support, Non-U.S. Gov't

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    DO - 10.1038/bjc.2015.473

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    JO - British Journal of Cancer

    JF - British Journal of Cancer

    SN - 0007-0920

    IS - 5

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