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      Investigating the Efficacy of HPV Vaccines in Preventing Cervical Cancer from 2006 to 2018 in the US: A SEER Data Set Analysis

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          Abstract

          Background

          Human papillomavirus (HPV) is the most common sexually transmitted infection in the US.The first HPV vaccine was introduced in 2006. There are three different HPV vaccines that commonly target high-risk HPV types.

          Objective

          This study compares HPV vaccine efficacy based on alternative endpoints with the most recently available cervical cancer incidence data from the Surveillance, Epidemiology and End Results (SEER) program and SEER*Stat statistical software.

          Methods

          The incidence of cervical cancer, mined from the most recent April 2021 SEER data set, was stratified according to age and racial groups. Trend analysis reporting cervical cancer incidence percentage change (PC) and annual percentage change (APC) was calculated by SEER*Stat statistical software.

          Results

          A total of 46,583 cases of cervical cancer were reported, with an average of about 3,580 incidents of cervical cancer per year, with an overall decrement of about 60 cases over the period of 12 years. The percentage change according to age and race groups varied between -15.9 among 40-44 years old (yo) and +13.8 among 30-34 yo, and from -12 among non-Hispanic White women to +13 among Hispanic women. Statistically significant APC was observed for five of the nine age groups and four of the five racial groups.

          Conclusion

          There seems to be little if any, correlation between cervical cancer incidence and the HPV vaccine program in the US. HPV vaccine efficacy based on alternative endpoints, such as nucleic acid testing and cytological, surgical, and seropositivity endpoints, is fair. Therefore, it is important to emphasize such alternative testing and surrogate endpoints.

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          Most cited references21

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          Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States

          Journal of Clinical Oncology, 29(32), 4294-4301
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            Human papillomavirus and cervical cancer.

            Cervical cancer is the second most common cancer in women worldwide, and knowledge regarding its cause and pathogenesis is expanding rapidly. Persistent infection with one of about 15 genotypes of carcinogenic human papillomavirus (HPV) causes almost all cases. There are four major steps in cervical cancer development: infection of metaplastic epithelium at the cervical transformation zone, viral persistence, progression of persistently infected epithelium to cervical precancer, and invasion through the basement membrane of the epithelium. Infection is extremely common in young women in their first decade of sexual activity. Persistent infections and precancer are established, typically within 5-10 years, from less than 10% of new infections. Invasive cancer arises over many years, even decades, in a minority of women with precancer, with a peak or plateau in risk at about 35-55 years of age. Each genotype of HPV acts as an independent infection, with differing carcinogenic risks linked to evolutionary species. Our understanding has led to improved prevention and clinical management strategies, including improved screening tests and vaccines. The new HPV-oriented model of cervical carcinogenesis should gradually replace older morphological models based only on cytology and histology. If applied wisely, HPV-related technology can minimise the incidence of cervical cancer, and the morbidity and mortality it causes, even in low-resource settings.
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              Screening for Cervical Cancer

              The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening and has declined from 2.8 to 2.3 deaths per 100 000 women from 2000 to 2015.
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                Author and article information

                Journal
                RRCT
                Rev Recent Clin Trials
                Reviews on Recent Clinical Trials
                Rev. Recent Clin. Trials
                Bentham Science Publishers
                1574-8871
                1876-1038
                2023
                : 18
                : 3
                : 214-222
                Affiliations
                [1 ] deptDepartment of Biomedical Laboratory Science, School of Medicine and Health Sciences , The George Washington University , Ashburn, VA, , USA;
                [2 ] Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir , VA, , USA, ;
                [3 ] deptSchool of System’s Biology , George Mason University , Fairfax, , VA, , USA
                Author notes
                [* ]Address correspondence to this author at the Department of Biomedical Laboratory Science, School of Medicine and Health Sciences, The George Washington University, Ashburn VA, USA; E-mail: agmattis@ 123456buffalo.edu
                Article
                RRCT-18-3-214
                10.2174/1574887118666230410093715
                10514505
                37046192
                ab5af2ab-c127-41e1-924e-ca20a7fc22f6
                Copyright @ 2023

                © 2023 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode

                History
                : 18 September 2022
                : 20 February 2023
                : 01 March 2023
                Categories
                Drug Design, Discovery and Therapy, Clinical Trials, Pharmacology, Clinical Trials, Research & Experimental Medicine

                Medicine,Chemistry,Life sciences
                cervical cancer,cancer incidence,vaccine efficacy,Human papillomavirus,alternative endpoints,sexually transmitted infection,SEER

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