CIN3+plus: What impact on cervical cancer will HPV vaccination have?
Krebsforschung Schweiz is funding a research project from Feb 2014 to Jan 2016 to start monitoring the impact that vaccination against human papillomavirus (HPV) will have on cervical cancer and its precursors (grade 3 cervical intraepithelial neoplasia, CIN3). Nicola Low, ISPM Bern, leads the research with co-investigators from the Swiss Federal Office of Public Health, National Institute of Cancer Epidemiology and Research, Luzern Cantonal Hospital and Lausanne and Geneva University Hospitals.
Almost all cases of cervical cancer are caused by a viral infection (human papillomavirus, HPV). HPV is transmitted through sexual intercourse; some types of HPV can cause cancer many years later. There are now vaccines that protect against two of the most common cancer-causing HPV types (16/18). Since 2008, Switzerland has had a national programme to offer HPV vaccination to girls aged 11-14 years. It is essential to monitor the effectiveness of vaccination in preventing cancer. Trends in pre-cancerous stages can be used to indicate how effective HPV vaccination will be in preventing future cases of cervical cancer. This project aims to a) describe the distribution of HPV types in cervical pre-cancer and cancer before it has been affected by the HPV vaccination programme and b) examine factors that might affect the reliability of a system for monitoring outcomes of the vaccination programme.
The project will take place in seven locations in Swiss German, French and Italian speaking regions. We will identify women diagnosed with cervical pre-cancer or cancer from laboratory records. We will study biopsy specimens that were used to make the diagnosis and test them for HPV type. We plan to determine HPV type in 200 specimens from the recent past (2013) and 700 from 2014-2015. We will ask women diagnosed from 2014 onwards for permission to collect additional information about factors that might be associated with cervical pre-cancer and cancer. We will compare basic characteristics of women who do, or do not give consent for additional data collection. We will then compare the characteristics of women with cervical pre-cancer and cancer with a random sample of women in the general Swiss population. The benefit of the project is that it provides the information needed to monitor the future effectiveness and fairness of HPV vaccination in Switzerland.