HPV immunisation and increased uptake of cervical screening in Scottish women

observational study of routinely collected national data

T. J. Palmer, M. McFadden, K. G. J. Pollock, K. Kavanagh, K. Cuschieri, M. Cruickshank, S. Nicoll, C. Robertson

Research output: Contribution to journalArticle

19 Citations (Scopus)
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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.
Original languageEnglish
Pages (from-to)576-581
Number of pages6
JournalBritish Journal of Cancer
Volume114
Issue number5
Early online date22 Jan 2016
DOIs
Publication statusPublished - 1 Mar 2016

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Observational Studies
Immunization
Immunization Programs
Registries
Vaccines
Retrospective Studies
Health
Population

Keywords

  • cervical cancer screening
  • screening uptake
  • HPV immunisation

Cite this

HPV immunisation and increased uptake of cervical screening in Scottish women : observational study of routinely collected national data. / Palmer, T. J.; 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

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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title = "HPV immunisation and increased uptake of cervical screening in Scottish women: observational study of routinely collected national data",
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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author = "Palmer, {T. J.} and M. McFadden and Pollock, {K. G. J.} and K. Kavanagh and K. Cuschieri and M. Cruickshank and S. Nicoll and C. Robertson",
note = "We acknowledge funding (reference CZH/4/528) from the Chief Scientist Office (part of the Scottish Government Health and Social Care Directorates), which has supported this programme of work.",
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T2 - 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.

N1 - We acknowledge funding (reference CZH/4/528) from the Chief Scientist Office (part of the Scottish Government Health and Social Care Directorates), which has supported this programme of work.

PY - 2016/3/1

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.

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KW - screening uptake

KW - HPV immunisation

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JF - British Journal of Cancer

SN - 0007-0920

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