Objectives To replicate previous analyses on the effectiveness of the English human papillomavirus (HPV) vaccination programme on incidence of cervical cancer and grade 3 cervical intraepithelial neoplasia (CIN3) using 12 additional months of follow-up, and to investigate effectiveness across levels of socioeconomic deprivation. Design Observational study. Setting England, UK. Participants Women aged 20-64 years resident in England between January 2006 and June 2020 including 29 968 with a diagnosis of cervical cancer and 335 228 with a diagnosis of CIN3. In England, HPV vaccination was introduced nationally in 2008 and was offered routinely to girls aged 12-13 years, with catch-up campaigns during 2008-10 targeting older teenagers aged <19 years. Main outcome measures Incidence of invasive cervical cancer and CIN3. Results In England, 29 968 women aged 20-64 years received a diagnosis of cervical cancer and 335 228 a diagnosis of CIN3 between 1 January 2006 and 30 June 2020. In the birth cohort of women offered vaccination routinely at age 12-13 years, adjusted age standardised incidence rates of cervical cancer and CIN3 in the additional 12 months of follow-up (1 July 2019 to 30 June 2020) were, respectively, 83.9% (95% confidence interval (CI) 63.8% to 92.8%) and 94.3% (92.6% to 95.7%) lower than in the reference cohort of women who were never offered HPV vaccination. By mid-2020, HPV vaccination had prevented an estimated 687 (95% CI 556 to 819) cervical cancers and 23 192 (22 163 to 24 220) CIN3s. The highest rates remained among women living in the most deprived areas, but the HPV vaccination programme had a large effect in all five levels of deprivation. In women offered catch-up vaccination, CIN3 rates decreased more in those from the least deprived areas than from the most deprived areas (reductions of 40.6% v 29.6% and 72.8% v 67.7% for women offered vaccination at age 16-18 and 14-16, respectively). The strong downward gradient in cervical cancer incidence from high to low deprivation in the reference unvaccinated group was no longer present among those offered the vaccine. Conclusions The high effectiveness of the national HPV vaccination programme previously seen in England continued during the additional 12 months of follow-up. HPV vaccination was associated with a substantially reduced incidence of cervical cancer and CIN3 across all five deprivation groups, especially in women offered routine vaccination. The cancer registry data analysed for this paper are securely held by the National Disease Registration Service (NDRS). Requests to access the data can be made through NHS England’s DARS service (). The Simulacrum () is a synthetic dataset developed by Health Data Insight and derived from anonymous cancer data provided by NHS England’s NDRS. Mid-year population estimates are freely downloadable from the Office for National Statistics website ().

中文翻译：

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英国社会经济剥夺导致 HPV 疫苗接种计划对宫颈癌和 3 级宫颈上皮内瘤变发病率的影响：基于人群的观察性研究

目的 通过另外 12 个月的随访，重复之前关于英国人乳头瘤病毒 (HPV) 疫苗接种计划对宫颈癌和 3 级宫颈上皮内瘤变 (CIN3) 发病率的有效性的分析，并调查不同社会经济剥夺水平的有效性。设计观察性研究。设置英格兰，英国。参与者 2006 年 1 月至 2020 年 6 月期间居住在英格兰的 20-64 岁女性，其中 29 968 名诊断为宫颈癌，335 228 名诊断为 CIN3。在英格兰，HPV 疫苗接种于 2008 年在全国范围内推广，并定期向 12-13 岁的女孩提供接种，并在 2008-10 年间针对年龄<19 岁的青少年开展了追赶运动。主要结果衡量浸润性宫颈癌和 CIN3 的发病率。结果 在英格兰，2006 年 1 月 1 日至 2020 年 6 月 30 日期间，29 968 名 20-64 岁女性被诊断为宫颈癌，335 228 名女性被诊断为 CIN3。在 12-13 岁常规接种疫苗的出生队列中，在另外12个月的随访期间（2019年7月1日至2020年6月30日），调整后的宫颈癌和CIN3的年龄标准化发病率分别为83.9%（95%置信区间（CI）63.8%至92.8%）和94.3 %（92.6% 至 95.7%）低于从未接种过 HPV 疫苗的女性参考队列。截至 2020 年中期，HPV 疫苗接种已估计预防了 687 例（95% CI 556 至 819）例宫颈癌和 23 192 例（22 163 例至 24 220）例 CIN3。生活在最贫困地区的妇女的感染率最高，但 HPV 疫苗接种计划对所有五个贫困级别都有很大影响。在接受补种疫苗接种的女性中，最贫困地区的 CIN3 率下降幅度大于最贫困地区的女性（16-18 岁和 14 岁接受疫苗接种的女性分别下降了 40.6% 和 29.6% 和 72.8% 和 67.7%） -16，分别）。在未接种疫苗的参考组中，宫颈癌发病率从高到低的强烈下降梯度在接受疫苗的人群中不再存在。结论 在另外 12 个月的随访期间，英格兰国家 HPV 疫苗接种计划的高效性继续保持。在所有五个剥夺组中，HPV 疫苗接种与宫颈癌和 CIN3 发病率的大幅降低相关，特别是在接受常规疫苗接种的女性中。本文分析的癌症登记数据由国家疾病登记服务中心 (NDRS) 安全保存。可以通过 NHS England 的 DARS 服务请求访问数据（）。拟像 (）是由 Health Data Insight 开发的综合数据集，源自英格兰 NHS NDRS 提供的匿名癌症数据。年中人口估计数可从国家统计局网站（）。