Pre-vaccination type-specific HPV prevalence in confirmed cervical high grade lesions in the Māori and non-Māori populations in New Zealand

摘要

Background New Zealand initiated HPV vaccination in 2008, and has attained 3-dose coverage of ~50?% in 12–13 year old girls. Due to the success of program initiatives in Māori girls, higher coverage rates of ~60?% have been achieved in this group. We have previously reported a benchmark overall pre-vaccination prevalence of oncogenic HPV infection in high grade cervical lesions in New Zealand. The current extended analysis provides separate pre-vaccination benchmark prevalence for Māori and non-Māori women. Methods The National Cervical Screening Programme Register (NCSP-R) was used to identify any woman aged 20–69 years of age with an index high grade cytology report from 2009–2011. Extended recruitment was performed until 2012 in clinics with a high proportion of Māori women. Ethnicity status was based on self-reported information by participating women through phone contact supplemented by recordings on the study questionnaire (the NCSP-R was not used to extract ethnicity status). A total of 730 women consented to participate and had a valid HPV test resu 418 of these had histologically-confirmed cervical intraepithelial neoplasia (CIN) 2/3 lesions (149 Māori, 269 non-Māori). The prevalence of any cervical oncogenic HPV infection, HPV16, and HPV18 was calculated in women with CIN2/3. Results In confirmed CIN2/3, the prevalence of any oncogenic HPV, HPV16 and HPV18 was 96?%?(95 % CI:91–99?%), 54?% (95 % CI:46–63?%), 11?% (95 % CI:7–18?%) in Māori and 96?% (95 % CI:93–98?%), 54?% (95 % CI:48–60?%), 11?% (95 % CI:7–15?%) in non-Māori women, respectively. Age-specific patterns of infection for HPV16/18 in confirmed CIN2/3 differed between the two groups (P _interaction =?0.02), with a lower prevalence in younger vs. older Māori women (57?% in 20–29 years vs 75?% in 40–69 years) but a higher prevalence in younger vs. older non-Māori women (70?% in 20–29 years vs 49?% in 40–69 years); the difference in the age-specific patterns of infection for HPV16/18 was not significant either when considering confirmed CIN2 alone (p?=?0.09) or CIN3 alone (p?=?0.22). Conclusions The overall prevalence of vaccine-included types in CIN2/3 was similar in Māori and non-Māori women, implying that the long-term effects of vaccination will be similar in the two groups.