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Prev Med Rep. 2015 Jul 31;2:711-6. doi: 10.1016/j.pmedr.2015.07.011. eCollection 2015.

Adherence to cervical cancer screening varies by human papillomavirus vaccination status in a high-risk population.

Author information

1
University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
2
Mayo School of Graduate Medical Education, Rochester, NY, USA.
3
Radboud University, Nijmegen, The Netherlands.
4
Rutgers-New Jersey Medical School, Newark, NJ, USA.
5
Jackson Memorial Hospital, Miami, FL, USA.
6
University of Texas Medical School Houston, TX, USA.
7
St. Louis University, St. Louis, MO, USA.
8
Brown University, Providence, RI, USA.
9
North Shore-LIJ Health System, New York, NY, USA.
10
University of Louisville, Department of Mathematics, Louisville, KY, USA.
11
McMaster University, Hamilton, ON, Canada.
12
University of Louisville, School of Public Health and Information Sciences, Department of Epidemiology and Population Health, Louisville, KY, USA.
13
University of Louisville, School of Public Health and Information Sciences, Department of Epidemiology and Population Health, Louisville, KY, USA; University of Louisville, School of Medicine, Department of Family and Geriatric Medicine, Louisville, KY, USA; University of Louisville, School of Medicine, Department of Obstetrics and Gynecology, Louisville, KY, USA; University of Louisville, School of Public Health and Information Sciences, Department of Health Promotion and Behavioral Health Sciences, Louisville, KY, USA; University of Louisville, Speed School of Engineering, Department of Bioengineering, Louisville, KY, USA.

Abstract

Cervical cancer screening has reduced the incidence of cervical cancer over the past 75 years. The primary aim of this study was to determine if women receiving Gardasil™ (HPV4 vaccine) participated in future cervical cancer screening at the same rate as that observed for unvaccinated women matched on birth year and health care campus. This is a retrospective cohort study of subjects selected from 27,786 females born from 1980 to 1992 who received health care in the Truman Medical Center safety net health system in Kansas City Missouri, USA. 1154 women 14-26 years old who received at least one dose of HPV4 vaccine between 2006 and 2009 were chosen at random from the vaccine records. 1154 randomly chosen unvaccinated women were age and health campus matched to the vaccinated women and all were followed until July 1, 2013. Women who were screened after 21 years and received three vaccine doses before 21 years, had the lowest screening rate of 24%. Their only predictive factor for screening, compared to the unvaccinated, was being closer to 21 years than 14 years at vaccination (aOR = 1.71 95% CI: 1.45, 2.00). Women vaccinated with three doses and screened at or after 21 years had the highest screening rate of 84% predicting a six-fold increase in screening participation over no vaccine received (aOR = 5.94 95% CI: 3.77, 9.35). Our results suggest that women who receive HPV4 vaccination closer to 21 years, not 14, are more likely to participate in cervical cancer screening in an underserved US population.

KEYWORDS:

Cervical cancer; Cervical cancer screening; Compliance; HPV4; HPV4, means quadrivalent HPV vaccine Gardasil™; Women

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