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Original Articles
Parental intention to vaccinate daughters with the human papillomavirus vaccine in Korea: a nationwide cross-sectional survey
Yejin Ha, Kyeongmin Lee, Bomi Park, Mina Suh, Jae Kwan Jun, Kui Son Choi
Epidemiol Health. 2023;45:e2023076.   Published online August 17, 2023
DOI: https://doi.org/10.4178/epih.e2023076
  • 2,648 View
  • 114 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to identify and compare the characteristics and factors associated with parental intention to vaccinate daughters under 12 years old against human papillomavirus (HPV), examining data from 2016 and 2020.
METHODS
Data were obtained from the Korean National Cancer Screening Survey conducted in 2016 and 2020. The present study included 3,510 parents with daughters under 12 years old. Changes in parental intention-to-vaccinate rates were calculated. To identify factors associated with parental intention to vaccinate their daughters, the chi-square test and logistic regression analysis were used.
RESULTS
The percentage of respondents intending to vaccinate their daughters increased from 33.4% in 2016 to 58.9% in 2020, constituting a 25.5 percentage point (%p) increase. Since 2016, the proportion of men expressing positive intention towards HPV vaccination increased by 31.5%p, while that of women demonstrated a 20.9%p increase. Logistic regression analysis indicated that parents with a strong intention to vaccinate their daughters tended to be younger, more educated, and aware of the free vaccination program available, as well as to have a history of HPV vaccination and to have undergone cervical cancer screening within 2 years, compared to those who did not intend to vaccinate. Being a mother with a history of HPV vaccination was the strongest predictor of positive intention to vaccinate a daughter.
CONCLUSIONS
The intention among parents to vaccinate daughters remains relatively low, although it is rising. To increase the HPV vaccination rate, strong recommendations and education should be provided to parents and the younger generation.
Summary
Korean summary
한국정부는 2016년부터 HPV 백신을 국가예방접종사업으로 도입하여 만 12세 여아를 대상으로 무료접종을 실시하고 있다. 12세 여아가 접종대상인만큼 부모의 HPV 백신에 대한 인식과 태도가 실제 예방접종에 중요한 영향을 미친다. 이 연구를 통해 2016년과 2020년을 비교했을 때 딸의 백신접종에 대한 의향이 증가하였음을 알 수 있었고, 특히 HPV 백신접종 경험이 있는 경우 딸의 백신접종에 대한 의향이 유의하게 높음을 확인하였다.
Key Message
In Korea, HPV vaccination was included in the national immunization program in 2016 for 12-year-old girls. The decision to undergo the HPV vaccination is closely associated with their parents’ perceptions of and attitudes toward the HPV vaccine. This study identified that parental intention increased from 2016 to 2020, and maternal history of HPV vaccination was the strongest predictor of positive intention to vaccinate a daughter.
The associations of tobacco use, sexually transmitted infections, HPV vaccination, and screening with the global incidence of cervical cancer: an ecological time series modeling study
Luyan Zheng, Yushi Lin, Jie Wu, Min Zheng
Epidemiol Health. 2023;45:e2023005.   Published online December 13, 2022
DOI: https://doi.org/10.4178/epih.e2023005
  • 3,537 View
  • 122 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to quantify the temporal associations between cervical cancer incidence and cervical cancer-related factors and to predict the number of new cervical cancer cases averted under counterfactual scenarios compared to the status quo scenario.
METHODS
We described temporal trends in cervical cancer and associated factors globally from 1990 to 2019. We then used generalized linear mixed models to explore the impact of tobacco use, sexually transmitted infections (STIs), human papillomavirus (HPV) vaccination, and cervical screening on cervical cancer incidence. A counterfactual analysis was performed to simulate the most effective scenario for reducing cervical cancer incidence.
RESULTS
The worldwide incidence of cervical cancer showed a downward trend over the past 3 decades (estimated annual percentage change, -0.72%), although the incidence remained high (>30 cases per 100,000 persons) in sub-Saharan Africa, Latin America, and the Caribbean. Higher smoking and STI prevalence showed significant direct associations with the incidence of cervical cancer, whereas HPV vaccination and screening coverage showed significant inverse associations. If the strategic goals for accelerating the elimination of cervical cancer and tobacco control programs had been achieved in 2019, the largest decrease in the number of new cervical cancer cases would have been observed, with 54,169 fewer new cases of cervical cancer in 2019.
CONCLUSIONS
Our counterfactual analysis found that a comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence.
Summary
Key Message
A comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence in our counterfactual analysis.
Estimated incidence of juvenile-onset recurrent respiratory papillomatosis in Korea
Jin-Kyoung Oh, Hwa Young Choi, Minji Han, Yuh-Seog Jung, Sang Joon Lee, Moran Ki
Epidemiol Health. 2021;43:e2021019.   Published online March 10, 2021
DOI: https://doi.org/10.4178/epih.e2021019
  • 11,518 View
  • 322 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea.
METHODS
We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1).
RESULTS
During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis.
CONCLUSIONS
The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.
Summary
Korean summary
재발성호흡기유두종증은 사람유두종바이러스에 의해 발현되는 희귀 질환이다. 건강보험 청구자료를 활용하여 2002년 이후 출생아 전수 중 2014년까지 후두양성종양으로 2회이상 입원 또는 2회이상 외래진료를 받은 어린이 코호트를 관찰하여 재발성호흡기유두종증 발생률을 추정하였다. 총 123명의 재발성호흡기유두종증 환자가 발생하였으며 (발생률 10만인년당 0.30명), 평균 첫 진단시기는 4세인 것으로 나타났다. 2회 이상 수술적 치료를 받은 경우는 18.7%였다.
Key Message
Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV). We conducted a cohort study using claims data to estimate the incidence of RRP. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits with diagnosis for benign neoplasms of the larynx. During 2002-2014, 123 children were diagnosed with RRP. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years. Twenty three patients (18.7%) underwent 2 or more surgical procedures.

Citations

Citations to this article as recorded by  
  • Global epidemiology of HPV-associated recurrent respiratory papillomatosis and effect of vaccination
    RY Seedat, FG Dikkers
    Future Virology.2022; 17(5): 265.     CrossRef
Review
Human papillomavirus infection and risk of lung cancer in never-smokers and women: an ‘adaptive’ meta-analysis
Jong-Myon Bae, Eun Hee Kim
Epidemiol Health. 2015;37:e2015052.   Published online November 17, 2015
DOI: https://doi.org/10.4178/epih/e2015052
  • 17,564 View
  • 189 Download
  • 6 Web of Science
  • 13 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The incidence of lung cancer in Koreans is increasing in women and in both men and women with a never-smoking history. Human papillomavirus (HPV) infection has been suggested as a modifiable risk factor of lung cancer in never-smokers and women (LCNSW). This systematic review (SR) aimed to evaluate an association between HPV infection and lung cancer risk in LCNSW.
METHODS
Based on a prior SR and some expert reviews, we identified refereed, cited, or related articles using the PubMed and Scopus databases. All case-control studies that reported the odds ratio of HPV infection in LCNSW were selected. An estimate of the summary odds ratio (SOR) with 95% confidence intervals (CI) was calculated.
RESULTS
A total of four case-control studies were included. The fixed-effect model was applied because of homogeneity (I-squared=0.0%). The SORs in women and in never-smokers were 5.32 (95% CI, 1.75 to 16.17) and 4.78 (2.25 to 10.15) respectively.
CONCLUSIONS
These results showed a significant effect of HPV infection in LCNSW. It is evident that developing a preventive plan against LCNSW may be necessary.
Summary

Citations

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Hypothesis
Modifiable risk factors of lung cancer in “never-smoker” women
Jong-Myon Bae
Epidemiol Health. 2015;37:e2015047.   Published online October 29, 2015
DOI: https://doi.org/10.4178/epih/e2015047
  • 18,226 View
  • 216 Download
  • 2 Web of Science
  • 10 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Korean women with a history of never smoking and with adenocarcinoma showed an increasing trend in lung cancer occurrence during 2002 to 2012. The two modifiable factors of never-smoker lung cancer in women are hormone and oncogenic virus infection. Based on previous studies, hormone replacement therapy (HRT) and human papillomavirus (HPV) infection might afford protection or be a risk factor, respectively. It is necessary to perform a pooled analysis of cohort studies to evaluate HRT and never-smoker lung cancer in women and a systematic review of case-control studies to determine the association between HPV infection and never-smoker lung cancer.
Summary
Korean summary
2002년에서 2012년간 폐암 통계를 살펴보면 비흡연 여성에서 선암종의 발생이 크게 증가하는 것으로 확인된다. 이렇게 여성에서 비흡연 폐암발생과 관련한 요인들로는 호르몬 대체요법 (HRT)과 인유두종바이러스 (HPV) 감염이 알려져 있다. 환자-대조군연구를 이용한 메타분석에 따르면 호르몬대체요법은 폐암발생을 억제하는 것으로 나왔다. HPV에 대한 메타분석은 아직 없는 가운데 위험요인으로 의심하고 있다. 따라서 HRT에 대하여는 코호트 연구 결과를 이용한 연합분석 (pooled analysis)이 필요하며, HPV에 대하여는 환자-대조군연구 결과를 이용한 메타분석이 수행될 필요가 있다.

Citations

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Review
Human papillomavirus 16 infection as a potential risk factor for prostate cancer: an adaptive meta-analysis
Jong-Myon Bae
Epidemiol Health. 2015;37:e2015005.   Published online February 11, 2015
DOI: https://doi.org/10.4178/epih/e2015005
  • 21,799 View
  • 188 Download
  • 26 Web of Science
  • 27 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Although an expert review published in 2013 concluded that an association between human papillomavirus (HPV) infection and prostate cancer (PCa) risk had not yet been firmly established, a 2011 systematic review of 14 articles revealed an increased prevalence of HPV-16 DNA in PCa tissues. Another meta-analysis of the related articles is needed to evaluate the potential link between HPV infection and PCa risk.
METHODS
A snowballing search strategy was applied to the previously cited articles in the above-mentioned expert review and systematic review. Additional articles selected for this meta-analysis should fulfill all following inclusion criteria: (a) evaluation of detected HPV-16 DNA in tissue samples and the PCa risk and (b) report of the HPV-16 prevalence in both cancer and control tissues. Estimated summary odds ratios (sOR) with 95% confidence intervals (CI) were calculated using fixed effect or random-effect models.
RESULTS
Hand searching identified 16 new articles. The sOR of the total 30 articles indicated a significant HPV-16 infection-related increase in the PCa risk (sOR, 1.851; 95% CI, 1.353 to 2.532, I2=37.82%).
CONCLUSIONS
These facts provide additional supportive evidence for a causal role of HPV-16 infection in prostate carcinogenesis. As the PCa incidence rates have increased rapidly in Asian countries, including Korea, during the last several decades, further studies of HPV-related PCa carcinogenesis may be necessary.
Summary
Korean summary
전립선암의 교정가능한 위험요인으로 만성재발성 염증을 야기하는 HPV 감염이 주목받고 있다. 지금까지의 체계적 고찰과 전문가 종설은 뚜렷한 인과성이 없다고 결론내고 있다. 이에 새로이 발표된 관련 논문들을 확보하여 메타분석을 다시 수행하였다. 총 30개의 대상논문에 대한 메타분석을 시행하였을 때, HPV 16 감염이 위험요인임을 확인하였다. (sOR = 1.851, 95% CI: 1.353 – 2.532, I2=37.82%).

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Original Article
Diagnostic accuracy of conventional Pap test, liquid-based cytology and human papillomavirus DNA testing in cervical cancer screening in Korea: a meta-analysis.
Jin Kyoung Oh, Hai Rim Shin, Gyungyub Gong, Jin Hee Sohn, Shin Kwang Khang
Korean J Epidemiol. 2008;30(2):178-187.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.178
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AbstractAbstract PDF
Abstract
Objective: The aim of this study was to compare the diagnostic accuracy of the Pap test, liquid-based cytology (LBC), and human papillomavirus (HPV) testing used as screening methods for the early detection of cervical cancer in Korea. Materials and Methods: Articles reporting the sensitivity and specificity of each screening method that were published between 1995 and March 2008 were retrieved from MEDLINE and KoreaMed. A meta-analysis was conducted to calculate pooled estimates for the sensitivity and specificity of each method. Only cases with histological confirmation were included, and cervical cancer was defined as samples exhibiting cervical intraepithelial neoplasia 2 or worse. In cytological tests, findings of atypical squamous cells of undetermined significance or worse were considered positive.
Results
Of the 24 studies, 15 studies of the Pap test, 3 studies of LBC, and 4 studies of HPV met the inclusion criteria and were included in the meta-analysis. The meta-analysis showed that the sensitivity was highest for LBC (92%), followed by HPV testing (83%) and the Pap test (76%), and the specificity of LBC was the highest (79%), followed by the Pap test (76%) and HPV testing (59%). However, except for the sensitivity of LBC (heterogeneity p-value = 0.682), significant heterogeneity was found among the results of the studies (heterogeneity p-value < 0.0001).
Discussion
Due to the significant heterogeneity among the studies, the results of this meta-analysis are limited in representing the accuracy of each test method. The accuracy and cost-effectiveness of cervical cancer screening methods should be further evaluated.
Summary

Citations

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