J Low Genit Tract Dis

Objectives:Since 2006, the U.S. human papillomavirus (HPV) vaccination program has led to decreases in HPV infections caused by high-risk vaccine-targeted HPV types (HPV16/18). We assessed differences in high-risk HPV prevalence by cervical cytology result among 20\u201324-year-old persons participating in routine cervical cancer screening in 2015\u20132017 compared to 2007.Methods:Residual routine cervical cancer screening specimens were collected from 20\u201324-year-old members of two integrated healthcare delivery systems as part of a cross-sectional study and were tested for 37 HPV types. Cytology results and vaccination status ( 651 dose) were extracted from medical records. Cytology categories were normal, atypical squamous cells of undefined significance (ASCUS), low-grade squamous intraepithelial lesions (SIL; LSIL), or high-grade SIL/atypical squamous cells cannot exclude high-grade SIL (HSIL/ASC-H). Prevalences of HPV categories (HPV16/18, HPV31/33/45/52/58, HPV35/39/51/56/59/66/68) were estimated by cytology result for 2007 and 2015\u20132017.Results:Specimens from 2007 (n=4046) were from unvaccinated participants; 4574 of 8442 (54.2%) specimens from 2015\u20132017 were from vaccinated participants. Overall, HPV16/18 positivity was lower in 2015\u20132017 compared to 2007 in all groups: HSIL/ASC-H, 16.0% vs 69.2%; LSIL, 5.4% vs 40.1%; ASCUS, 5.0% vs 25.6%; normal, 1.3% vs 8.1%. HPV31/33/45/52/58 prevalence was stable for all cytology groups; HPV35/39/51/56/59/66/68 prevalence increased among LSIL specimens (53.9% to 65.2%) but remained stable in other groups.Conclusions:Prevalence of vaccine-targeted high-risk HPV types 16/18 was dramatically lower in 2015\u20132017 than 2007 across all cytology result groups while prevalence of other high-risk HPV types was mainly stable, supporting vaccine impact with no evidence of type replacement.CC999999/ImCDC/Intramural CDC HHSUnited States