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Articles by S. K Kjaer
Total Records ( 3 ) for S. K Kjaer
  S. K Kjaer , K Sigurdsson , O. E Iversen , M Hernandez Avila , C. M Wheeler , G Perez , D. R Brown , L. A Koutsky , E. H Tay , P Garcia , K. A Ault , S. M Garland , S Leodolter , S. E Olsson , G. W.K Tang , D. G Ferris , J Paavonen , M Lehtinen , M Steben , F. X Bosch , J Dillner , E. A Joura , S Majewski , N Munoz , E. R Myers , L. L Villa , F. J Taddeo , C Roberts , A Tadesse , J Bryan , R Maansson , S Lu , S Vuocolo , T. M Hesley , A Saah , E Barr and R. M. Haupt
 

Quadrivalent human papillomavirus (HPV) vaccine has been shown to provide protection from HPV 6/11/16/18–related cervical, vaginal, and vulvar disease through 3 years. We provide an update on the efficacy of the quadrivalent HPV vaccine against high-grade cervical, vaginal, and vulvar lesions based on end-of-study data from three clinical trials. Additionally, we stratify vaccine efficacy by several baseline characteristics, including age, smoking status, and Papanicolaou (Pap) test results. A total of 18,174 females ages 16 to 26 years were randomized and allocated into one of three clinical trials (protocols 007, 013, and 015). Vaccine or placebo was given at baseline, month 2, and month 6. Pap testing was conducted at regular intervals. Cervical and anogenital swabs were collected for HPV DNA testing. Examination for the presence of vulvar and vaginal lesions was also done. Endpoints included high-grade cervical, vulvar, or vaginal lesions (CIN 2/3, VIN 2/3, or VaIN 2/3). Mean follow-up time was 42 months post dose 1. Vaccine efficacy against HPV 6/11/16/18–related high-grade cervical lesions in the per-protocol and intention-to-treat populations was 98.2% [95% confidence interval (95% CI), 93.3-99.8] and 51.5% (95% CI, 40.6-60.6), respectively. Vaccine efficacy against HPV 6/11/16/18–related high-grade vulvar and vaginal lesions in the per-protocol and intention-to-treat populations was 100.0% (95% CI, 82.6-100.0) and 79.0% (95% CI, 56.4-91.0), respectively. Efficacy in the intention-to-treat population tended to be lower in older women, women with more partners, and women with abnormal Pap test results. The efficacy of quadrivalent HPV vaccine against high-grade cervical and external anogenital neoplasia remains high through 42 months post vaccination.

  H Song , S. J Ramus , S. K Kjaer , R. A DiCioccio , G Chenevix Trench , C. L Pearce , E Hogdall , A. S Whittemore , V McGuire , C Hogdall , J Blaakaer , A. H Wu , D. J Van Den Berg , D. O Stram , U Menon , A Gentry Maharaj , I. J Jacobs , P. M Webb , J Beesley , X Chen , The Australian Ovarian Cancer Study Group the Australian Cancer (Ovarian) Study , J. A Doherty , J Chang Claude , S Wang Gohrke , M. T Goodman , G Lurie , P. J Thompson , M. E Carney , R. B Ness , K Moysich , E. L Goode , R. A Vierkant , J. M Cunningham , S Anderson , J. M Schildkraut , A Berchuck , E. S Iversen , P. G Moorman , M Garcia Closas , S Chanock , J Lissowska , L Brinton , H Anton Culver , A Ziogas , W. R Brewster , B. A.J Ponder , D. F Easton , S. A Gayther , P. D.P Pharoah and on behalf of the Ovarian Cancer Association Consortium (OCAC)
 

Because both ovarian and breast cancer are hormone-related and are known to have some predisposition genes in common, we evaluated 11 of the most significant hits (six with confirmed associations with breast cancer) from the breast cancer genome-wide association study for association with invasive ovarian cancer. Eleven SNPs were initially genotyped in 2927 invasive ovarian cancer cases and 4143 controls from six ovarian cancer case–control studies. Genotype frequencies in cases and controls were compared using a likelihood ratio test in a logistic regression model stratified by study. Initially, three SNPs (rs2107425 in MRPL23, rs7313833 in PTHLH, rs3803662 in TNRC9) were weakly associated with ovarian cancer risk and one SNP (rs4954956 in NXPH2) was associated with serous ovarian cancer in non-Hispanic white subjects (P-trend < 0.1). These four SNPs were then genotyped in an additional 4060 cases and 6308 controls from eight independent studies. Only rs4954956 was significantly associated with ovarian cancer risk both in the replication study and in combined analyses. This association was stronger for the serous histological subtype [per minor allele odds ratio (OR) 1.07 95% CI 1.01–1.13, P-trend = 0.02 for all types of ovarian cancer and OR 1.14 95% CI 1.07–1.22, P-trend = 0.00017 for serous ovarian cancer]. In conclusion, we found that rs4954956 was associated with increased ovarian cancer risk, particularly for serous ovarian cancer. However, none of the six confirmed breast cancer susceptibility variants we tested was associated with ovarian cancer risk. Further work will be needed to identify the causal variant associated with rs4954956 or elucidate its function.

  N Munoz , S. K Kjaer , K Sigurdsson , O. E Iversen , M Hernandez Avila , C. M Wheeler , G Perez , D. R Brown , L. A Koutsky , E. H Tay , P. J Garcia , K. A Ault , S. M Garland , S Leodolter , S. E Olsson , G. W. K Tang , D. G Ferris , J Paavonen , M Steben , F. X Bosch , J Dillner , W. K Huh , E. A Joura , R. J Kurman , S Majewski , E. R Myers , L. L Villa , F. J Taddeo , C Roberts , A Tadesse , J. T Bryan , L. C Lupinacci , K. E. D Giacoletti , H. L Sings , M. K James , T. M Hesley , E Barr and R. M. Haupt
  Background

The impact of the prophylactic vaccine against human papillomavirus (HPV) types 6, 11, 16, and 18 (HPV6/11/16/18) on all HPV-associated genital disease was investigated in a population that approximates sexually naive women in that they were "negative to 14 HPV types" and in a mixed population of HPV-exposed and -unexposed women (intention-to-treat group).

Methods

This analysis studied 17 622 women aged 15–26 years who were enrolled in one of two randomized, placebo-controlled, efficacy trials for the HPV6/11/16/18 vaccine (first patient on December 28, 2001, and studies completed July 31, 2007). Vaccine or placebo was given at day 1, month 2, and month 6. All women underwent cervicovaginal sampling and Papanicolaou (Pap) testing at day 1 and every 6–12 months thereafter. Outcomes were any cervical intraepithelial neoplasia; any external anogenital and vaginal lesions; Pap test abnormalities; and procedures such as colposcopy and definitive therapy. Absolute rates are expressed as women with endpoint per 100 person-years at risk.

Results

The average follow-up was 3.6 years (maximum of 4.9 years). In the population that was negative to 14 HPV types, vaccination was up to 100% effective in reducing the risk of HPV16/18-related high-grade cervical, vulvar, and vaginal lesions and of HPV6/11-related genital warts. In the intention-to-treat group, vaccination also statistically significantly reduced the risk of any high-grade cervical lesions (19.0% reduction; rate vaccine = 1.43, rate placebo = 1.76, difference = 0.33, 95% confidence interval [CI] = 0.13 to 0.54), vulvar and vaginal lesions (50.7% reduction; rate vaccine = 0.10, rate placebo = 0.20, difference = 0.10, 95% CI = 0.04 to 0.16), genital warts (62.0% reduction; rate vaccine = 0.44, rate placebo = 1.17, difference = 0.72, 95% CI = 0.58 to 0.87), Pap abnormalities (11.3% reduction; rate vaccine = 10.36, rate placebo = 11.68, difference = 1.32, 95% CI = 0.74 to 1.90), and cervical definitive therapy (23.0% reduction; rate vaccine = 1.97, rate placebo = 2.56, difference = 0.59, 95% CI = 0.35 to 0.83), irrespective of causal HPV type.

Conclusions

High-coverage HPV vaccination programs among adolescents and young women may result in a rapid reduction of genital warts, cervical cytological abnormalities, and diagnostic and therapeutic procedures. In the longer term, substantial reductions in the rates of cervical, vulvar, and vaginal cancers may follow.

 
 
 
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