Human Papillomavirus Vaccine Impact Monitoring Project

Purpose

The Human Papillomavirus (HPV) Vaccine Impact Project (HPV-IMPACT), part of the Centers for Disease Control and Prevention Emerging Infections Program (EIP) is an ongoing surveillance project that monitors the impact of HPV vaccine on HPV types associated with cervical cancer and cervical cancer precursors. HPV-IMPACT determines rates of high-grade cervical lesions in women in the United States. 

Goals and Objectives

• Describe the incidence of HPV-associated high-grade cervical lesions and cervical cancer over time.
• Obtain diagnostic biopsy specimens on all reported cases of high-grade cervical lesions in females 18 to 39 years of age in Monroe County.
• Obtain additional detailed information on all reported cases of high-grade cervical lesions in females 18 to 39 years of age in Monroe County, including HPV vaccination history, complete demographic information and relevant medical history.
• Describe cervical cancer screening utilization among females 18 to 39 years to monitor trends over time using methodology other than self-report.

Activities

The pathology laboratories in our catchment area continue to identify all cases of high-grade cervical lesions and cervical cancer in women 18 years of age and older. Lists are generated at each lab every month, using anatomic site language to capture all possible cases. Using a combination of administrative data and medical records, complete case information is collected. This includes: patient demographics, health insurance information, ordering provider and submitting pathologist contact information, cervical pathology information related to the current diagnosis, and detailed information relevant to women aged 18 to 39 years as outlined above.

Women aged 18 to 39 have a cervical pathology specimen selected for highest grade associated with that infection by the designated lab pathologist, retrieved, prepared and submitted to the CDC for histopathologic review and HPV typing.

Publications

• Russ S., Kurtz R., Bennett N.M., Felson C., Bostick E. Characterization of Cervical Cancer Screening History Among Patients with Invasive Cervical Cancer: A Population-Based Approach, Gynecologic Oncology Reports, Volume 55, 2024, 101480, ISSN 2352-5789, https://doi.org/10.1016/j.gore.2024.101480.

• Rosenblum HG, Gargano JW, Cleveland AA, Dahl RM, Park IU, Whitney E, Castilho JL, Sackey E, Niccolai LM, Brackney M, Debess E, Ehlers S, Bennett NM, Kurtz R, Unger ER, Markowitz LE. U.S. Women with Invasive Cervical Cancer: Characteristics and Potential Barriers to Prevention. J Womens Health (Larchmt). 2024 Apr 12. doi: 10.1089/jwh.2023.0462. Epub ahead of print. PMID: 38608239.

• Gargano JW, McClung N, Lewis RM, Park IU, Whitney E, Castilho JL, Pemmaraju M, Niccolai LM, Brackney M, Debess E, Ehlers S, Bennett NM, Scahill M, Cleveland AA, Querec TD, Unger ER, Markowitz LE; HPV-IMPACT Working Group. HPV type-specific trends in cervical precancers in the United States, 2008-2016. Int J Cancer. 2022 Jul 29. doi: 10.1002/ijc.34231. Epub ahead of print. PMID: 35904861.
• Cleveland AA, Gargano JW, Griffin MR, Park IU, Niccolai LM, Bennett NM, Pemmaraju M, Fink D, Brackney M, Scahill M, Ehlers SJ, Unger ER, Markowitz LE; HPV-IMPACT Working Group. Increases in Human Papillomavirus Testing Preceding Diagnosis of Cervical Precancer in 5 US States, 2008-2016. J Low Genit Tract Dis. 2021 Jul 1;25(3):192-198. doi: 10.1097/LGT.0000000000000606. PMID: 33797511.
• Johnson Jones ML, Gargano JW, Powell M, Bennett NM, et al. Effectiveness of 1, 2, and 3 Doses of Human Papillomavirus Vaccine Against High-Grade Cervical Lesions Positive for Human Papillomavirus 16 or 18. Am J Epidemiol. 2020; 189(4):265-276. doi:10.1093/aje/kwz253 
• McClung NM, Gargano JW, Park IU, Whitney E, Abdullah N, Ehlers S, Bennett NM, Scahill M, Niccolai LM, Brackney M, Griffin MR, Pemmaraju M, Querec TD, Cleveland AA, Unger ER, Markowitz LE; HPV-IMPACT Working Group. Estimated Number of Cases of High-Grade Cervical Lesions Diagnosed Among Women - United States, 2008 and 2016. MMWR Morb Mortal Wkly Rep. 2019 April; 68(15):337-343. doi: 10.15585/mmwr.mm6815a1.
• Cleveland AA, Gargano JW, Park IU, Griffin MR, Niccolai MP, Bennett NM, Saadeh K, Manideepthi P, Higgins K, Ehlers S, Scahill M, Johnson Jones ML, Querec T, Markowitz LE, Unger ER; for the HPV-IMPACT Working Group. Cervical adenocarcinoma in situ: Human papillomavirus types and incidence trends in five states, 2008–2015International Journal of Cancer, April 2019, doi: 10.1002/ijc.32340. [Epub ahead of print]
• McClung NM, Gargano JW, Bennett NM, Niccolai LM, Abdullah N, Griffin MR, Park IU, Cleveland AA, Querec TD, Unger ER and Markowitz LE; for the HPV-IMPACT Working Group. Trends in Human Papillomavirus Vaccine Types 16 and 18 in Cervical Precancers, 2008-2014. Cancer Epidemiol Biomarkers Prev., Feb 2019. doi: 10.1158/1055-9965. EPI-18-0885. (Epub ahead of print)
• Bennett NM; Viewpoint: The role of the advisory committee on immunization practices in insuring optimal use of vaccines. JAMA, Jan. 2019. doi:10.1001/jama.2018.20792. 
• Gargano JW, Park IU, Griffin MR, Niccolai LM, Powell M, Bennett NM, Johnson Jones ML, Whitney E, Pemmaraju M, Brackney M, Abdullah N, Scahill M, Dahl RM, Cleveland AA, Unger ER, Markowitz LE; HPV-IMPACT Working Group. Trends in High-grade Cervical Lesions and Cervical Cancer Screening in Five States, 2008-2015. Clin Infect Dis. 2018 Aug 23. doi: 10.1093/cid/ciy707.
• Hariri S, Unger ER, Powell SE, Bauer HM, Bennett NM, Bloch KC, Niccolai LM, Schafer S, Markowitz LE; HPV-IMPACT Working Group. The HPV vaccine impact monitoring project (HPV-IMPACT): assessing early evidence of vaccination impact on HPV-associated cervical cancer precursor lesions. Cancer Causes and Control 2012: Feb 23(2):281-288.