Is there Equity in HPV vaccination and Cervical Screening in the North West of England? : A Study of Mothers and Daughters

IntroductionCervical screening uptake is steadily declining with evidence of inequalities by deprivation and ethnicity. The introduction of the HPV vaccination programme has the potential to reverse the downward trend in cervical cancer prevention by protecting girls who in future may not attend for cervical screening.ObjectiveTo investigate equity in cervical cancer prevention by examining uptake of adolescent HPV vaccination of daughters and cervical cancer screening attendance in their mothers. Methods HPV vaccination records of girls aged 12-13 years were linked by address to their mothers cervical screening records from 15 North West Primary Care Trusts (PCTs) (n = 24,409 mother-daughter pairs). Vaccination and Screening records were matched to deprivation quintiles (as measured by the 2007 Index of Multiple Deprivation [IMD] scores) and ethnicity (classified by South Asian ethnicity using the Nam Pehchan computer programme). Results Results from preliminary analysis show daughters vaccination completion was associated with mothers screening attendance. Screening uptake was significantly lower in mothers whose daughters had received no vaccination doses compared to those that had received three doses (Odds Ratio [OR] = 1.35; 95% Confidence Interval [CI] 1.24 to 1.47) or partial immunisation status (OR=1.19; 95% CI 1.05 to 1.35). Uptake of both vaccination and screening programmes were associated with deprivation quintile (Chi Square, p