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While CIN is well described, less is known about the epidemiology of AIS, a rare cervical precancer. We identified AIS and CIN grade 3 (CIN3) cases through population\u2010based surveillance, and analyzed data on HPV types and incidence trends overall, and among women screened for cervical cancer. From 2008 to 2015, 470 AIS and 6,587 CIN3 cases were identified. The median age of women with AIS was older than those with CIN3 (35 <jats:italic>vs<\/jats:italic>. 31\u2009years; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). HPV16 was the most frequently detected type in both AIS and CIN3 (57% in AIS; 58% in CIN3), whereas HPV18 was the second most common type in AIS and less common in CIN3 (38% <jats:italic>vs<\/jats:italic>. 5%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). AIS lesions were more likely than CIN3 lesions to be positive for high\u2010risk types targeted by the bivalent and quadrivalent vaccines (HPV16\/18, 92% <jats:italic>vs<\/jats:italic>. 63%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and 9\u2010valent vaccine (HPV16\/18\/31\/33\/45\/52\/58, 95% <jats:italic>vs<\/jats:italic>. 87%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). AIS incidence rates decreased significantly in the 21\u201324\u2009year age group (annual percent change [APC] overall: \u221222.1%, 95% CI: \u221233.9 to \u22128.2; APC among screened: \u221216.1%, 95% CI: \u221228.8 to \u22121.2), but did not decrease significantly in any older age group. This report on the largest number of genotyped AIS cases to date suggests an important opportunity for vaccine prevention of AIS, and is the first to document a decline in AIS incidence rates among young women during the vaccine era.<\/jats:p>","DOI":"10.1002\/ijc.32340","type":"journal-article","created":{"date-parts":[[2019,4,13]],"date-time":"2019-04-13T15:40:07Z","timestamp":1555170007000},"page":"810-818","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Cervical adenocarcinoma <i>in situ<\/i>: Human papillomavirus types and incidence trends in five states, 2008\u20132015"],"prefix":"10.1002","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1375-8964","authenticated-orcid":false,"given":"Angela A.","family":"Cleveland","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia 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