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In Japan, the preventive effect of CIN3+ in the real world has not yet been demonstrated in age\u2010adjusted cohort or case\u2013control studies. This study aimed to estimate the effect of the HPV vaccine against CIN3+ in Japanese women. This nationwide case\u2013control study from April 2013 to March 2020 targeted women aged 20\u201326\u2009years old at the time of cervical screening. We compared HPV vaccination exposure between those with abnormal and those with normal cytology. Abnormal cytology was classified into cervical intraepithelial neoplasia (CIN)1+, CIN2+, and CIN3+. We calculated the odds ratio (OR) and 95% confidence interval (CI) of the above endpoints and vaccination exposure using the conditional logistic regression model and estimated vaccine effectiveness using the formula (1 \u2212OR)\u2009\u00d7\u2009100. A total of 2790 cases and 13,990 controls (one\u2010to\u2010five matching) were eligible in 37 municipalities in Japan. In this study, 61 CIN3 (2.2%) and 10 squamous cell carcinomas (SCC) (0.4%) were found. The OR for CIN3+ versus controls was 0.14 (95% CI, 0.03\u20130.75), equating to a vaccine effectiveness of 86%. Of the 10 patients who had SCC none were vaccinated. This nationwide case\u2013control study in Japan demonstrated a substantial risk reduction in CIN3+ among women who did versus those who did not receive HPV vaccination.<\/jats:p>","DOI":"10.1111\/cas.16375","type":"journal-article","created":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T05:45:12Z","timestamp":1729921512000},"page":"226-232","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Human papillomavirus vaccine to prevent <scp>CIN3<\/scp> or worse (<scp>CIN3<\/scp>+): A nationwide case\u2013control study in Japan"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7948-8990","authenticated-orcid":false,"given":"Sayaka","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine Osaka University  Osaka 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