MMWR News Synopsis for Friday, April 19, 2019
Estimated Number of Cases of High-Grade Cervical Lesions Diagnosed Among Women — United States, 2008 and 2016
This first estimate of U.S. cervical precancers using population-based data, including the decline in detection of precancers in women under 30 years old, is important in understanding precancer trends across all age groups and helps explain the impact of changing cervical cancer prevention strategies, including HPV vaccination and cervical cancer screening guidelines. We report the first estimate of the number of high-grade cervical precancers (CIN2+ cases) in the United States using population-based data. In 2008, before vaccine impact, an estimated 216,000 women were diagnosed with CIN2+, and 10 years after vaccine introduction, an estimated 196,000. In 2008, 55% of cervical precancers were detected in women less than 30 years of age; in 2016, only 36% of cervical precancers were diagnosed in this age group. This decline reflects both the impact of the U.S. HPV vaccination program and changes in cervical cancer screening recommendations between 2008 and 2016. Some of the changes include initiating cervical cancer screening at an older age, incorporating HPV testing as part of screening, and having longer intervals between screenings. Overall, an estimated 76% of cervical precancers were attributable to HPV vaccine types.
Outbreak of Human Immunodeficiency Virus Infection Among Heterosexual Persons Who Inject Drugs and Are Living Homeless — Seattle, Washington, 2018
Vulnerability to outbreaks of HIV infection among people who inject drugs is widespread throughout the U.S. and control of these outbreaks requires sustained vigilance and rapid public health responses. Public health officials in King County, WA, identified a cluster of 14 cases of HIV infection diagnosed between February and November 2018 among homeless heterosexuals, most of whom were injecting drugs. This cluster was part of a larger, almost 300% increase in new HIV diagnoses among heterosexuals who injected drugs in King County between 2017 and 2018. That this outbreak occurred in King County, the first urban area in the U.S. to achieve World Health Organization goals for HIV diagnosis and treatment and despite the presence of a syringe exchange program that distributed over 7 million syringes in 2018, highlights the fact that vulnerability to outbreaks of HIV among people who inject drugs is widespread.