2021/12/04 更新

写真a

クドウ リサ
工藤 梨沙
KUDO Risa
所属
医歯学総合病院 産科婦人科 助教
職名
助教
外部リンク

学位

  • 学士(医学) ( 2008年3月   新潟大学 )

経歴

  • 新潟大学   医歯学総合病院 産科婦人科   助教

    2021年7月 - 現在

  • 新潟大学   医歯学総合病院 産科婦人科   特任助教

    2016年4月 - 2021年6月

  • 新潟大学   医歯学総合研究科   特任助教

    2014年12月 - 2016年3月

 

論文

  • Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women. 国際誌

    Manako Yamaguchi, Masayuki Sekine, Sharon J B Hanley, Risa Kudo, Megumi Hara, Sosuke Adachi, Yutaka Ueda, Etsuko Miyagi, Takayuki Enomoto

    Scientific reports   11 ( 1 )   2898 - 2898   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. Although vaccine opponents claim modifying sexual behavior can prevent cervical cancer, no comprehensive data exist on sexual behavior and the risk of high-grade cervical disease in a Japanese population. This study investigates sexual behavior and the risk of HPV infection and cervical disease in 3968 women aged 20-41 yrs undergoing cervical screening between April 2014 and March 2016. Mean age at first intercourse was 18.4 yrs ± 2.8 and 32% of women reported ≥ 6 lifetime sexual partners. In regression analyses, number of partners was a significant risk factor for HPV infection. However, for high-grade disease (CIN2+), when HPV genotype was adjusted for, number of partners was not statistically significant. The greatest risk factor was an HPV16/18 infection (adjusted odds ratio 113.7, 95% CI: 40.8-316.9). In conclusion, we found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately.

    DOI: 10.1038/s41598-021-82354-6

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  • Internet Survey of Awareness and Behavior Related to HPV Vaccination in Japan. 国際誌

    Risa Kudo, Masayuki Sekine, Manako Yamaguchi, Megumi Hara, Sharon J B Hanley, Yutaka Ueda, Asami Yagi, Sosuke Adachi, Megumi Kurosawa, Etsuko Miyagi, Takayuki Enomoto

    Vaccines   9 ( 2 )   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears in Japan. We aimed to clarify the differences between vaccinated and unvaccinated females in their awareness, knowledge, and behaviors toward cervical cancer, HPV vaccination and sex. Questionnaires were administered online to women aged 16 to 20. We conducted investigations for the following: awareness, knowledge, and actions for cervical cancer, HPV vaccination, and sexual activity, as well as items related to participants' social background. The survey in 828 girls revealed three points. The first is that more than half of the surveyed Japanese girls had poor knowledge about cervical cancer screening, HPV, or HPV vaccines. The second is that those in the unvaccinated group had a particularly poor knowledge of the subject and tended to have higher sexual activity. The final is that only 0.5% of the girls experienced changes in awareness about sexual activity after vaccination. In conclusion, this is the first large-scale survey analyzing the association between HPV vaccination and sexual activity in Japanese girls. Not only do unvaccinated girls not benefit from vaccines, but they also tend to engage in high-risk sexual behavior, and thus it is even more important to provide information on the effectiveness of vaccines and the usefulness of cancer screening.

    DOI: 10.3390/vaccines9020087

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  • A survey of 20-year-old Japanese women: how is their intention to undergo cervical cancer screening associated with their childhood HPV vaccination status?

    Reisa Kakubari, Tomomi Egawa-Takata, Yutaka Ueda, Yusuke Tanaka, Asami Yagi, Akiko Morimoto, Yoshito Terai, Masahide Ohmichi, Tomoyuki Ichimura, Toshiyuki Sumi, Hiromi Murata, Hidetaka Okada, Hidekatsu Nakai, Noriomi Matsumura, Kiyoshi Yoshino, Tadashi Kimura, Junko Saito, Risa Kudo, Masayuki Sekine, Takayuki Enomoto, Yorihiko Horikoshi, Tetsu Takagi, Kentaro Shimura

    Human Vaccines and Immunotherapeutics   17 ( 2 )   434 - 442   2021年

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    掲載種別:研究論文(学術雑誌)  

    © 2020 Taylor & Francis Group, LLC. Introduction: In Japan, two groups of women, HPV vaccinated and unvaccinated, are approaching age 20, when they should begin cervical cancer screening. To improve Japan’s current poor cervical cancer screening rate, we need to know how these women are thinking about screening. Methods: We conducted an internet survey of 20-y-old women, exploring their understanding of HPV and cervical cancer screening. We then gave them leaflets with basic information about HPV and cervical cancer, stressing the importance of early detection by screening. We analyzed the leaflet’s effects on their attitudes based on their vaccination status. Results: Our study of 618 women found a significantly higher intention for engagement for cervical cancer screening in women HPV-vaccinated as teenagers (29% versus 17%). They were also more aware that: (1) HPV is transmitted by sexual intercourse (49.1% versus 39.2%); (2) the HPV vaccine prevents cervical cancer (49.0% to 34.0%); and (3) the appropriate cervical cancer screening interval is every 2 y (63.3% versus 56.2%). Women in both groups responded well to the leaflet, with significant improvements in intention to receive screening. However, 65%-67% were not swayed. Discussion: HPV-vaccinated women were more knowledgeable about cervical cancer and had a greater intention to receive screening. Our educational leaflet was moderately effective in both groups for increasing intentions to screen, but the majority in both groups were still resistant to screening. Conclusion: Japan needs to develop more effective educational programs and tools to vigorously impart the importance of cervical cancer screening.

    DOI: 10.1080/21645515.2020.1788326

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  • Epidemiologic Profile of Type-Specific Human Papillomavirus Infection after Initiation of HPV Vaccination. 国際誌

    Masayuki Sekine, Manako Yamaguchi, Risa Kudo, Sharon J B Hanley, Megumi Hara, Sosuke Adachi, Yutaka Ueda, Etsuko Miyagi, Sayaka Ikeda, Asami Yagi, Takayuki Enomoto

    Vaccines   8 ( 3 )   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Organized human papillomavirus vaccination (OHPV) in Japan was introduced in 2010 for girls aged 12-16 years who were born in 1994 or later. The rate of OHPV coverage was 70-80%. However, after suspension of the government vaccination recommendation, the coverage dramatically decreased. We aim to investigate the change in prevalence of HPV infection after the initiation of HPV vaccination. We recruited females aged 20-21 years attending public cervical cancer screening from 2014 to 2017 fiscal years (April 2014 to March 2018). Residual Pap test specimens were collected for HPV testing. We compared the prevalence of HPV type-specific infection between women registered in 2014 (born in 1993-1994, including the pre-OHPV generation) and registered in 2015-2017 (born in 1994-1997, the OHPV generation). We collected 2379 specimens. The vaccination coverage figures were 30.7%, 86.6%, 88.4% and 93.7% (p < 0.01) from 2014 to 2017, respectively. The prevalence of HPV16/18 infection significantly decreased from 1.3% in 2014 to 0% in 2017 (p = 0.02). The three most prevalent types were HPV52, 16 and 56 in 2014, and HPV52, 58 and 56 in 2015-2017, respectively. HPV16 and 33 infection rates decreased. On the other hand, the HPV58 infection rate was obviously increased after OHPV from 0.3% to 2.1%. Our study demonstrates that the prevalence of HPV16/18 infection dramatically decreased and the profile of type-specific HPV infection was changed after OHPV.

    DOI: 10.3390/vaccines8030425

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  • Japan's Ongoing Crisis on HPV Vaccination. 国際誌

    Masayuki Sekine, Risa Kudo, Manako Yamaguchi, Sharon J B Hanley, Megumi Hara, Sosuke Adachi, Yutaka Ueda, Etsuko Miyagi, Sayaka Ikeda, Asami Yagi, Takayuki Enomoto

    Vaccines   8 ( 3 )   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    : The Japanese government suspended proactive recommendations for the HPV vaccine in June 2013. The suspension is now in its seventh year, despite all the data pointing to the safety of the HPV vaccine. We reported a high vaccine effectiveness in the group of women vaccinated before their first intercourse (93.9%). The prevalence of cross-protected types of HPV 31/45/52 was also lower in the vaccinated group, and the vaccine effectiveness was 67.7%. Furthermore, prevalence of HPV16, 31 and 52 infection rates in the vaccinated group were obviously lower than that in the unvaccinated group, and no one had HPV18 or 45 infection in the vaccinated group. The addition of a cross-protective effect toward HPV types 31/45/52 to HPV types 16/18, which is the direct target of the bivalent HPV vaccine, may possibly prevent around 82% of invasive cervical cancer cases in Japan. With regard to the preventive effect of histological abnormalities, we also reported significant reduction in incidence of cervical intraepithelial neoplasia (CIN)3 or worse. Thus, the efficacy of the vaccine has been demonstrated for precancerous disease, and the diverse symptoms after HPV vaccination are likely functional somatic. For the future of Japanese girls, there is a need to resume the proactive recommendation of HPV vaccination and for immediate action to be taken by the Japanese government.

    DOI: 10.3390/vaccines8030362

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  • Bivalent Human Papillomavirus Vaccine Effectiveness in a Japanese Population: High Vaccine-Type-Specific Effectiveness and Evidence of Cross-Protection. 国際誌

    Risa Kudo, Manako Yamaguchi, Masayuki Sekine, Sosuke Adachi, Yutaka Ueda, Etsuko Miyagi, Megumi Hara, Sharon J B Hanley, Takayuki Enomoto

    The Journal of infectious diseases   219 ( 3 )   382 - 390   2019年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Proactive recommendations for human papillomavirus (HPV) vaccines in Japan have been suspended for 5 years because of safety concerns. While no scientific evidence exists to substantiate these concerns, one reason given for not reinstating recommendations is the lack of reliable vaccine effectiveness (VE) data in a Japanese population. This study reports the VE of the bivalent HPV vaccine in Japanese women aged 20-22 years. Methods: During cervical screening between 2014 and 2016, women had Papanicolaou smears and HPV tests performed and provided data about their sexual history. Estimates of VE for vaccine-targeted HPV type 16 (HPV16) and 18 and cross-protection against other types were calculated. Results: Overall, 2197 women were tested, and 1814 were included in the analysis. Of these, 1355 (74.6%) were vaccinated, and 1295 (95.5%) completed the 3-dose schedule. In women sexually naive at vaccination, the pooled VEs against HPV16 and 18 and for HPV31, 45, and 52 were 95.5% (P < .01) and 71.9% (P < .01), respectively. When adjusted for number of sex partners and birth year, pooled VEs were 93.9% (P = .01) and 67.7% (P = .01) for HPV16 and 18 and HPV31, 45, and 52, respectively. Conclusions: The bivalent HPV vaccine is highly effective against HPV16 and 18. Furthermore, significant cross-protection against HPV31, 45, and 52 was demonstrated and sustained up to 6 years after vaccination. These findings should reassure politicians about the VE of bivalent HPV vaccine in a Japanese population.

    DOI: 10.1093/infdis/jiy516

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  • Differential misclassification between self-reported status and official HPV vaccination records in Japan: Implications for evaluating vaccine safety and effectiveness. 国際誌

    Manako Yamaguchi, Masayuki Sekine, Risa Kudo, Sosuke Adachi, Yutaka Ueda, Etsuko Miyagi, Megumi Hara, Sharon J B Hanley, Takayuki Enomoto

    Papillomavirus research (Amsterdam, Netherlands)   6   6 - 10   2018年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Japan has no national vaccine registry and approximately 1700 municipalities manage the immunization records independently. In June 2013, proactive recommendations for the human papillomavirus (HPV) vaccine were suspended after unconfirmed reports of adverse events following immunization in the media, despite no vaccine safety signal having been raised. Furthermore, studies assessing HPV vaccine safety and effectiveness published post suspension are predominantly based on self-reported information. Our aim was to examine the accuracy of self-reported vaccination status compared with official municipal records. Participants were women aged 20-22 yrs, who were attending for cervical screening in Niigata city. Among the 1230 eligible registrants, vaccine uptake, defined as any dose, was 75.0% and 77.2% according to a self-reported questionnaire and municipal records, respectively. The accuracy rate of self-reported information was as follows: positive predictive value (PPV) was 87.7%; negative predictive value (NPV) was 54.5%; sensitivity was 85.2%; and specificity was 59.8%. The validity of self-reported information was only moderate (Kappa statistic = 0.44, 95% confidence interval 0.37-0.50). This combined with the low NPV may lead to reduced estimation of effectiveness and safety. A more reliable method, such as a national HPV vaccine registry, needs to be established for assessing HPV immunization status in Japan.

    DOI: 10.1016/j.pvr.2018.05.002

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  • HPVワクチン接種による子宮頸がん検診細胞診異常例におけるハイリスクHPV感染率の変化

    工藤 梨沙, 関根 正幸, 山口 真奈子, 安達 聡介, 八木 麻美, 上田 豊, 原 めぐみ, Hanley Sharon, 宮城 悦子, 榎本 隆之

    日本癌治療学会学術集会抄録集   56回   PS - 6   2018年10月

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    記述言語:英語   出版者・発行元:(一社)日本癌治療学会  

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  • 日本人若年女性におけるHPVワクチン公費接種者のHPV感染予防効果

    工藤 梨沙, 山口 真奈子, 安達 聡介, 関根 正幸, 八木 麻未, 田中 佑典, 上田 豊, 宮城 悦子, 榎本 隆之

    日本癌治療学会学術集会抄録集   55回   PS - 6   2017年10月

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    記述言語:日本語   出版者・発行元:(一社)日本癌治療学会  

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  • 日本人若年女性のsexual activityとHPV感染、子宮頸部細胞診異常との相関

    山口 真奈子, 工藤 梨沙, 安達 聡介, 関根 正幸, 八木 麻未, 田中 佑典, 上田 豊, 宮城 悦子, 榎本 隆之

    日本癌治療学会学術集会抄録集   55回   P165 - 1   2017年10月

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    記述言語:日本語   出版者・発行元:(一社)日本癌治療学会  

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  • Realistic fear of cervical cancer risk in Japan depending on birth year. 国際誌

    Asami Yagi, Yutaka Ueda, Tomomi Egawa-Takata, Yusuke Tanaka, Ruriko Nakae, Akiko Morimoto, Yoshito Terai, Masahide Ohmichi, Tomoyuki Ichimura, Toshiyuki Sumi, Hiromi Murata, Hidetaka Okada, Hidekatsu Nakai, Masaki Mandai, Shinya Matsuzaki, Eiji Kobayashi, Kiyoshi Yoshino, Tadashi Kimura, Junko Saito, Yumiko Hori, Eiichi Morii, Tomio Nakayama, Yukio Suzuki, Yoko Motoki, Akiko Sukegawa, Mikiko Asai-Sato, Etsuko Miyagi, Manako Yamaguchi, Risa Kudo, Sosuke Adachi, Masayuki Sekine, Takayuki Enomoto, Yorihiko Horikoshi, Tetsu Takagi, Kentaro Shimura

    Human vaccines & immunotherapeutics   13 ( 7 )   1700 - 1704   2017年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: In Japan, the possible adverse events upon HPV vaccination was widely reported in the media. MHLW announced the suspension of aggressively encouraging HPV vaccination in 2013, and inoculation rate has sharply declined. The aim of the present study was estimation of future cervical cancer risk. METHODS: The latest data on vaccination rate at each age in Sakai City were first investigated. The rate of experiencing sexual intercourse at the age of 12, 13, 14, 15, 16, 17 and throughout lifetime is assumed to be 0%, 1%, 2%, 5%, 15%, 25%, and 85% respectively. The cervical cancer risk was regarded to be proportional to the relative risk of HPV infection over the lifetime. The risk in those born in 1993 whom HPV vaccination was not available yet for was defined to be 1.0000. RESULTS: The cumulative vaccination rates were 65.8% in those born in 1994, 72.7% in 1995, 72.8% in 1996, 75.7% in 1997, 75.0% in 1998, 66.8% in 1999, 4.1% in 2000, 1.5% in 2001, 0.1% in 2002, and 0.1% in 2003. The relative cervical cancer risk in those born in 1994-1999 was reduced to 0.56-0.70, however, the rate in those born in 2000-2003 was 0.98-1.0, almost the same risk as before introduction of the vaccine. DISCUSSION: The cumulative initial vaccination rates were different by the year of birth. It is confirmed that the risk of future cervical cancer differs in accordance with the year of birth. For these females, cervical cancer screening should be recommended more strongly.

    DOI: 10.1080/21645515.2017.1292190

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  • ヒトパピローマウイルス(HPV)検査におけるハイリスクスクリーニング法とジェノタイピング法による結果不一致例の検討

    工藤 梨沙, 関根 正幸, 山口 真奈子, 安達 聡介, 榎本 隆之, 上田 豊, 高田 友美, 森本 晶子, 田中 佑典, 八木 麻未

    日本産科婦人科学会雑誌   69 ( 2 )   674 - 674   2017年2月

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    記述言語:日本語   出版者・発行元:(公社)日本産科婦人科学会  

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  • Project conducted in Hirakata to improve cervical cancer screening rates in 20-year-old Japanese: Influencing parents to recommend that their daughters undergo cervical cancer screening. 国際誌

    Asami Yagi, Yutaka Ueda, Tomomi Egawa-Takata, Yusuke Tanaka, Yoshito Terai, Masahide Ohmichi, Tomoyuki Ichimura, Toshiyuki Sumi, Hiromi Murata, Hidetaka Okada, Hidekatsu Nakai, Masaki Mandai, Shinya Matsuzaki, Eiji Kobayashi, Kiyoshi Yoshino, Tadashi Kimura, Junko Saito, Yumiko Hori, Eiichi Morii, Tomio Nakayama, Yukio Suzuki, Yoko Motoki, Akiko Sukegawa, Mikiko Asai-Sato, Etsuko Miyagi, Manako Yamaguchi, Risa Kudo, Sosuke Adachi, Masayuki Sekine, Takayuki Enomoto, Yorihiko Horikoshi, Tetsu Takagi, Kentaro Shimura

    The journal of obstetrics and gynaecology research   42 ( 12 )   1802 - 1807   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: In Japan, the rate of routine cervical cancer screening is quite low, and the incidence of cervical cancer has recently been increasing. Our objective was to investigate ways to effectively influence parental willingness to recommend that their 20-year-old daughters undergo cervical cancer screening. METHODS: We targeted parents whose 20-year-old daughters were living with them. In fiscal year 2013, as usual, the daughter received a reminder postcard several months after they had received a free coupon for cervical cancer screening. In fiscal year 2014, the targeted parents received a cervical cancer information leaflet, as well as a cartoon about cervical cancer to show to their daughters, with a request that they recommend to their daughter that she undergo cervical cancer screening. The subsequent screening rates for fiscal years 2013 and 2014 were compared. RESULTS: The cervical cancer screening rate of 20-year-old women whose parents received the information packet in fiscal year 2014 was significantly higher than for the women who, in fiscal year 2013, received only a simple reminder postcard (P < 0.001). As a result, the total screening rate for 20-year-old women for the whole of the 2014 fiscal year was significantly increased over 2013 (P < 0.001). CONCLUSION: For the first time, we have shown that the parents of 20-year-old daughters can be motivated to recommend that their daughters receive their first cervical cancer screening. This was achieved by sending a cervical cancer information leaflet and a cartoon about cervical cancer for these parents to show to their daughters. This method was significantly effective for improving cervical cancer screening rates.

    DOI: 10.1111/jog.13122

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  • Mothers' attitudes in Japan regarding cervical cancer screening correlates with intention to recommend cervical cancer screening for daughters.

    Tomomi Egawa-Takata, Yutaka Ueda, Yusuke Tanaka, Akiko Morimoto, Satoshi Kubota, Asami Yagi, Yoshito Terai, Masahide Ohmichi, Tomoyuki Ichimura, Toshiyuki Sumi, Hiromi Murata, Hidetaka Okada, Hidekatsu Nakai, Masaki Mandai, Kiyoshi Yoshino, Tadashi Kimura, Junko Saito, Risa Kudo, Masayuki Sekine, Takayuki Enomoto, Yorihiko Horikoshi, Tetsu Takagi, Kentaro Shimura

    International journal of clinical oncology   21 ( 5 )   962 - 968   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Cervical cancer and its precancerous lesions caused by human papilloma virus (HPV) are steadily increasing in women in Japan. In comparison with women in other resource-rich countries, young women in Japan have a dismally low screening rate for cervical cancer. Our preliminary research has shown that 20-year-old women in Japan usually ask their mothers for advice regarding their initial cervical cancer screening. The objective of our current research is to determine the social factors among mothers in Japan that are causing them to give advice to their daughters regarding the HPV vaccine and cervical cancer screening. METHODS: The survey's targets were mothers who had 20-year-old daughters. We recruited respondents from the roster of a commercial internet survey panel. We analyzed for correlations between a mother's knowledge concerning cervical cancer, her recent cancer screening history, and the advice she gave to her daughter regarding cervical cancer screening. RESULTS: We obtained 618 valid answers to the survey. Compared with mothers who did not get screening, mothers who had cervical cancer screening had significantly more knowledge about cervical cancer and its screening (p < 0.05). The daughters of mothers with recent screening had received HPV vaccination more often than those of mothers without recent screening (p = 0.018). Mothers with recent screening histories tended more often to encourage their daughters to have cervical cancer screening (p < 0.05). When mothers were properly educated concerning cervical cancer and its screening, they were significantly more likely than before to recommend that their daughters have it (p < 0.0001). CONCLUSIONS: In young Japanese women, given the important role their mothers have in their lives, it is probable that we could improve their cervical cancer screening rate significantly by giving their mothers better medical information, and a chance to experience cervical cancer screening for themselves.

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  • 20-21歳女性におけるHPVワクチン接種とHPV感染率、および性活動性との相関

    関根 正幸, 山口 真奈子, 工藤 梨沙, 安達 聡介, 田中 佑典, 森本 晶子, 高田 友美, 八木 麻未, 上田 豊, 榎本 隆之

    日本婦人科腫瘍学会雑誌   34 ( 3 )   411 - 411   2016年6月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 20-21歳女性におけるHPVワクチン接種とHPV感染率および性活動性との相関

    関根 正幸, 山口 真奈子, 工藤 梨沙, 安達 聡介, 榎本 隆之, 上田 豊, 高田 友美, 森本 晶子, 田中 佑典, 八木 麻未

    日本産科婦人科学会雑誌   68 ( 2 )   825 - 825   2016年2月

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    記述言語:日本語   出版者・発行元:(公社)日本産科婦人科学会  

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