Faculty Profiles - KUDO Risa

Papers - KUDO Risa

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HPVワクチンの現状有効性と安全性

工藤梨沙, 関根正幸, 山口真奈子, 黒澤めぐみ, 安達聡介, 榎本隆之

新潟県臨床検査技師会誌 61 ( 2 ) 50 - 57 2021.4

HPV16型感染が確認されながらp16免疫染色が陰性であったVIN3の若年症例

櫛谷直寿, 小林暁子, 工藤梨沙, 石黒竜也, 安達聡介, 吉原弘祐, 磯部真倫, 西野幸治, 山口雅幸, 西川伸道, 関根正幸, 榎本隆之

日本産科婦人科学会雑誌 73 ( 臨増 ) S - 295 2021.3

クロミフェンクエン酸塩療法後のheterotopic pregnancyに対する腹腔鏡下手術経験

石黒竜也, 櫛谷直寿, 齋藤宏美, 工藤梨沙, 茅原誠, 西野幸治, 小林暁子, 山口雅幸, 西川伸道, 関根正幸, 榎本隆之

新潟産科婦人科学会会誌 115 ( 2 ) 137 - 137 2021.3

完全直腸脱を伴うstage IV骨盤臓器脱に対して腹腔鏡下直腸固定術と同時に腹腔鏡下仙骨腟固定術を行った2症例

春谷千智, 小林暁子, 明石英彦, 鈴木美保, 工藤梨沙, 茅原誠, 石黒竜也, 安達聡介, 吉原弘祐, 磯部真倫, 西野幸治, 西川伸道, 関根正幸, 榎本隆之

新潟産科婦人科学会会誌 115 ( 2 ) 81 - 85 2021.3

Language：Japanese Publisher：新潟産科婦人科学会

症例1は80歳で、約2年前から子宮下垂感を自覚し、約1年前から排便時に直腸脱を認めるようになった。今回、Stage IVの子宮脱および完全直腸脱の診断で一期的根治手術を行う方針となり、腹腔鏡下にWells直腸後方固定術+子宮腟上部切断+両側付属器切除+シングルメッシュによる仙骨腟固定術を施行し、術後経過良好であった。症例2は78歳で、約2年前から子宮脱を自覚し、間欠的自己還納で対応していた。半年前に排尿困難感が出現し、手術目的で当科を紹介受診した。初回受診時は子宮脱のみであったが、2回目の診察で直腸脱の併発を認めた。今回、Stage IVの子宮脱および完全直腸脱の診断で症例1と同様の手術を行い、術後経過良好であった。

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【ワクチンの安全性と社会学-HPVワクチンの接種はなぜ広まらないのか?-】HPVワクチンについて HPVワクチンの有効性最近の動向

関根正幸, 工藤梨沙, 山口真奈子, 安達聡介, 黒澤めぐみ, 榎本隆之

産婦人科の実際 70 ( 3 ) 285 - 291 2021.3

Language：Japanese Publisher：金原出版(株)

＜文献概要＞HPVワクチンの積極的勧奨が中止されて8年が経過しようとしている。HPVワクチン接種者が検診年齢である20歳に到達したことで,HPV感染率の低下だけでなく,細胞診異常と組織診異常の低下も報告されてきている。NIIGATA STUDYではHPV16/18型感染に対する高い有効性に加え,HPV31/45/52型に対する交叉防御効果が示され,厚生労働科学研究費補助金上田班とAMED榎本班のJ Studyでは,それぞれCIN3以上の減少効果,CIN2以上の減少効果が示された。海外では,スウェーデンから世界で初めて浸潤子宮頸癌の減少効果が報告され,わが国でも浸潤癌に対するデータの検証が待たれている。

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Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women. International journal

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 2021.2

Language：English Publishing type：Research paper (scientific journal)

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. International journal

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 ) 2021.1

Language：English Publishing type：Research paper (scientific journal)

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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日本人女性における性的活動性とHPV感染、子宮頸部組織診異常との関係

山口真奈子, 関根正幸, 工藤梨沙, 安達聡介, 榎本隆之

新潟産科婦人科学会会誌 115 ( 1 ) 37 - 37 2021.1

日本人若年女性におけるHPV9価ワクチン導入効果の予測

山口真奈子, 関根正幸, 工藤梨沙, 安達聡介, 榎本隆之

日本婦人科腫瘍学会雑誌 39 ( 1 ) 277 - 277 2021.1

腹腔鏡下手術におけるセプラフィルム体腔内搬入および貼付法の工夫 Endoロールの使用経験

鈴木美保, 小林暁子, 黒澤めぐみ, 明石英彦, 明石絵里菜, 工藤梨沙, 田村亮, 石黒竜也, 安達聡介, 吉原弘祐, 磯部真倫, 西野幸治, 山口雅幸, 西川伸道, 関根正幸, 榎本隆之

新潟産科婦人科学会会誌 115 ( 1 ) 1 - 6 2021.1

Language：Japanese Publisher：新潟産科婦人科学会

セプラフィルムは優れた癒着防止効果が報告されているが、腹腔鏡下手術での体腔内搬入や貼付操作に難渋することが多い。今回、セプラフィルムの操作にEndoロールを用いた方法を試行し、その有効性について従来法(リデューサーを用いる方法)と比較検討した。腹腔鏡下単純子宮全摘出術3例にEndoロールを使用した結果、3例とも充填が比較的簡便に途中で破損することなく可能であった。最も優れていた点は、5mmポートから挿入可能なため、カメラで確認しながら安全に体腔内搬入でき、周囲臓器にセプラフィルムが付着する前に、広がったままの状態で受け取ることにより貼付が容易な点であった。

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当科における腹腔鏡下仙骨腟固定術の治療成績

明石英彦, 小林暁子, 春谷千智, 明石絵里菜, 鈴木美保, 工藤梨沙, 田村亮, 安達聡介, 磯部真倫, 西野幸治, 西川伸道, 関根正幸, 榎本隆之

新潟産科婦人科学会会誌 115 ( 1 ) 25 - 30 2021.1

Language：Japanese Publisher：新潟産科婦人科学会

骨盤臓器脱に対して2018年6月〜2020年2月に腹腔鏡下仙骨腟固定術を行った31例のうち、直腸脱の同時手術を行った2例を除く29例を対象とし、「手術時間」「術中出血量」「術中・術後合併症」「再発の有無」「術前後の排尿機能」などについて検討した。手術時間は128〜256分(中央値199分)、出血量は5〜10mL(中央値5mL)であった。術中合併症は認めなかった。術後合併症として腹腔内感染を1例に認めたが保存的治療で改善した。再発は1例に認め、再発部位はメッシュ固定部位以外の後壁であり、追加手術は要しなかった。排尿機能はOABSSとIPSSで評価し、術前のOABSSは軽症(5点以下)5例、中等症(6〜11点)6例、術後のOABSSは軽症1例、中等症1例、重症(12点以上)1例であった。術前のIPSSは軽症(0〜7点)50%、中等症(8〜19点)35%、重症(20〜35点)15%、術後のIPSSは軽症81%、中等症15%、重症4%であった。

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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

Publishing type：Research paper (scientific journal)

© 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

Scopus

PubMed

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Epidemiologic Profile of Type-Specific Human Papillomavirus Infection after Initiation of HPV Vaccination. International journal

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 ) 2020.7

Language：English Publishing type：Research paper (scientific journal)

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. International journal

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 ) 2020.7

Language：English Publishing type：Research paper (scientific journal)

: 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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【子宮頸がん予防-日本はどうする?-】HPVワクチン接種プログラムのインパクト-日本の現状と課題-

工藤梨沙, 関根正幸

産婦人科の実際 69 ( 3 ) 257 - 262 2020.3

Language：Japanese Publisher：金原出版(株)

＜文献概要＞わが国においてヒトパピローマウイルス(HPV)ワクチンは2009年に認可され,2010年に自治体ごとの公費接種助成が開始し,接種対象年齢の女性は無料でワクチン接種が可能となった。2013年には国が定める定期接種ワクチンの1つとなったが,現在は積極的勧奨が中止されており,新規のワクチン接種者がほぼいない状況が継続している。その一方で,積極的勧奨中止前にワクチンを接種した公費接種対象世代が子宮頸がん検診の対象年齢となっており,諸外国と同様にわが国からも若年女性におけるHPVワクチンによるHPV感染率と前がん病変発症率の減少効果に関するデータが続々と報告されてきた。本稿では,わが国におけるHPVワクチン接種の現状と子宮頸がん予防に対する今後の課題について解説する。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00535&link_issn=&doc_id=20200403100012&doc_link_id=10.18888%2Fsp.0000001212&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000001212&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

HPVワクチン公費接種の導入による若年世代のHPV感染プロファイルの変化

山口真奈子, 関根正幸, 工藤梨沙, 安達聡介, 榎本隆之

新潟産科婦人科学会会誌 113 ( 2 ) 85 - 85 2019.2

【子宮頸がんとHPVワクチンを考える】HPVワクチンの有効性最近の動向

関根正幸, 工藤梨沙, 山口真奈子, 安達聡介, 榎本隆之

外来小児科 22 ( 1 ) 55 - 60 2019.2

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

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 2019.1

Language：English Publishing type：Research paper (scientific journal)

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. International journal

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 2018.12

Language：English Publishing type：Research paper (scientific journal)

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 2018.10

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