The Japanese government began a human papillomavirus (HPV) vaccination program for girls aged 12‐16 years in 2010 but withdrew its recommendation in 2013 because of potential adverse effects, leading to drastically reduced vaccination uptake. To evaluate population‐level effects of HPV vaccination, women younger than 40 years of age newly diagnosed with cervical intraepithelial neoplasia grade 1‐3 (CIN1‐3), adenocarcinoma in situ (AIS), or invasive cervical cancer (ICC) have been registered at 21 participating institutes each year since 2012. A total of 7709 women were registered during 2012‐2017, of which 5045 were HPV genotyped. Declining trends in prevalence of vaccine types HPV16 and HPV18 during a 6‐year period were observed in CIN1 (50.0% to 0.0%, Ptrend < .0001) and CIN2‐3/AIS (83.3% to 45.0%, Ptrend = .07) only among women younger than 25 years of age. Overall, HPV vaccination reduced the proportion of HPV16/18‐attributable CIN2‐3/AIS from 47.7% to 33.0% (P = .003): from 43.5% to 12.5% as routine vaccination (P = .08) and from 47.8% to 36.7% as catch‐up vaccination (P = .04). The HPV16/18 prevalence in CIN2‐3/AIS cases was significantly reduced among female individuals who received their first vaccination at age 20 years or younger (P = .02). We could not evaluate vaccination effects on ICC owing to low incidence of ICC among women aged less than 25 years. We found HPV vaccination to be effective in protecting against HPV16/18‐positive CIN/AIS in Japan; however, our data did not support catch‐up vaccination for women older than 20 years. Older adolescents who skipped routine vaccination due to the government’s suspension of its vaccine recommendation could benefit from receiving catch‐up vaccination before age 20 years.

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We attempted to assess the clinical utility of squamous cell carcinoma antigen (SCC) for detecting squamous cell carcinoma arising in mature cystic teratoma of the ovary. SCC in serum from 16 patients with this malignancy and from 56 patients with mature cystic teratoma without malignancy was measured using radioimmunoassay. Serum SCC levels exceeded the cut-off of 2.0 ng/ml in 9 (56%) of the 16 patients with malignancy. This rate was significantly higher than that in the patients with nonmalignant mature cystic teratoma (9 to 56, 16%; p < 0.01). The positive rate for SCC was as low as 30% for stage I cancer. All cases in which the tumor size was > 500 cm³ had a positive response for SCC, whereas all other cases had a negative response (p < 0.001). SCC is useful as a tumor marker for this malignancy. However, the serum SCC level depends on the tumor volume, so it may not be suitable for early detection of small tumors.

For operable patients, surgery as an initial treatment and reduction of the residual tumor size to less than 2 cm appeared to contribute to a better prognosis. In addition, conservative initial treatment and the presence of non-lung hematogenous metastasis were poor prognostic factors.