Age-specific HPV type distribution in high-grade cervical disease in screened and unvaccinated women

Aro, Karoliina; Nieminen, Pekka; Louvanto, Karolina; Jakobsson, Maija; Virtanen, Seppo; Lehtinen, Matti; Dillner, Joakim; Kalliala, Ilkka

doi:10.1016/j.ygyno.2019.05.024

Cited by 48 publications

(72 citation statements)

References 37 publications

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“…Growing evidence suggest how various HPV types might have a different impact on the basis of age [ 11 12 13 ]. Aro et al, [ 14 ] evaluated HPV types distribution among a cohort of 1,279 women with cervical dysplasia [ 11 ]. The authors observed that HPV type distribution was distinctly polarized by age with HPV16/18 being markedly HPV16/18-related lesions more prevalent young women.…”

Section: Discussionmentioning

confidence: 99%

Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women

et al. 2020

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Objective: This study aimed to identify predictors of recurrence/persistence of cervical intraepithelial neoplasia grade 2+ (CIN2+) lesion (r-CIN2+) after primary conization. Methods: Retrospective analysis involving all consecutive women having conization for CIN2+ between 1998 and 2018. The risk of r-CIN2+ was assessed using Kaplan-Meier and Cox models. Results: Data of 3,212 women were retrospectively identified. After a mean follow-up of 47 (±22.2) months, 112 (3.5%) patients developed r-CIN2+. Mean time interval between prior conization and diagnosis of r-CIN2+ was 26.2 (±13.2) months. Via multivariate analysis, presence of high-risk human papillomavirus (HPV) types at the time of CIN2+ diagnosis, hazard ratio (HR)=3.40 (95% confidence interval [CI]=1.66-6.95) for HPV16/18 and HR=2.59 (95% CI=1.21-5.55) for HPV types other than 16/18, positive margins at primary conization, HR=4.11 (95% CI=2.04-8.26) and HPV persistence after conization, HR=16.69 (95% CI=8.20-33.9), correlated with r-CIN2+, independently. Considering age-specific HPV types distribution, we observed that HPV16/18 infection correlated to an increased risk of r-CIN2+ only in young women (aged ≤25 years; p=0.031, log-rank test); while in the older population (>25 years) HPV type(s) involved had not impact on r-CIN2+ risk (p>0.200, log-rank test). Conclusion: HPV persistence is the main factor predicting r-CIN2+. Infection from HPV16/18 has a detrimental effect in young women, thus highlighting the need of implementing vaccination against HPV in this population. Further prospective studies are warranted for tailoring clinical decision-making for post-conization follow-up on the basis of risk factors.

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Section: Discussionmentioning

confidence: 99%

Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women

et al. 2020

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“…The morbidity and mortality of cervical cancer incidence in developed countries has fallen over the last two decades because of an enhanced awareness of cervical cancer prevention and effective screening [5]. However, infection rate of HPV has uctuated and not shown a downward trend, indicating a relatively heavy burden of HPV infection in China [6,7]. HPV genotypes are linked to the degree of cervical lesions [6].…”

Section: Introductionmentioning

confidence: 99%

“…Contrarily, high-risk HPV (HR-HPV) type cause cervical, anal, and other genital cancers, which could be detected in 99% of cervical cancers-the second most common cancer in women worldwide. HPV16 and -18 have been found to be the most pathogenic of the HR-HPV types, causing about 70% of cervical cancers worldwide [7][8][9][10]. Of note, most HPV infections are completely asymptomatic, resulting in a delay in diagnosis and follow-up treatment with disastrous consequences [11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012-2018: baseline measures prior to mass HPV vaccination

Luo

Qiao-tu

et al. 2020

Preprint

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Background: The epidemiology on the human papillomavirus (HPV) among females in Southern China is not well-established. Baseline data on the prevalence of HPV infection in China prior to mass prophylactic HPV vaccination would be useful. Thus, this study aimed to determine the type-specific HPV prevalence and distribution among females from Southern China prior to mass HPV vaccination. Methods: A retrospective cross-sectional study employing 214,715 women attending ChenZhou NO.1 People’s Hospital for cervical screening during 2012-2018 was conducted prior to widespread HPV vaccination. HPV genotype was detected using nucleic acid molecular diversion hybridization tests. The overall prevalence, age-specific prevalence, type distribution, and annual trend were analyzed. Results: The overall HPV prevalence was 18.71% (95% confidence interval [CI], 18.55%-18.88%) among Southern China females. During 2012–2018, the prevalence of HPV infection showed a downward tendency, from 21.63% (95% CI, 21.07%-22.20%) in 2012 to 18.75% (95% CI, 18.35%-19.16%) in 2018. Age-specific HPV distribution displayed a peak at young women aged less than 21 years (33.11%, 95% CI, 31.13%-35.15%), 20.07% (95% CI, 19.70%-20.44%) among women aged 21-30 years, 17.29% (95% CI, 17.01%-17.57%) among women aged 31-40 years, 17.23% (95% CI, 16.95%-17.51%) among women aged 41-50 years, 21.65% (95% CI, 21.11%-22.20%) among women aged 51-60 years, and 25.95% (95% CI, 24.86%-27.07%) among women aged over 60 years. Of the 21 subtypes identified, the most three prevalent high-risk HPV (HR-HPV) genotypes were HPV52 (5.12%; 95% CI, 21.11%-22.20%), -16 (2.96%; 95% CI, 2.89%-3.03%), and -58 (2.51%; 95% CI, 2.44%-2.58%); the predominant low-risk HPV (LR-HPV) genotypes were HPV81 (1.86%; 95%CI, 1.80%-1.92%) and -6 (0.69%; 95% CI, 0.66%-0.73%) respectively. Incidence of HR-HPV only, LR-HPV only and mixed LR- and HR-HPV were 15.17%, 2.07% and 1.47% respectively. Besides, single HPV infection accounted for 77.30% of all positive cases in this study.Conclusions: This study highlights 1) a high prevalence of HPV infection among females with a decreasing tendency towards 2012-2018, especially for young women under the age of 21 prior to mass HPV vaccination; 2) HPV52, -16 and -58 were the predominant HPV genotypes, suggesting potential use of HPV vaccine covering these HPV genotypes in Southern China.

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“…The morbidity and mortality of cervical cancer incidence in developed countries has fallen over the last two decades because of an enhanced awareness of cervical cancer prevention and effective screening [5]. However, infection rate of HPV has fluctuated and not shown a downward trend, indicating a relatively heavy burden of HPV infection in China [6,7]. HPV genotypes are linked to the degree of cervical lesions [6].…”

Section: Introductionmentioning

confidence: 99%

“…Contrarily, high-risk HPV (HR-HPV) type cause cervical, anal, and other genital cancers, which could be detected in 99% of cervical cancers-the second most common cancer in women worldwide. Especially, HPV16 and − 18 have been found to be the most pathogenic of the HR-HPV types, causing about 70% of cervical cancers worldwide [7][8][9][10]. Of note, most HPV infections are completely asymptomatic, resulting in a delay in diagnosis and follow-up treatment with disastrous consequences [11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012-2018: baseline surveys prior to mass HPV vaccination

Luo

Qiao-tu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background : The epidemiology on the human papillomavirus (HPV) among females in Southern China is not well-established. Baseline data on the prevalence of HPV infection in China prior to mass prophylactic HPV vaccination would be useful. Thus, this study aimed to determine the type-specific HPV prevalence and distribution among females from Southern China prior to mass HPV vaccination.Methods : A retrospective cross-sectional study employing 214,715 women attending ChenZhou NO.1 People’s Hospital for cervical screening during 2012-2018 was conducted prior to widespread HPV vaccination. HPV genotype was detected using nucleic acid molecular diversion hybridization tests. The overall prevalence, age-specific prevalence, type distribution，and annual trend was analyzed.Results : The overall HPV prevalence was 18.71% (95% confidence interval [CI], 18.55%-18.88%) among Southern China females. During 2012–2018, the prevalence of HPV infection showed a downward tendency, from 21.63% (95% CI, 21.07%-22.20%) in 2012 to 18.75% (95% CI, 18.35%-19.16%) in 2018. Age-specific HPV distribution displayed a peak at young women aged less than 21 years (33.11%, 95% CI, 31.13%-35.15%), 20.07% ( 95% CI, 19.70%-20.44% ) among women aged 21-30 years, 17.29% (95% CI, 17.01%-17.57%) among women aged 31-40 years, 17.23% (95% CI, 16.95%-17.51%) among women aged 41-50 years, 21.65% (95% CI, 21.11%-22.20%) among women aged 51-60 years, and 25.95% (95% CI, 24.86%-27.07%) among women aged over 60 years. Of the 21 subtypes identified, the most three prevalent high-risk HPV (HR-HPV) genotypes were HPV52 (5.12%; 95% CI, 21.11%-22.20%), -16 (2.96%; 95% CI, 2.89%-3.03%), and -58 (2.51%; 95% CI, 2.44%-2.58%); the predominant low-risk HPV (LR-HPV) genotypes were HPV81 (1.86%; 95%CI, 1.80%-1.92%) and -6 (0.69%; 95% CI, 0.66%-0.73%) respectively. Incidence of HR-HPV only, LR-HPV only and mixed LR- and HR-HPV were 15.17%, 2.07% and 1.47% respectively. Besides, single HPV infection accounted for 77.30% of all positive cases in this study.Conclusions: This study highlights 1) a high prevalence of HPV infection among females with a decreasing tendency towards 2012-2018, especially for young women under the age of 21 prior to mass HPV vaccination; 2) HPV52, -16 and -58 were the predominant HPV genotypes, suggesting potential use of HPV vaccine covering these HPV genotypes in Southern China.

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Age-specific HPV type distribution in high-grade cervical disease in screened and unvaccinated women

Cited by 48 publications

References 37 publications

Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women

Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women

Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012-2018: baseline measures prior to mass HPV vaccination

Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012-2018: baseline surveys prior to mass HPV vaccination

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