Human papillomavirus type distribution in invasive cervical cancer and high‐grade cervical lesions: A meta‐analysis update

Abstract

Data on human papillomavirus (HPV) type distribution in invasive and pre-invasive cervical cancer is essential to predict the future impact of HPV16/18 vaccines and HPV-based screening tests. A meta-analyses of HPV type distribution in invasive cervical cancer (ICC) and high-grade squamous intraepithelial lesions (HSIL) identified a total of 14,595 and 7,094 cases, respectively. In ICC, HPV16 was the most common, and HPV18 the second most common, type in all continents. Combined HPV16/18 prevalence among ICC cases was slightly higher in Europe, North America and Australia (74-77%) than in Africa, Asia and South/Central America (65-70%). The next most common HPV types were the same in each continent, namely HPV31, 33, 35, 45, 52 and 58, although their relative importance differed somewhat by region. HPV18 was significantly more prevalent in adeno/adenosquamous carcinoma than in squamous cell carcinoma, with the reverse being true for HPV16, 31, 33, 52 and 58. Among HSIL cases, HPV16/18 prevalence was 52%. However, HPV 16, 18 and 45 were significantly under-represented, and other highrisk HPV types significantly over-represented in HSIL compared to ICC, suggesting differences in type-specific risks for progression. Data on HPV-typed ICC and HSIL cases were particularly scarce from large regions of Africa and Central Asia. ' 2007 Wiley-Liss, Inc.Key words: human papillomavirus; genotype; cervical cancer; highgrade squamous intraepithelial lesions; meta-analysis; epidemiology Data on human papillomavirus (HPV) type distribution in women with invasive cervical cancer (ICC) and its precursor lesions are essential to predict the potential worldwide impact of new prophylactic vaccines against HPV16/18, 1,2 as well as to determine priorities for the inclusion of HPV types in future HPV vaccines and HPV-based screening tests.A standardised pooled analysis of 3,607 ICC cases 3 and a wider meta-analysis of 10,058 ICC cases 4 both confirmed that a majority of worldwide ICC cases are associated with HPV16/18. They also suggested some geographical variation in the importance of specific HPV types, 3,4 although data were limited or missing from many regions in Africa and Asia.A further meta-analysis in 4,338 high-grade squamous intraepithelial lesions (HSIL) showed that the most common HPV types in HSIL were broadly similar, but not identical, to those in ICC. 5 The purpose of the present publication is to update previous meta-analyses of HPV type distribution in ICC and HSIL with studies published between January 2002 and January 2006, including many from previously under-studied regions, and to identify remaining worldwide epidemiological data gaps prior to HPV vaccine implementation. Material and methodsThe detailed methods used for this meta-analysis of type-specific HPV prevalence have been reported previously, and are similar for both ICC and HSIL. 4,5 In brief, Medline was employed to search for citations published from January 2002 to January 2006 using the following MeSH terms: ''cervical cancer'', ''cervical intraepit...

Human papillomavirus infection in women with and without cervical cancer in Nepal

“…As in most previous similar studies, HPV16 was confirmed to be the most common type in the whole range of women considered, i.e., 1.5, 14.7, and 68.5%, respectively, in cytologically normal and abnormal women and in women with HPV-positive ICC [9,30]. HPV52 and 58, however, were not as predominant as in similar surveys in China [16][17][18].…”

Association of human papillomavirus type 31 variants with risk of cervical intraepithelial neoplasia grades 2–3

“…When data were stratified by HPV16 status, the increased risk of CIN2/3 remained associated with A or B, compared to C, variants among women without, but not with, HPV16 coinfection. 1 All variables were based on information at study entry except for cytology, coinfection with non-HPV31 oncogenic types and coinfection with HPV16 which were based on the results at the first HPV31-positive visit. 2 Excluded was one woman who did not provide information on race.…”

“…[1][2][3] To date, >150 papillomavirus types have been fully characterized and classified, from the higher to lower taxon, as genera, species and type. 4,5 HPV types are known to differ in their tropisms and oncogenic potentials.…”

“…Results from a recent meta-analysis (including 215 studies worldwide) have shown that on average prevalence of HPV31 infection ranks fourth, after types 16, 18 and 45, in cases of cervical cancer and second, only after type 16, in women with high-grade squamous intraepithelial lesion (referring both to cytologically detected high-grade lesions and histologically diagnosed CIN2/3 or carcinoma in situ in this analysis). 1 Clinical relevance of HPV31 variants has been rarely described, [13][14][15] although the intratypic variations in the L1, E6, E7 and long control region were recognized. [14][15][16][17][18][19][20][21] A recent study by Chen et al 22 has defined HPV31 variants as A, B and C lineages based on the whole genome analyses.…”

Benefits, cost requirements and cost-effectiveness of the HPV16,18 vaccine for cervical cancer prevention in developing countries: policy implications

“…1 Human papillomavirus (HPV), an extremely common sexually transmitted virus, is the known aetiologic agent responsible for cervical cancer. Although there is considerable epidemiological variation, HPV types 16 and 18 cause approximately 70% of cervical cancer, [2][3][4] and the eight most common genotypes (HPV 16,18,45,31,33,52, 58 and 35) account for 90%. Persistent infection with high-risk HPV genotypes is also the cause of 90% of anal cancer, 40% of other anogenital cancers, and at least 12% of oropharyngeal cancers.…”