Prospective Study of Human Papillomavirus (HPV) Types, HPV Persistence, and Risk of Squamous Cell Carcinoma of the Cervix

Abstract

Background: The link between squamous cell cervical carcinoma and human papillomavirus (HPV) 16/18 is well established, but the magnitude of the risk association is uncertain and the importance of other highrisk HPV (HRHPV) types is unclear.Methods: In two prospective nested case-control series among women participating in cytologic screening in Sweden, we collected 2,772 cervical smears from 515 women with cancer in situ (CIS), 315 with invasive squamous cell carcinoma (SCC), and individually matched controls. All smears were tested for HPV with PCR assays, and the median follow-up until diagnosis was 5 to 7 years. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI).Results: The presence of HPV16/18 in the first smear was associated with 8.5-fold (95% CI, 5.3-13.7) and 18.6-fold (95% CI, 9.0-38.9) increased risks of CIS and SCC, respectively, compared with women negative for HPV. Infection with other HRHPV types in the first smear was also associated with significantly increased risks for both CIS and SCC. Persistence of HPV16 infection conferred a RR of 18.5 (95% CI, 6.5-52.9) for CIS and 19.5 (95% CI, 4.7-81.7) for SCC. The HPV16/18 attributable risk proportion was estimated at 30% to 50% for CIS, and 41% to 47% for SCC. Other HRHPV types also conferred significant proportions.Conclusions: Our large population-based study provides quantification of risks for different HPV types and prospective evidence that non-16/18 HRHPV types increase the risk for future cervical cancer.Impact: This study gives further insights into cervical cancer risk stratification with implications for HPVbased prevention strategies. Cancer Epidemiol Biomarkers Prev; 19(10); 2469-78. ©2010 AACR.

Impact of human papillomavirus infection on the neovaginal and vulval tissues of women who underwent surgical treatment for Mayer-Rokitansky-Kuster-Hauser syndrome

“…The persistence of a high-risk HPV infection is regarded as a significant risk factor for cancer development (23,24). Moreover, HPV infection has been documented in cancers of the vagina and in its precursors (VAINs) (25)(26)(27)(28).…”

Sequence variation analysis of the E2 gene of human papilloma virus type 16 in cervical lesions from women in Greece

“…Consequently, five HPV16 variants have been characterized: East Asian, European, African type I, African type II and Asian American [3,4]. Moreover, HPV16, HPV18 and HPV45 are the most frequently identified HR HPV types found in invasive cervical cancer [5][6][7][8][9]. Nevertheless, it has been proposed that epigenetic alterations may also be necessary for the establishment of cervical neoplastic progression [10,11].…”

Comparison of Clinical Performance of Abbott RealTi m e High Risk HPV Test with That of Hybrid Capture 2 Assay in a Screening Setting

“…Several studies (12,21) suggest that infections supported by HPV16 and HPV18 are associated with a higher risk for the progression of cervical cancer. Consequently, the genotyping of HPV16 and HPV18 has been proposed to guide the management of HPV-positive women throughout the follow-up procedures (12).…”