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Cancer Epidemiol Biomarkers Prev. 2014 Oct;23(10):1997-2008. doi: 10.1158/1055-9965.EPI-14-0410.

Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease.

Author information

1
Department of Gynecology and Obstetrics, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. elmar.joura@meduniwien.ac.at.
2
Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas.
3
Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain.
4
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
5
Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.
6
Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia.
7
Department of Microbiology Infectious Diseases, The Royal Women's Hospital, Department of Obstetrics and Gynaecology, University of Melbourne, Australia.
8
Center for Infection Research in Cancer (CIRC), Moffitt Cancer Center, Tampa, Florida.
9
National Institute of Public Health, Cuernavaca, Morelos, Mexico.
10
Division of Gynecologic Oncology, University of Alabama, Birmingham, Alabama.
11
Institute of Clinical Medicine, University of Bergen/Haukeland University Hospital, Bergen, Norway.
12
Danish Cancer Society Research Center, Copenhagen, Denmark and Department of Gynecology, Rigshospitalet, University of Copenhagen, Denmark.
13
Department of Obstetrics and Gynecology, Clinica Colsanitas, Fundacion Universitaria Sanitas, Bogota, Colombia.
14
Department of Obstetrics and Gynaecology, University of British Colombia, Vancouver, Canada.
15
Institut du col, Paris, France.
16
National Institute of Cancer, Bogotá, Colombia.
17
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
18
Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland.
19
Faculty of Tropical Medicine, Mahidol University, Thailand.
20
Direction des Risques Biologiques et de la Santé au travail, Institut National de Santé Publique du Québec, Montréal, Quebec, Canada.
21
Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
22
Merck & Co., Inc., Whitehouse Station, New Jersey. Universidad del Rosario, Bogota, Colombia.
23
Merck & Co., Inc., Whitehouse Station, New Jersey.

Abstract

BACKGROUND:

We estimated the prevalence and incidence of 14 human papillomavirus (HPV) types (6/11/16/18/31/33/35/39/45/51/52/56/58/59) in cervicovaginal swabs, and the attribution of these HPV types in cervical intraepithelial neoplasia (CIN), and adenocarcinoma in situ (AIS), using predefined algorithms that adjusted for multiple-type infected lesions.

METHODS:

A total of 10,656 women ages 15 to 26 years and 1,858 women ages 24 to 45 years were enrolled in the placebo arms of one of three clinical trials of a quadrivalent HPV vaccine. We estimated the cumulative incidence of persistent infection and the proportion of CIN/AIS attributable to individual carcinogenic HPV genotypes, as well as the proportion of CIN/AIS lesions potentially preventable by a prophylactic 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine.

RESULTS:

The cumulative incidence of persistent infection with ≥1 of the seven high-risk types included in the 9-valent vaccine was 29%, 12%, and 6% for women ages 15 to 26, 24 to 34, and 35 to 45 years, respectively. A total of 2,507 lesions were diagnosed as CIN or AIS by an expert pathology panel. After adjusting for multiple-type infected lesions, among women ages 15 to 45 years, these seven high-risk types were attributed to 43% to 55% of CIN1, 70% to 78% of CIN2, 85% to 91% of CIN3, and 95% to 100% of AIS lesions, respectively. The other tested types (HPV35/39/51/56/59) were attributed to 23% to 30% of CIN1, 7% to 14% of CIN2, 3% to 4% of CIN3, and 0% of AIS lesions, respectively.

CONCLUSIONS:

Approximately 85% or more of CIN3/AIS, >70% CIN2, and approximately 50% of CIN1 lesions worldwide are attributed to HPV6/11/16/18/31/33/45/52/58.

IMPACT:

If 9-valent HPV vaccination programs are effectively implemented, the majority of CIN2 and CIN3 lesions worldwide could be prevented, in addition to approximately one-half of CIN1.

PMID:
25274978
DOI:
10.1158/1055-9965.EPI-14-0410
[Indexed for MEDLINE]
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