Format

Send to

Choose Destination
Int J Cancer. 2015 Dec 15;137(12):2858-68. doi: 10.1002/ijc.29651. Epub 2015 Jul 14.

Human papillomavirus prevalence and type-distribution in cervical glandular neoplasias: Results from a European multinational epidemiological study.

Author information

1
Global Health Economics, GSK Vaccines, Wavre, Belgium.
2
First Department of Oncologic Gynaecology and Gynaecology, Medical University of Lublin, Poland.
3
Department of Gynaecology and Oncologic Gynaecology, Military Institute of Medicine, Warsaw, Poland.
4
Institute of Cancer and Genetics, HPV Research Group, Cardiff University School of Medicine, Cardiff, Wales, United Kingdom.
5
Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom.
6
Department of Pathology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY.
7
4Clinics, Biostatistics, Paris, France (at the time of study).
8
Multidisciplinary Breast Clinic-Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Antwerp University Hospital, University of Antwerp, Antwerpen, Belgium.
9
IMS Health, Stockholm, Sweden.
10
Center for Pharmacoepidemiology, Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden.
11
Obstetrics and Gynaecology Department, University Hospital Puerto De Hierro Majadahonda, Madrid, Spain.
12
Department of Anatomical Pathology, General Hospital of Patras, Achaia, Greece.
13
Comprehensive Cancer Center, Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria.
14
Department of Obstetrics and Gynaecology, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark.
15
Department of Obstetrics and Gynecologic Oncology, St. Stephan Hospital, Budapest, Hungary.
16
CERVIVA Research Consortium, Funded by the Health Research Board Ireland, Based at the Department of Pathology, The Coombe Women and Infants University Hospital and Trinity College, Dublin, Ireland.
17
DDL Diagnostic Laboratory, Rijswijk, The Netherlands.
18
Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
19
Hospital Clinic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.
20
Department of Oncology, University of Sheffield Medical School, Sheffield, England, United Kingdom.
21
University Hospital Motol, Prague, Czech Republic.
22
Institute of Oncology of RAMS Siberian Branch, Tomsk, Russia.
23
Laboratory of Microbiology, DO Ott Research Institute of Obstetrics and Gynaecology, St. Petersburg, Russia.
24
Epidemiology Department, GlaxoSmithKline Vaccines, Wavre, Belgium.

Abstract

Cervical glandular neoplasias (CGN) present a challenge for cervical cancer prevention due to their complex histopathology and difficulties in detecting preinvasive stages with current screening practices. Reports of human papillomavirus (HPV) prevalence and type-distribution in CGN vary, providing uncertain evidence to support prophylactic vaccination and HPV screening. This study [108288/108290] assessed HPV prevalence and type-distribution in women diagnosed with cervical adenocarcinoma in situ (AIS, N = 49), adenosquamous carcinoma (ASC, N = 104), and various adenocarcinoma subtypes (ADC, N = 461) from 17 European countries, using centralised pathology review and sensitive HPV testing. The highest HPV-positivity rates were observed in AIS (93.9%), ASC (85.6%), and usual-type ADC (90.4%), with much lower rates in rarer ADC subtypes (clear-cell: 27.6%; serous: 30.4%; endometrioid: 12.9%; gastric-type: 0%). The most common HPV types were restricted to HPV16/18/45, accounting for 98.3% of all HPV-positive ADC. There were variations in HPV prevalence and ADC type-distribution by country. Age at diagnosis differed by ADC subtype, with usual-type diagnosed in younger women (median: 43 years) compared to rarer subtypes (medians between 57 and 66 years). Moreover, HPV-positive ADC cases were younger than HPV-negative ADC. The six years difference in median age for women with AIS compared to those with usual-type ADC suggests that cytological screening for AIS may be suboptimal. Since the great majority of CGN are HPV16/18/45-positive, the incorporation of prophylactic vaccination and HPV testing in cervical cancer screening are important prevention strategies. Our results suggest that special attention should be given to certain rarer ADC subtypes as most appear to be unrelated to HPV.

KEYWORDS:

adenocarcinoma in situ; adenosquamous carcinoma; cervical adenocarcinoma; cervical glandular neoplasia; human papillomavirus

PMID:
26096203
PMCID:
PMC5034816
DOI:
10.1002/ijc.29651
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center