Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe

Wiebren A Tjalma, Alison Fiander, Olaf Reich, Ned Powell, Andrzej M Nowakowski, Benny Kirschner, Robert Koiss, John O'Leary, Elmar A Joura, Mats Rosenlund, Brigitte Colau, Doris Schledermann, Kersti Kukk, Vasileia Damaskou, Maria Repanti, Radu Vladareanu, Larisa Kolomiets, Alevtina Savicheva, Elena Shipitsyna, Jaume OrdiAnco Molijn, Wim Quint, Alice Raillard, Dominique Rosillon, Sabrina Collas De Souza, Christopher David Jenkins, Katsiaryna Holl, HERACLES/SCALE Study Group

175 Citationer (Scopus)

Abstract

Knowledge of differences in human papillomavirus (HPV)-type prevalence between high-grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) is crucial for understanding the natural history of HPV-infected cervical lesions and the potential impact of HPV vaccination on cervical cancer prevention. More than 6,000 women diagnosed with HG-CIN or ICC from 17 European countries were enrolled in two parallel cross-sectional studies (108288/108290). Centralised histopathology review and standardised HPV-DNA typing were applied to formalin-fixed paraffin-embedded cervical specimens dated 2001-2008. The pooled prevalence of individual HPV types was estimated using meta-analytic methods. A total of 3,103 women were diagnosed with HG-CIN and a total of 3,162 with ICC (median ages: 34 and 49 years, respectively), of which 98.5 and 91.8% were HPV-positive, respectively. The most common HPV types in women with HG-CIN were HPV16/33/31 (59.9/10.5/9.0%) and in ICC were HPV16/18/45 (63.3/15.2/5.3%). In squamous cell carcinomas, HPV16/18/33 were most frequent (66.2/10.8/5.3%), and in adenocarcinomas, HPV16/18/45 (54.2/40.4/8.3%). The prevalence of HPV16/18/45 was 1.1/3.5/2.5 times higher in ICC than in HG-CIN. The difference in age at diagnosis between CIN3 and squamous cervical cancer for HPV18 (9 years) was significantly less compared to HPV31/33/'other' (23/20/17 years), and for HPV45 (1 year) than HPV16/31/33/'other' (15/23/20/17 years). In Europe, HPV16 predominates in both HG-CIN and ICC, whereas HPV18/45 are associated with a low median age of ICC. HPV18/45 are more frequent in ICC than HG-CIN and associated with a high median age of HG-CIN, with a narrow age interval between HG-CIN and ICC detection. These findings support the need for primary prevention of HPV16/18/45-related cervical lesions.
OriginalsprogEngelsk
TidsskriftInternational journal of cancer. Journal international du cancer
Vol/bind132
Udgave nummer4
Sider (fra-til)854-67
Antal sider14
ISSN0020-7136
DOI
StatusUdgivet - 15 feb. 2013

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