Francesca Carozzi1, Laura De Marco2, Anna Gillio-Tos3, Annarosa Del Mistro4, Salvatore Girlando5, Lorena Baboci6, Morena Trevisan7, Elena Burroni8, Stefano Grasso9, Paolo Giorgi Rossi10, Guglielmo Ronco11. 1. ISPO Cancer Prevention and Research Institute, Via Cosimo il Vecchio 2, 50139 Florence, Italy. Electronic address: f.carozzi@ispo.toscana.it. 2. Cancer Epidemiology Unit - C.E.R.M.S., University of Turin, Via Santena 7, 10126 Turin, Italy. Electronic address: ldemarco@cittadellasalute.to.it. 3. Cancer Epidemiology Unit - C.E.R.M.S., University of Turin, Via Santena 7, 10126 Turin, Italy. Electronic address: gilliotos.demarco@cpo.it. 4. Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padova, Italy. Electronic address: annarosa.delmistro@ioveneto.it. 5. S. Chiara Hospital, Largo Medaglie d'Oro 9, 38122 Trento, Italy. Electronic address: salvatore.girlando@apss.tn.it. 6. Venetian Oncology Institute-IRCCS, Via Gattamelata 64, 35128 Padova, Italy. Electronic address: lorena.baboci@gmail.com. 7. Cancer Epidemiology Unit - C.E.R.M.S., University of Turin, Via Santena 7, 10126 Turin, Italy. Electronic address: morena.trevisan@matica.eu. 8. ISPO Cancer Prevention and Research Institute, Via Cosimo il Vecchio 2, 50139 Florence, Italy. Electronic address: e.burroni@ispo.toscana.it. 9. Centre for Cancer Prevention, Via S. Francesco da Paola 31, 10123 Turin, Italy. Electronic address: stefano.grasso@cpo.it. 10. Servizio Interaziendale di Epidemiologia - Azienda Unità Sanitaria Locale and IRCCS, Arcispedale Santa Maria Nuova, Via Amendola 2, 42122 Reggio Emilia, Italy. Electronic address: Paolo.GiorgiRossi@ausl.re.it. 11. Centre for Cancer Prevention, Via S. Francesco da Paola 31, 10123 Turin, Italy. Electronic address: guglielmo.ronco@cpo.it.
Abstract
BACKGROUND: The prevalence of infections with human papillomavirus (HPV) specific genotypes differs by age and areas. Knowledge of these differences will help predicting how prophylactic HPV vaccination and screening program could best be integrated. OBJECTIVES: To investigate variations in the HPV distribution between areas and ages in Italy and the impact of vaccination on HPV prevalence. STUDY DESIGN: 37,367 women aged 25-60 years who attended cervical screening in eight different areas in Northern and Central Italy were tested for HPV infection with the high-risk hybrid capture (hr-HC2) assay. hr-HC2 positive samples were genotyped by an intensive integrated strategy. RESULTS: hr-HPV types were detected in 79.1% of HC2 positive women. HPV16 was the most frequent type, followed by HPV31, HPV18 and HPV56. A statistically significant variability in HPV type distribution between centres (overall χ84df(2)=195.86p<0.001) was observed. No significant overall difference in the HPV type distribution was observed in the age groups 25-34, 35-44 and 45-60 years. Considering cross-protection, overall 57.6% (95%CI 56.0-59.3) of all infections by hr-HPV types was preventable by vaccination with the bivalent vaccine and 49% (95%CI 46.9-51.1) with the quadrivalent vaccine. The variability between centres was statistically significant with both bivalent (χ7df(2)=43.8, p<0.0001) and quadrivalent vaccine (χ7df(2)=32.9, p<0.0001). CONCLUSIONS: We observed differences in HPV genotype distribution according to centres but not to age. Results suggest that the higher proportion of HPV16/18 related high grade CIN in younger women could be the result of faster progression and not of earlier infection by these types.
BACKGROUND: The prevalence of infections with human papillomavirus (HPV) specific genotypes differs by age and areas. Knowledge of these differences will help predicting how prophylactic HPV vaccination and screening program could best be integrated. OBJECTIVES: To investigate variations in the HPV distribution between areas and ages in Italy and the impact of vaccination on HPV prevalence. STUDY DESIGN: 37,367 women aged 25-60 years who attended cervical screening in eight different areas in Northern and Central Italy were tested for HPV infection with the high-risk hybrid capture (hr-HC2) assay. hr-HC2 positive samples were genotyped by an intensive integrated strategy. RESULTS: hr-HPV types were detected in 79.1% of HC2 positive women. HPV16 was the most frequent type, followed by HPV31, HPV18 and HPV56. A statistically significant variability in HPV type distribution between centres (overall χ84df(2)=195.86p<0.001) was observed. No significant overall difference in the HPV type distribution was observed in the age groups 25-34, 35-44 and 45-60 years. Considering cross-protection, overall 57.6% (95%CI 56.0-59.3) of all infections by hr-HPV types was preventable by vaccination with the bivalent vaccine and 49% (95%CI 46.9-51.1) with the quadrivalent vaccine. The variability between centres was statistically significant with both bivalent (χ7df(2)=43.8, p<0.0001) and quadrivalent vaccine (χ7df(2)=32.9, p<0.0001). CONCLUSIONS: We observed differences in HPV genotype distribution according to centres but not to age. Results suggest that the higher proportion of HPV16/18 related high grade CIN in younger women could be the result of faster progression and not of earlier infection by these types.
Authors: Annarosa Del Mistro; Rachael Adcock; Francesca Carozzi; Anna Gillio-Tos; Laura De Marco; Salvatore Girlando; Raffaella Rizzolo; Helena Frayle; Morena Trevisan; Cristina Sani; Elena Burroni; Paolo Giorgi Rossi; Jack Cuzick; Guglielmo Ronco Journal: Int J Cancer Date: 2018-03-09 Impact factor: 7.396