Karoliina Aro1, Pekka Nieminen2, Karolina Louvanto3, Maija Jakobsson4, Seppo Virtanen5, Matti Lehtinen6, Joakim Dillner7, Ilkka Kalliala8. 1. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: karoliina.aro@helsinki.fi. 2. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: pekka.nieminen@hus.fi. 3. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: karoyt@utu.fi. 4. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: maija.jakobsson@hus.fi. 5. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: seppo.virtanen@hus.fi. 6. Department of Laboratory Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden. Electronic address: matti.lehtinen@tuni.fi. 7. Department of Laboratory Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden. Electronic address: joakim.dillner@ki.se. 8. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: ilkka.kalliala@hus.fi.
Abstract
BACKGROUND AND AIM: Age-specific type-distribution of high-risk human papillomavirus (hrHPV) in cervical precancerous lesions is subject to change in the HPV vaccination era. Knowing the pre-vaccination type-distribution helps to anticipate changes induced by mass vaccination and optimize screening. METHODS: We recruited 1279 women referred to colposcopy for abnormal cytology into a population-based study on HPV type distribution in diagnostic cervical samples (ISRCTN10933736). The HPV genotyping findings were grouped as: HPV16/18+, other hrHPV+ (HPV31/33/35/39/45/51/52/56/58/59/66/68), non-vaccine targeted hrHPV+ (HPV35/39/51/56/59/66/68), low-risk HPV, and HPV negative. We estimated the HPV group-specific prevalence rates according to diagnostic histopathological findings in the age groups of <30 (n = 339), 30-44.9 (n = 614), and ≥45 (n = 326). RESULTS: Altogether 503 cases with high grade squamous intraepithelial lesion or worse (HSIL+) were diagnosed. More than half, 285 (56.7%) of HSIL+ cases were associated with HPV16/18: 64.3% (101/157) in women <30 years (reference group), 58.4% (157/269) in women 30-44.9 years (risk ratio (RR) 0.91, 95% confidence interval (95% CI) 0.78-1.06), and 35.1% (27/77) in women ≥45 years of age (RR 0.55, 95% CI 0.39-0.75). Conversely, other hrHPV's were associated with 191 (38.0%) of HSIL+: 31.9% (50/157) in women <30, 36.8% (99/269) in women 30-44.9 years, 54.6% (42/77) and in women ≥45 (RR 1.71, 95% CI 1.26-2.33). The proportion of non-vaccine targeted hrHPV and HPV negative HSIL+ increased with advancing age. CONCLUSIONS: Pre-vaccination HPV type distribution in HSIL+ was distinctly polarised by age with HPV16/18 attributed disease being markedly more prevalent in women aged <30. In the older women the other hrHPV types, however, dominated suggesting a need for more age-dependent screening strategies.
BACKGROUND AND AIM: Age-specific type-distribution of high-risk human papillomavirus (hrHPV) in cervical precancerous lesions is subject to change in the HPV vaccination era. Knowing the pre-vaccination type-distribution helps to anticipate changes induced by mass vaccination and optimize screening. METHODS: We recruited 1279 women referred to colposcopy for abnormal cytology into a population-based study on HPV type distribution in diagnostic cervical samples (ISRCTN10933736). The HPV genotyping findings were grouped as: HPV16/18+, other hrHPV+ (HPV31/33/35/39/45/51/52/56/58/59/66/68), non-vaccine targeted hrHPV+ (HPV35/39/51/56/59/66/68), low-risk HPV, and HPV negative. We estimated the HPV group-specific prevalence rates according to diagnostic histopathological findings in the age groups of <30 (n = 339), 30-44.9 (n = 614), and ≥45 (n = 326). RESULTS: Altogether 503 cases with high grade squamous intraepithelial lesion or worse (HSIL+) were diagnosed. More than half, 285 (56.7%) of HSIL+ cases were associated with HPV16/18: 64.3% (101/157) in women <30 years (reference group), 58.4% (157/269) in women 30-44.9 years (risk ratio (RR) 0.91, 95% confidence interval (95% CI) 0.78-1.06), and 35.1% (27/77) in women ≥45 years of age (RR 0.55, 95% CI 0.39-0.75). Conversely, other hrHPV's were associated with 191 (38.0%) of HSIL+: 31.9% (50/157) in women <30, 36.8% (99/269) in women 30-44.9 years, 54.6% (42/77) and in women ≥45 (RR 1.71, 95% CI 1.26-2.33). The proportion of non-vaccine targeted hrHPV and HPV negative HSIL+ increased with advancing age. CONCLUSIONS: Pre-vaccination HPV type distribution in HSIL+ was distinctly polarised by age with HPV16/18 attributed disease being markedly more prevalent in women aged <30. In the older women the other hrHPV types, however, dominated suggesting a need for more age-dependent screening strategies.
Authors: Luz Del Carmen Alarcón-Romero; Jorge Organista-Nava; Yazmín Gómez-Gómez; Julio Ortiz-Ortiz; Daniel Hernández-Sotelo; Oscar Del Moral-Hernández; Miguel Angel Mendoza-Catalán; Ramón Antaño-Arias; Marco Antonio Leyva-Vázquez; Natividad Sales-Linares; Verónica Antonio-Véjar; Berenice Illades-Aguiar Journal: Cancer Control Date: 2022 Jan-Dec Impact factor: 2.339
Authors: Maria Kyrgiou; Marc Arbyn; Christine Bergeron; F Xavier Bosch; Joakim Dillner; Mark Jit; Jane Kim; Mario Poljak; Pekka Nieminen; Peter Sasieni; Vesna Kesic; Jack Cuzick; Murat Gultekin Journal: Br J Cancer Date: 2020-06-08 Impact factor: 7.640
Authors: Navkiran K Shokar; Amy Doan; Jessica Calderon-Mora; Rajkumar Lakshmanaswamy; Subramani Ramadevi; Gurjeet S Shokar; Jennifer Molokwu; Adam Alomari; Alok Dwivedi Journal: Cancer Control Date: 2020 Jan-Dec Impact factor: 3.302