Mónica S Sierra1, Sabrina H Tsang1, Shangying Hu1, Carolina Porras2, Rolando Herrero2,3, Aimée R Kreimer1, John Schussler4, Joseph Boland1,5, Sarah Wagner1,5, Bernal Cortes2, Ana C Rodríguez6, Wim Quint7, Leen-Jan van Doorn7, Mark Schiffman1, Joshua N Sampson1, Allan Hildesheim1. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA. 2. Agencia Costarricense de Investigaciones Biomédicas, formerly Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica. 3. Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France. 4. Information Management Services, Silver Spring, Maryland, USA. 5. Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc, Frederick, Maryland, USA. 6. Independent Consultant, San José, Costa Rica. 7. DDL Diagnostic Laboratory, Rijswijk, The Netherlands.
Abstract
BACKGROUND: Factors that lead human papillomavirus (HPV) infections to persist and progress to cancer are not fully understood. We evaluated co-factors for acquisition, persistence, and progression of non-HPV-16/18 infections among HPV-vaccinated women. METHODS: We analyzed 2153 women aged 18-25 years randomized to the HPV-vaccine arm of the Costa Rica HPV Vaccine Trial. Women were HPV DNA negative for all types at baseline and followed for approximately 11 years. Generalized estimating equation methods were used to account for correlated observations. Time-dependent factors evaluated were age, sexual behavior, marital status, hormonally related factors, number of full-term pregnancies (FTPs), smoking behavior, and baseline body mass index. RESULTS: A total of 1777 incident oncogenic non-HPV-16/18 infections were detected in 12 292 visits (average, 0.14 infections/visit). Age and sexual behavior-related variables were associated with oncogenic non-HPV-16/18 acquisition. Twenty-six percent of incident infections persisted for ≥1 year. None of the factors evaluated were statistically associated with persistence of oncogenic non-HPV-16/18 infections. Risk of progression to Cervical Intraepithelial Neoplasia grade 2 or worst (CIN2+) increased with increasing age (P for trend = .001), injectable contraceptive use (relative risk, 2.61 [95% confidence interval, 1.19-5.73] ever vs never), and increasing FTPs (P for trend = .034). CONCLUSIONS: In a cohort of HPV-16/18-vaccinated women, age and sexual behavior variables are associated with acquisition of oncogenic non-HPV-16/18 infections; no notable factors are associated with persistence of acquired infections; and age, parity, and hormonally related exposures are associated with progression to CIN2+. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
BACKGROUND: Factors that lead human papillomavirus (HPV) infections to persist and progress to cancer are not fully understood. We evaluated co-factors for acquisition, persistence, and progression of non-HPV-16/18 infections among HPV-vaccinated women. METHODS: We analyzed 2153 women aged 18-25 years randomized to the HPV-vaccine arm of the Costa Rica HPV Vaccine Trial. Women were HPV DNA negative for all types at baseline and followed for approximately 11 years. Generalized estimating equation methods were used to account for correlated observations. Time-dependent factors evaluated were age, sexual behavior, marital status, hormonally related factors, number of full-term pregnancies (FTPs), smoking behavior, and baseline body mass index. RESULTS: A total of 1777 incident oncogenic non-HPV-16/18 infections were detected in 12 292 visits (average, 0.14 infections/visit). Age and sexual behavior-related variables were associated with oncogenic non-HPV-16/18 acquisition. Twenty-six percent of incident infections persisted for ≥1 year. None of the factors evaluated were statistically associated with persistence of oncogenic non-HPV-16/18 infections. Risk of progression to Cervical Intraepithelial Neoplasia grade 2 or worst (CIN2+) increased with increasing age (P for trend = .001), injectable contraceptive use (relative risk, 2.61 [95% confidence interval, 1.19-5.73] ever vs never), and increasing FTPs (P for trend = .034). CONCLUSIONS: In a cohort of HPV-16/18-vaccinated women, age and sexual behavior variables are associated with acquisition of oncogenic non-HPV-16/18 infections; no notable factors are associated with persistence of acquired infections; and age, parity, and hormonally related exposures are associated with progression to CIN2+. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
Authors: Patricia Luhn; Joan Walker; Mark Schiffman; Rosemary E Zuna; S Terence Dunn; Michael A Gold; Katherine Smith; Cara Mathews; Richard A Allen; Roy Zhang; Sophia Wang; Nicolas Wentzensen Journal: Gynecol Oncol Date: 2012-11-10 Impact factor: 5.482
Authors: Carolina Porras; Sabrina H Tsang; Rolando Herrero; Diego Guillén; Teresa M Darragh; Mark H Stoler; Allan Hildesheim; Sarah Wagner; Joseph Boland; Douglas R Lowy; John T Schiller; Mark Schiffman; John Schussler; Mitchell H Gail; Wim Quint; Rebeca Ocampo; Jorge Morales; Ana C Rodríguez; Shangying Hu; Joshua N Sampson; Aimée R Kreimer Journal: Lancet Oncol Date: 2020-12 Impact factor: 41.316
Authors: Cosette M Wheeler; William C Hunt; Nancy E Joste; Charles R Key; Wim G V Quint; Philip E Castle Journal: J Natl Cancer Inst Date: 2009-03-24 Impact factor: 13.506