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Lee J, Kim DJ, Lee HJ. Assessment of malignant potential for HPV types 16, 52, and 58 in the uterine cervix within a Korean cohort. Sci Rep 2024; 14:14619. [PMID: 38918416 DOI: 10.1038/s41598-024-65056-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
High-risk human papillomavirus (HR-HPV) is the primary carcinogen in uterine cervical carcinoma. While genotype-specific carcinogenic risks have been extensively studied in Western populations, data from Korean are sparse. This study evaluates the malignant potential of the three most prevalent HR-HPVs in Korea: HPV16, HPV52, and HPV58. We analyzed 230 patients who underwent cervical conization and had been tested for HPV within a year prior to the procedure, excluding those with multiple infections. This analysis was confined to patients with single HPV infections and assessed outcomes of CIN3+, which includes carcinoma in situ (CIN3) and invasive carcinoma. The incidence of invasive cervical cancer was 6.7% for HPV16, 1.7% for HPV52, and 2.0% for HPV58; however, these differences were not statistically significant (p = 0.187). The rate of CIN3+ for HPV16, HPV52, and HPV58 were 70.6%, 51.7%, and 58.8%, respectively. Despite the small sample size, which may limit the robustness of statistical analysis, the data suggest a higher observed risk with HPV16. These findings highlight the need for vigilant clinical management tailored to specific HPV genotypes and support the implementation of a nine-valent vaccine in Korea. Physicians should be aware of these genotype-specific risks when treating patients.
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Affiliation(s)
- Juhun Lee
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Dong Ja Kim
- Department of Forensic Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hyun Jung Lee
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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2
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Bandeira IC, Comerlato J, Bessel M, Fernandes BV, Mota G, Villa LL, de Souza FMA, Pereira GFM, Wendland EM. Comparative evaluation of HPV genotyping: A study on the performance concordance between Anyplex II HPV28 detection and Linear Array genotyping tests in nationwide studies in Brazil. PLoS One 2024; 19:e0305122. [PMID: 38861542 PMCID: PMC11166333 DOI: 10.1371/journal.pone.0305122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/24/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Advances in laboratory techniques for HPV diagnosis necessitate a thorough assessment of the efficiency, replicability, sensitivity, and specificity of those methods. This study aims to validate and compare HPV detection/genotyping using the Anyplex™ II HPV28 Detection assay (Seegene) assay and the Linear Array HPV Genotyping test (Roche Diagnostics) on genital samples for use in epidemiological studies. METHODS From 6,388 penile and cervical DNA samples collected in the POP-Brazil, 1,745 were randomly selected to be included in this study. The samples were submitted to HPV detection and genotyping following the manufacturers' protocols. DNA was genotyped using the Anyplex™ II HPV28 Detection kit (Seegene), and the results were compared to those obtained using the Linear Array HPV Genotyping test (Roche Diagnostics). Concordance of HPV genotyping results was assessed by the percentage agreement and Cohen's kappa score (κ). RESULTS The agreement between the two methodologies was deemed good for HPV detection (κ = 0.78). Notably, Anyplex™ II HPV28 demonstrated enhanced capability in detecting a broader spectrum of genotypes compared to Linear Array. CONCLUSION Anyplex™ II HPV28 exhibited comparable results to the Linear Array assay in clinical specimens, showcasing its potential suitability for a diverse array of research applications requiring the detection and genotyping of HPV. The study supports the utility of Anyplex™ II HPV28 as an effective tool for HPV screening in epidemiological studies, emphasizing its robust performance in comparison to established diagnostic tests.
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Affiliation(s)
| | | | | | | | - Giana Mota
- Innovation in Cancer Laboratory, Center for Translational Research in Oncology of the Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Luisa Lina Villa
- Innovation in Cancer Laboratory, Center for Translational Research in Oncology of the Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | | | - Eliana Marcia Wendland
- Hospital Moinhos de Vento, Porto Alegre, Brazil
- Department of Community Health, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Abate A, Munshea A, Nibret E, Alemayehu DH, Alemu A, Abdissa A, Mihret A, Abebe M, Mulu A. Characterization of human papillomavirus genotypes and their coverage in vaccine delivered to Ethiopian women. Sci Rep 2024; 14:7976. [PMID: 38575600 PMCID: PMC10995144 DOI: 10.1038/s41598-024-57085-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/14/2024] [Indexed: 04/06/2024] Open
Abstract
Cervical cancer is a significant public health concern in Ethiopia. It is mainly caused by persistent infection with the human papillomaviruses. The aim of this study was to assess the relationship between carcinogenic risk of probable, possible and low risk HPV infection and those of cervical intraepithelial neoplasia (CIN) and cervical cancer. A cross sectional study nested from prospective cohort study was conducted in Bahir Dar, northwest Ethiopia. Statistical analyses were performed using SPSSversion 26.0. HPV-16 was associated with a relatively higher risk of CIN II+, (AOR = 15.42; 95% CI 6.81-34.91). In addition, HPV-52, -18, -53 and -58, were significantly associated with an increased risk of CIN II+, (AOR = 7.38 (1.73-31.54), 5.42 (1.61-18.31), 4.08 (1.53-10.87), and 3.17 (1.00-10.03)), respectively. The current study shows high rate of HPV with predominance of HPV-16, -53, -58, -18, -35, and -52. The quadrivalent and nonavalent vaccine had only covered 27.1% and 45% of the circulating HPV genotypes. Ethiopia may need to consider introduction of nonavalent vaccine into the national public health strategy. Polyvalent vaccine which includes the genotypes not covered by existing approved vaccines should be considered.
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Affiliation(s)
- Alemayehu Abate
- Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, P. O. Box 79, Bahir Dar, Ethiopia.
- Amhara Public Health Institute, Bahir Dar, Ethiopia.
| | - Abaineh Munshea
- Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, P. O. Box 79, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, P. O Box 79, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Health Biotechnology, Institute of Biotechnology, Bahir Dar University, P. O. Box 79, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, P. O Box 79, Bahir Dar, Ethiopia
| | | | - Ashenafi Alemu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Markos Abebe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Sarmiento-Medina MI, de Amaya MP, Villamizar-Gómez L, González-Coba AC, Guzmán-Barajas L. High-risk HPV prevalence and vaccination coverage among Indigenous women in the Colombian Amazon: Implications for cervical cancer prevention. Cross-sectional study. PLoS One 2024; 19:e0297579. [PMID: 38315664 PMCID: PMC10843138 DOI: 10.1371/journal.pone.0297579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Cervical cancer, primarily caused by Human Papillomavirus (HPV) transmission through sexual contact, necessitates comprehensive strategies to combat its impact on women's health. Yet, certain underserved populations, such as low socioeconomic and ethnic minority groups, encounter barriers in accessing timely interventions and early diagnosis. This cross-sectional study was conducted with the aim of assessing HPV prevalence, genotype distribution, and co-infections among 280 adult women residing in a Colombian Indigenous Reserve within the Amazon region. The research adhered to a community-centric approach that respected cultural norms, native languages, and Indigenous authorities' permission. The study revealed an overall HPV infection prevalence of 31.1% (n = 87, 95% CI 25.7-36.8), with 22.5% (n = 63, 95% CI 17.7-27.8) of women infected by at least one high-risk HPV genotype and 15.0% (n = 42, 95% CI 11-19.7) infected by at least one LR genotype. These results align with the findings of other Colombian studies. Notable high-frequency genotypes included 16, 52, 66, 56, and 68, with the most common combinations being [66-52] and [66-58]. The study also assessed the prevalence of HPV vaccination, revealing a rate of 22.9%, lower than the national average. In vaccinated women, the prevalence of genotypes 16 and 18 was significantly reduced, as anticipated. Importantly, it was observed that 57.1% of all high-risk HPV infections could have been prevented with the use of the nonavalent vaccine. These findings underscore the critical need to enhance adherence to early cervical cancer detection and monitor positive cases to evaluate high-risk HPV persistence. Efforts should be directed toward continuing vaccination coverage against high-risk HPV 16 and 18 with the quadrivalent vaccine, while also striving to make the nonavalent vaccine accessible for inclusion in large-scale public health programs. Additionally, the study did not identify a specific pattern of co-infection. The study emphasizes the significance of adopting a locally tailored epidemiological approach to guide and promote cervical cancer prevention efforts in Indigenous communities.
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Affiliation(s)
| | - Miryam Puerto de Amaya
- Facultad de Tecnologías en Salud, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia
| | - Licet Villamizar-Gómez
- Vicerrectoría de Investigaciones, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia
| | | | - Laura Guzmán-Barajas
- Facultad de Tecnologías en Salud, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia
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Hellsten C, Holmberg A, Astrom J, Forslund O, Borgfeldt C. Cervical cancer in Region Skåne, Sweden 2017-2020 after the implementation of primary HPV screening: A quality assurance audit. Acta Obstet Gynecol Scand 2024; 103:129-137. [PMID: 37817563 PMCID: PMC10755128 DOI: 10.1111/aogs.14691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/25/2023] [Accepted: 09/22/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Primary human papilloma virus (HPV) screening to detect cervical cancer and dysplastic lesions was implemented in Region Skåne 2017 for women aged 30-70. The aim of this study was to characterize the screening history of women diagnosed with cervical cancer to evaluate the performance of the screening program, as well as to assess the cancer treatments given and shortcomings in the follow-up of women with cervical dysplasia. MATERIAL AND METHODS We performed a quality assurance audit. The data was collected from the National Cervical Cancer Prevention Registry, Region Skåne Labmedicin database and the Melior Journal system in 2017-2020. RESULTS We identified 247 women diagnosed with invasive cervical cancer in Region Skåne in 2017-2020. Of these, 35 (14.2%) had a screening history over at least two screening rounds before diagnosis. There were 25 (10.1%) women diagnosed with cervical cancer in between screening intervals, i.e., interval cancer. The most common screening history in women with cervical cancer was irregular screening (143, 57.9%), followed by women being above screening age (44, 17.8%). HPV was detected in 96% of the cases, either in cervical cytology or in the tumor tissue. The screening program detected the disease in 96 (38.9%) of the patients, 149 (60.3%) were diagnosed through symptoms and two (0.80%) as a result of incidental findings. CONCLUSIONS The most powerful tool in the prevention of cervical cancer is screening program attendance. Prolongation with HPV screening among elderly women will also reduce the incidence of cervical cancer. Today, such cancers are usually discovered when symptoms appear.
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Affiliation(s)
- Caroline Hellsten
- Department of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical Science LundLund UniversityLundSweden
| | - Anna Holmberg
- Department of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical Science LundLund UniversityLundSweden
| | - Jennica Astrom
- Department of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical Science LundLund UniversityLundSweden
| | - Ola Forslund
- Department of Laboratory MedicineLund UniversityLundSweden
- Clinical Microbiology, Infection Prevention and Control, Office for Medical ServicesRegion SkåneSweden
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical Science LundLund UniversityLundSweden
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Martinelli M, Giubbi C, Di Meo ML, Perdoni F, Musumeci R, Leone BE, Fruscio R, Landoni F, Cocuzza CE. Accuracy of Human Papillomavirus (HPV) Testing on Urine and Vaginal Self-Samples Compared to Clinician-Collected Cervical Sample in Women Referred to Colposcopy. Viruses 2023; 15:1889. [PMID: 37766295 PMCID: PMC10537107 DOI: 10.3390/v15091889] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
In the context of cervical cancer prevention, where human papillomavirus (HPV) infection is pivotal, HPV testing is replacing Pap Smear in primary screening. This transition offers an opportunity for integrating self-sampling to enhance coverage. We evaluated the accuracy of HPV testing using self-collected urine and vaginal samples, comparing them to physician-collected cervical swabs. From a cohort of 245 women with abnormal cytology, we collected self-sampled vaginal, urine, and clinician-administered cervical specimens. Employing Anyplex™II HPV28 assay, outcomes revealed HPV positivity rates of 75.1% (cervical), 78.4% (vaginal), and 77.1% (urine). Significant, hr-HPV detection concordance was observed between self-taken cervical samples and clinical counterparts (k = 0.898 for vaginal; k = 0.715 for urine). This study extends beyond accuracy, highlighting self-collected sample efficacy in detecting high-grade cervical lesions. The insight underscores self-sampling's role in bolstering participation and aligns with WHO's goal to eliminate cervical cancer by 2030.
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Affiliation(s)
- Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
| | - Chiara Giubbi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
| | | | - Federica Perdoni
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
| | - Rosario Musumeci
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
| | - Biagio Eugenio Leone
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
- IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Robert Fruscio
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
- IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Fabio Landoni
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
- IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Clementina Elvezia Cocuzza
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (C.G.); (F.P.); (R.M.); (B.E.L.); (R.F.); (F.L.); (C.E.C.)
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Nygård S, Nygård M, Orumaa M, Hansen BT. Quadrivalent HPV vaccine effectiveness against anogenital warts: A registry-based study of 2,2 million individuals. Vaccine 2023; 41:5469-5476. [PMID: 37516572 DOI: 10.1016/j.vaccine.2023.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND In 2009, Norway initiated routine quadrivalent HPV (qHPV) vaccination for girls at 12-13 years of age to protect against virus types causing cervical cancer, HPV16/18, and HPV6/11 which cause anogenital warts (AGW). We wanted to investigate qHPV vaccine effectiveness (VE) against AGW in females before and after first AGW episode and to assess the impact of female vaccination in males. MATERIALS AND METHODS QHPV vaccination and AGW episodes were collected for the time period 2006-2016 for birth cohorts 1975-2003. Cox models were applied to age at first, as well as at second AGW episode. Finally, we estimated the impact of the female vaccination program on unvaccinated males. RESULTS The VE against the first episode of AGW was strongly dependent on vaccination age, with hazard ratios (HRs) compared to unvaccinated individuals of 0.2, 0.2, 0.3, 0.5, 1.0, 1.3, and 2.7, for age groups of ⩽13, 14-15, 16-17, 18-19, 20-24, 25-29, and 30+ years at first vaccination, respectively. Among women who had suffered a first episode of AGW, subsequent qHPV vaccination did not protect against a second episode, with HRs of 0.8, 1.0, and 1.4, for age groups of ⩽17, 18-24, and 25+ years at first vaccination. A gradually decreasing AGW risk was seen in unvaccinated male cohorts neighboring the first routinely vaccinated female 1997 cohort. CONCLUSIONS When administered before 14 years of age, qHPV vaccination reduced the probability of AGW about fivefold. The effect decreased sharply with vaccination age, and was not significant among women vaccinated after age 20 years. QHPV administered after the first AGW episode did not protect against a second AGW episode. Herd effects were indicated in unvaccinated males, as we observed a gradual decrease in AGW rates from the 1993 male birth cohort and onwards.
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Affiliation(s)
- Ståle Nygård
- Department of Research, Cancer Registry of Norway, Norway.
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Norway
| | - Madleen Orumaa
- Department of Research, Cancer Registry of Norway, Norway; Tervise Arengu Instituut, National Institute for Health Development, Estonia
| | - Bo T Hansen
- Department of Research, Cancer Registry of Norway, Norway; Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Norway
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Abbas M, de Jonge J, Bettendorf O. Prevalence of High-Risk HPV Subtypes and Efficacy of the HPV Vaccine in Preventing Cervical Epithelial Lesions: Survey and Insights from a German Study. Life (Basel) 2023; 13:1637. [PMID: 37629494 PMCID: PMC10455871 DOI: 10.3390/life13081637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Historically, cervical cytology has been the standard method for detecting dysplastic cervical changes. However, extensive research has established that human papillomavirus (HPV) infection is a primary cause of these changes, necessitating a shift in screening and preventive strategies towards the molecular detection of high-risk HPV subtypes. To combat HPV infection, prophylactic vaccines have been developed, including the nonavalent, quadrivalent, and bivalent vaccines. An essential criterion for an effective HPV vaccine is to provide comprehensive coverage against the most prevalent high-risk HPV types associated with cervical cancer, ensuring optimal efficacy in preventing cervical lesions. Long-term protection against these types is crucial for effective prevention strategies; Material and Methods: A cohort of 210,510 women's samples was included in the analysis conducted within one year of implementing a screening program in Germany. The screening program involved the molecular detection of high-risk HPV subtypes, targeting specific age groups. The cohort comprised 63,710 women below 35 years of age and 146,800 women aged 35 years and above. The selection of high-risk HPV subtypes followed the guidelines provided by Becton-Dickinson. This study focused exclusively on cases with a documented history of vaccination, which were categorized into two main groups: Group I consisted of vaccinated individuals under 35 years old (12,765 cases), while Group II comprised vaccinated individuals aged 35 years and above (296 cases); Results: The HPV types HPV56/59/66 were found to be widely distributed across all age groups, with certain age groups exhibiting a higher incidence compared to HPV16 and HPV18. Similarly, HPV35/39/69, along with HPV31 and HPV45, were also observed to have a broad distribution among women. The incidence of high-grade squamous intraepithelial lesions (HSIL), including both CIN2 and CIN3, varied between 0.076% and 0.5% across all age groups, regardless of the individuals' vaccination status; Aim of the study: Our study provides valuable insights into the distribution, incidence, and prevalence of various high-risk HPV subtypes, including HPV56/59/66, HPV33/58, HPV35/39/68, and HPV45, in relation to precancerous cervical lesions. These subtypes are not adequately covered by the currently available HPV vaccines. Addressing the discrepancies between the prevalent HPV subtypes and existing vaccines is crucial in developing an ideal HPV vaccine that offers comprehensive protection. Tailoring screening programs and vaccination strategies to the local distribution of HPV subtypes is essential for effective prevention. By raising awareness and implementing targeted preventive measures, including vaccination, we can significantly reduce the incidence of precancerous and cancerous cervical lesions.
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Affiliation(s)
- Mahmoud Abbas
- Department of Pathology, Gerhard-Domagk Institute for Pathology, University Muenster, Domagkstrasse 17, 48149 Muenster, Germany
| | - Jan de Jonge
- Department of Pathology, Institute for Pathology and Cytology (IPN), 48465 Schuettorf, Germany; (J.d.J.); (O.B.)
| | - Olaf Bettendorf
- Department of Pathology, Institute for Pathology and Cytology (IPN), 48465 Schuettorf, Germany; (J.d.J.); (O.B.)
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Rad A, Sørbye SW, Tiwari S, Løchen ML, Skjeldestad FE. Risk of Intraepithelial Neoplasia Grade 3 or Worse (CIN3+) among Women Examined by a 5-Type HPV mRNA Test during 2003 and 2004, Followed through 2015. Cancers (Basel) 2023; 15:3106. [PMID: 37370716 DOI: 10.3390/cancers15123106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The study's purpose was to evaluate the performance of a five-type HPV mRNA test to predict cervical intraepithelial neoplasia grade 3 or worse (CIN3+) during up to 12 years of follow-up. METHODS Overall, 19,153 women were recruited by gynecologists and general practitioners in different parts of Norway between 2003 and 2004. The study population comprised 9582 women of these women, aged 25-69 years with normal cytology and a valid five-type HPV mRNA test at baseline. Follow-up for CIN3+ through 2015 was conducted in the Norwegian Cervical Cancer Screening Programme. RESULTS The cumulative incidence of CIN3+ by baseline status for HPV mRNA-positive and mRNA-negative women were 20.8% and 1.1%, respectively (p < 0.001). Age did not affect the long-term ability of the HPV mRNA test to predict CIN3+ during follow-up. CONCLUSION The low long-term risk of CIN3+ among HPV mRNA-negative women and the high long-term risk among HPV mRNA-positive women strengthen the evidence that the five-type HPV mRNA test is an appropriate screening test for women of all ages. Our findings suggest that women with a negative result may extend the screening interval up to 10 years.
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Affiliation(s)
- Amir Rad
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | | | - Sweta Tiwari
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Finn Egil Skjeldestad
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
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Pärna K, Nygård M, Tisler A, Toompere K, Naaber P, Ratnik K, Ķīvīte Urtāne A, Zodzika J, Stankūnas M, Baltzer N, Uusküla A. Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia. BMJ Open 2023; 13:e069558. [PMID: 37263686 DOI: 10.1136/bmjopen-2022-069558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To describe age-specific and type-specific carcinogenic human papillomavirus (HPV) prevalence prior to large-scale effect of HPV vaccines in Estonia and to analyse the risk factors associated with carcinogenic HPV. DESIGN Cross-sectional study using self-administered questionnaire and self-collected vaginal swabs for detection of HPV infection. SETTING Estonian Biobank database. PARTICIPANTS Stratified random sample of women aged 30-33, 57-60 and 67-70 years living in one of the three largest counties in Estonia. Of 3065 women approached, 1347 (43.9%) returned questionnaires and specimens for HPV DNA detection. OUTCOME MEASURES HPV prevalence and fully adjusted ORs with 95% CIs for risk factors. RESULTS HPV prevalence was highest among women aged 30-33 years (18.7%; 95% CI 15.8 to 21.9) followed by those aged 67-70 years (16.7%; 95% CI 12.4 to 22.0) and 57-60 years (10.2%; 95% CI 7.8 to 13.3). HPV16 and HPV56 were the most common among women aged 30-33 years (both 4.0%; 95% CI 2.7 to 5.9), and HPV68 was the most common among women aged 57-60 years (2.8%; 95% CI 1.5 to 4.7) and 67-70 years (6.4%; 95% CI 3.6 to 10.4). Vaccination with nonavalent vaccine would have halved the carcinogenic HPV prevalence among women aged 30-33 years. The odds of infection with carcinogenic HPV were higher among women with six or more sexual partners among younger (OR 2.99; 95% CI 1.54 to 5.81) and older (OR 3.80; 95% CI 1.25 to 11.55) women and lower (OR 0.35; 95% CI 0.17 to 0.72) among younger married women. CONCLUSIONS This study demonstrated U-shaped age-specific genotype profile of carcinogenic HPV prevalence, indicating that public health providers should focus on developing exit strategies for the cervical cancer screening programme in Estonia with a possible extension of HPV testing beyond the current screening age of 65 years. Generalisability of the findings of this study may be affected by the low response rate.
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Affiliation(s)
- Kersti Pärna
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Anna Tisler
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Karolin Toompere
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Paul Naaber
- SYNLAB Estonia, Tallinn, Estonia
- Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Kaspar Ratnik
- SYNLAB Estonia, Tallinn, Estonia
- Department of Human Genetics, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Anda Ķīvīte Urtāne
- Institute of Public Health, Rīga Stradiņš University, Rīga, Latvia
- Department of Public Health and Epidemiology, Rīga Stradiņš University, Rīga, Latvia
| | - Jana Zodzika
- Institute of Public Health, Rīga Stradiņš University, Rīga, Latvia
- Department of Obstetrics and Gynaecology, Rīga Stradiņš University, Rīga, Latvia
| | - Mindaugas Stankūnas
- Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nicholas Baltzer
- Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Uusküla
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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11
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Zhong F, Li Z, Sun Y, Xiao Y, Li J, Zhou X, Cong Q, Sui L, Tao X, Zhao C. HPV genotyping of cervical histologic specimens of 61, 422 patients from the largest women hospital in China. Front Oncol 2023; 13:1161631. [PMID: 37064129 PMCID: PMC10090690 DOI: 10.3389/fonc.2023.1161631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
ObjectivesWe investigated HPV genotypes in a large cohort of patients with definitive cervical histologic diagnosis.MethodsHPV testing was performed by real-time PCR assay, including 18 high-risk HPV (hrHPV) and 3 low-risk HPV (lrHPV). Totally 61,422 patients with documented HPV genotyping results within 6 months before cervical histologic diagnoses were included.ResultsHrHPV positive rate was 55.1% among all tested cases with the highest in adenosquamous carcinoma (94.1%), followed by squamous cell carcinoma (SCC) (93.7%), cervical intraepithelial neoplasia 2/3 (CIN2/3) (92.8%). HrHPV positive rates were significantly higher in high-grade squamous lesions than in those in glandular lesions. HPV16 was the most common genotype followed by HPV52 and HPV58 in CIN2/3. The most frequent hrHPV genotype in adenocarcinoma in situ (AIS) was HPV18, followed by HPV16, HPV45 and HPV52. In SCC cases, HPV16 was the most common type followed by HPV58, HPV52, HPV18 and HPV33. However, HPV18 showed significantly higher prevalence in adenocarcinoma and adenosquamous carcinoma than in that in SCC. Theoretically, the protective rates of 2/4-valent and 9-valent vaccine were 69.1% and 85.8% for cervical cancers.ConclusionsThe prevalence of HPV genotypes in Chinese population was different from that in Western population. Some hrHPV types were identified in cervical precancerous lesions and cancers, which are not included in current HPV vaccines. These data provide baseline knowledge for future HPV vaccine development.
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Affiliation(s)
- Fangfang Zhong
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zaibo Li
- Department of Pathology, The Ohio State University, Columbus, OH, United States
| | - Yihua Sun
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yaoxing Xiao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Juan Li
- Department of Pathology, Jinan Maternity and Child Care Hospital, Jinan, Shandong, China
| | - Xianrong Zhou
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qing Cong
- Center for Diagnosis and Treatment of Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Center for Diagnosis and Treatment of Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiang Tao
- Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- *Correspondence: Xiang Tao, ; Chengquan Zhao,
| | - Chengquan Zhao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- *Correspondence: Xiang Tao, ; Chengquan Zhao,
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12
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Uusküla A, Oja M, Tamm S, Tisler A, Laanpere M, Padrik L, Nygard M, Reisberg S, Vilo J, Kolde R. Prevaccination Prevalence of Type-Specific Human Papillomavirus Infection by Grade of Cervical Cytology in Estonia. JAMA Netw Open 2023; 6:e2254075. [PMID: 36745455 DOI: 10.1001/jamanetworkopen.2022.54075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
IMPORTANCE Large-scale data on type-specific human papillomavirus (HPV) prevalence and disease burden worldwide are needed to guide cervical cancer prevention efforts. Promoting the research and application of health care big data has become a key factor in modern medical research. OBJECTIVE To examine the prevaccination prevalence of high-risk HPV (hrHPV) and type distribution by cervical cytology grade in Estonia. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used text mining and the linking of data from electronic health records and health care claims to examine type-specific hrHPV positivity in Estonia from 2012 to 2019. Participants were women aged at least 18 years. Statistical analysis was performed from September 2021 to August 2022. MAIN OUTCOMES AND MEASURES Type-specific hrHPV positivity rate by cervical cytological grade. RESULTS A total of 11 017 cases of cervical cytology complemented with data on hrHPV testing results between 2012 and 2019 from 66 451 women aged at least 18 years (mean [SD] age, 48.1 [21.0] years) were included. The most common hrHPV types were HPV16, 18, 31, 33, 51 and 52, which accounted for 73.8% of all hrHPV types detected. There was a marked decline in the positivity rate of hrHPV infection with increasing age, but the proportion did not vary significantly based on HPV type. Implementation of nonavalent prophylactic vaccination was estimated to reduce the number of women with high-grade cytology by 50.5% (95% CI, 47.4%-53.6%) and the number with low-grade cytology by 27.8% (95% CI, 26.3%-29.3%), giving an overall estimated reduction of 33.1% (95% CI, 31.7%-34.5%) in the number of women with precancerous cervical cytology findings. CONCLUSIONS AND RELEVANCE In this cross-sectional study, text mining and natural language processing techniques allowed the detection of precursors to cervical cancer based on data stored by the nationwide health system. These findings contribute to the literature on type-specific HPV distribution by cervical cytology grade and document that α-9 phylogenetic group HPV types 16, 31, 33, 52 and α-7 phylogenetic group HPV 18 are the most frequently detected in normal-to-high-grade precancerous lesions in Estonia.
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Affiliation(s)
- Anneli Uusküla
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Marek Oja
- Institute of Computer Science, University of Tartu, Tartu, Estonia
- STACC, Tartu, Estonia
| | - Sirli Tamm
- Institute of Computer Science, University of Tartu, Tartu, Estonia
- STACC, Tartu, Estonia
| | - Anna Tisler
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Made Laanpere
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu; Tartu University Hospital Women's Clinic, Tartu, Estonia
| | - Lee Padrik
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu; Tartu University Hospital Women's Clinic, Tartu, Estonia
| | - Mari Nygard
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Sulev Reisberg
- Institute of Computer Science, University of Tartu, Tartu, Estonia
- STACC, Tartu, Estonia
- Quretec, Tartu, Estonia
| | - Jaak Vilo
- Institute of Computer Science, University of Tartu, Tartu, Estonia
- STACC, Tartu, Estonia
| | - Raivo Kolde
- Institute of Computer Science, University of Tartu, Tartu, Estonia
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13
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Fu Y, Li Y, Li X, Wang X, Lü W. Risk stratification for cervical precancer and cancer by DH3-HPV partial genotyping and cytology in women attending cervical screening: A retrospective cohort study. J Med Virol 2023; 95:e28482. [PMID: 36609841 DOI: 10.1002/jmv.28482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/19/2022] [Accepted: 01/03/2023] [Indexed: 01/08/2023]
Abstract
To evaluate the effect of DH3-human papillomavirus (HPV) partial genotyping for risk stratification in cervical cancer screening, we conducted a post hoc analysis within a retrospective cohort of 7263 Chinese women aged 21-71 years who participated in population-based screening. The residual cytological samples at baseline were retested with DH3-HPV and Hybrid Capture 2 (HC2) assay after 3-year follow-up. Risk values with 95% confidence intervals (CIs) of cervical intraepithelial neoplasia (CIN) grade 3/2 or worse (CIN3+/CIN2+) were estimated based on HPV and cytology results. The report complies with the STROBE statement. Across every cytological result, risk estimates obtained from DH3-HPV and HC2 were similar or almost identical. By DH3-HPV partial genotyping, risks of CIN3+/CIN2+ were invariably higher for HPV16/18 than other high-risk HPV (hrHPV). Among women with normal cytology, immediate CIN3+ risks were 8.16% (95% CI = 4.19%-15.28%) for HPV16/18 positive and 0.48% (95% CI = 0.13%-1.73%) for other hrHPV positive. Among women with any abnormal cytology, immediate CIN3+ risks were 33.33% (95% CI = 22.24%-46.64%) for HPV16/18, and 13.33% (95% CI = 8.37%-20.56%) for other hrHPV. Among 5840 women completed 3-year follow-up, the cumulative CIN3+ risk was 25.56% (95% CI = 18.91%-33.59%) for HPV16/18 and 8.22% (95% CI = 6.02%-11.13%) for other hrHPV. Women with an HPV-negative result with DH3-HPV or HC2 test had very low cumulative 3-year CIN3+ risk (0.06%, 95% CI = 0.02%-0.17%), which was about one-tenth of women with normal cytology at baseline (0.62%, 95% CI = 0.45%-0.86%). Similar patterns were observed for the endpoint of CIN2+. These findings suggest that partial genotyping of DH3-HPV performs well in risk stratification, which can better balance the benefits and harms of cervical cancer screening.
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Affiliation(s)
- Yunfeng Fu
- Medical Centre for Cervical Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Li
- Medical Centre for Cervical Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Li
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinyu Wang
- Department of Gynecology and Obstetrics, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weiguo Lü
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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14
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Muresu N, Sotgiu G, Marras S, Gentili D, Sechi I, Cossu A, Dettori A, Pietri RE, Paoni L, Ghi ME, Bagella MP, Marrazzu A, Cossu A, Genovesi A, Piana A, Saderi L. Cervical Screening in North Sardinia (Italy): Genotype Distribution and Prevalence of HPV among Women with ASC-US Cytology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020693. [PMID: 35055515 PMCID: PMC8775344 DOI: 10.3390/ijerph19020693] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023]
Abstract
The assessment of human papillomavirus (HPV) genotype dynamics could support the adoption of more tailored preventive actions against cervical cancer. The aim of the study was to describe the prevalence of HPV infection, HPV genotype distribution, and the epidemiological characteristics of women with ASC-US cytology since the introduction of HPV-DNA testing in Sardinia (Italy), (March 2016–December 2020). Specimens were tested by RT-PCR for 14 high-risk HPV genotypes. A total of 1186 patients were enrolled, with a median (IQR) age of 41 (38–48) years. Of these women, 48.1% were positive for at least one HPV genotype; 311 (26.2%) women were vaccinated with a median (IQR) age of 38 (30/47) years. The percentage of prevalence of HPV-16, -31, -66, -56, and -51 was 36.3%, 18.7%, 11.9%, 11.4% and 10.7%, respectively. The highest prevalence of infection was found in women aged <41 years, and single women. Moreover, women aged >41 years (OR: 0.51, 95% CI: 0.31–0.86; p-value: 0.01), having parity (OR: 0.57, 95% CI: 0.34–0.96, p-value: 0.04), and higher educational level (OR: 0.39, 95% CI: 0.18–0.87; p-value: 0.02) were associated with a lower CIN2+ risk. We did not find a significant difference in terms of prevalence of HPV-16 infection between vaccinated and non-vaccinated (18.3% vs. 17.1%; p-value < 0.001). Our results support the adoption of nonavalent HPV-vaccine to prevent the most prevalent infections caused by HPV-16 and -31 genotypes and underscore the need of surveillance to implement tailored vaccination programs and preventive strategies.
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Affiliation(s)
- Narcisa Muresu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy; (N.M.); (S.M.); (D.G.); (I.S.); (A.C.); (A.P.)
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy;
- Correspondence: ; Tel.: +39-079-228472
| | - Silvia Marras
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy; (N.M.); (S.M.); (D.G.); (I.S.); (A.C.); (A.P.)
| | - Davide Gentili
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy; (N.M.); (S.M.); (D.G.); (I.S.); (A.C.); (A.P.)
| | - Illari Sechi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy; (N.M.); (S.M.); (D.G.); (I.S.); (A.C.); (A.P.)
| | - Andrea Cossu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy; (N.M.); (S.M.); (D.G.); (I.S.); (A.C.); (A.P.)
| | - Arianna Dettori
- Biomedical Science Ph.D. School, Biomedical Science Department, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy;
| | - Roberto Enrico Pietri
- ASSL Sassari, Coordinamento Consultori Familiari ASSL, Sassari 07100, Italy; (R.E.P.); (L.P.); (M.E.G.); (M.P.B.); (A.M.)
| | - Luisa Paoni
- ASSL Sassari, Coordinamento Consultori Familiari ASSL, Sassari 07100, Italy; (R.E.P.); (L.P.); (M.E.G.); (M.P.B.); (A.M.)
| | - Maria Eugenia Ghi
- ASSL Sassari, Coordinamento Consultori Familiari ASSL, Sassari 07100, Italy; (R.E.P.); (L.P.); (M.E.G.); (M.P.B.); (A.M.)
| | - Maria Paola Bagella
- ASSL Sassari, Coordinamento Consultori Familiari ASSL, Sassari 07100, Italy; (R.E.P.); (L.P.); (M.E.G.); (M.P.B.); (A.M.)
| | - Adriano Marrazzu
- ASSL Sassari, Coordinamento Consultori Familiari ASSL, Sassari 07100, Italy; (R.E.P.); (L.P.); (M.E.G.); (M.P.B.); (A.M.)
| | - Antonio Cossu
- Department of Medical, Surgical and Experimental Sciences, Institute of Pathology, University of Sassari, Via Matteotti, 07100 Sassari, Italy;
| | - Antonio Genovesi
- Department Health Education, Prevention, and Health Promotion Activities, 07100 Sassari, Italy;
| | - Andrea Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy; (N.M.); (S.M.); (D.G.); (I.S.); (A.C.); (A.P.)
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street, 07100 Sassari, Italy;
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15
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Song F, Yan P, Huang X, Wang C, Du H, Qu X, Wu R. Roles of extended human papillomavirus genotyping and multiple infections in early detection of cervical precancer and cancer and HPV vaccination. BMC Cancer 2022; 22:42. [PMID: 34991494 PMCID: PMC8734293 DOI: 10.1186/s12885-021-09126-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background The aim of the study was to investigate the risk of human papillomavirus (HPV) genotyping particularly vaccine genotypes and multiple infections for cervical precancer and cancer, which might contribute to developing genotype-specific screening strategy and assessing potential effects of HPV vaccine. Methods The HPV genotypes were identified using the Seq HPV assay on self-collected samples. Hierarchical ranking of each genotype was performed according to positive predictive value (PPV) for cervical intraepithelial neoplasia 2/3 or worse (CIN2+/CIN3+). Multivariate logistic regression model was used to estimate the odds ratios (ORs) with 95% confidence interval (CI) of CIN2+ according to multiplicity of types and vaccine types. Results A total of 2811 HPV-positive women were analyzed. The five dominant HPV genotypes in high-grade lesions were 16/58/52/33/18. The overall ranking orders were HPV16/33/35/58/31/68/18/ 56/52/66/51/59/45/39 for CIN2+ and HPV16/33/31/58/45/66/52/18/35/56/51/68/59/39 for CIN3+. The risks of single infection versus co-infections with other types lower in the hierarchy having CIN2+ were not statistically significant for HPV16 (multiple infection vs. single infection: OR = 0.8, 95%CI = 0.6-1.1, P = 0.144) or other genotypes (P > 0.0036) after conservative Bonferroni correction. Whether HPV16 was present or not, the risks of single infection versus multiple infection with any number (2, ≥2, or ≥ 3) of types for CIN2+ were not significantly different. In addition, HPV31/33/45/52/58 covered by nonavalent vaccine added 27.5% of CIN2, 23.0% of CIN3, and 12.5% of cancer to the HPV16/18 genotyping. These genotype-groups were at significantly higher risks than genotypes not covered by nonavalent vaccine. Moreover, genotypes covered by nonavalent vaccine contributed to 85.2% of CIN2 lesions, 97.9% of CIN3 and 93.8% of cancers. Conclusions Partial extended genotyping such as HPV33/31/58 but not multiplicity of HPV infections could serve as a promising triage for HPV-positive self-samples. Moreover, incidence rates of cervical cancer and precancer were substantial attributable to HPV genotypes covered by current nonavalent vaccination. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09126-3.
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Affiliation(s)
- Fangbin Song
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Peisha Yan
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Xia Huang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Chun Wang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Hui Du
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China. .,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China. .,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China.
| | - Xinfeng Qu
- Sanming Project of Medicine in Shenzhen, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China.
| | - Ruifang Wu
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China. .,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China. .,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China.
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16
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Comparison of DNA and RNA sequencing of total nucleic acids from human cervix for metagenomics. Sci Rep 2021; 11:18852. [PMID: 34552145 PMCID: PMC8458301 DOI: 10.1038/s41598-021-98452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Although metagenomics and metatranscriptomics are commonly used to identify bacteria and viruses in human samples, few studies directly compare these strategies. We wished to compare DNA and RNA sequencing of bacterial and viral metagenomes and metatranscriptomes in the human cervix. Total nucleic acids from six human cervical samples were subjected to DNA and RNA sequencing. The effect of DNase-treatment before reverse transcription to cDNA were also analyzed. Similarities and differences in the metagenomic findings with the three different sequencing approaches were evaluated. A higher proportion of human sequences were detected by DNA sequencing (93%) compared to RNA sequencing without (76%) and with prior DNase-treatment (11%). On the contrary, bacterial sequences increased 17 and 91 times. However, the number of detected bacterial genera were less by RNA sequencing, suggesting that only a few contribute to most of the bacterial transcripts. The viral sequences were less by RNA sequencing, still twice as many virus genera were detected, including some RNA viruses that were missed by DNA sequencing. Metatranscriptomics of total cDNA provided improved detection of mainly transcribed bacteria and viruses in cervical swabs as well as detection of RNA viruses, compared to metagenomics.
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17
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Luo D, Peng M, Wei X, Pan D, Xue H, Xu Y, Dong B. Prevalence of Human Papillomavirus and Genotype Distribution in Pregnant and Non-Pregnant Women in China. Risk Manag Healthc Policy 2021; 14:3147-3157. [PMID: 34349575 PMCID: PMC8326939 DOI: 10.2147/rmhp.s288838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The status of human papillomavirus (HPV) infection in pregnant and non-pregnant women in China remains unclear. This study aimed to compare the prevalence and genotype distributions of HPV between pregnant and non-pregnant women in China. Patients and Methods A case-control study was conducted of pregnant women during the second trimester and age-matched non-pregnant women attending the Fujian Maternity and Child Health Hospital between January 1, 2017 and December 31, 2018. Participants underwent cervical cytology testing and HPV genotyping. The genotyping test was able to identify 14 high-risk HPV (HR-HPV), four possible HR-HPV, and five low-risk HPV (LR-HPV) types. Further colposcopy and a cervical biopsy were performed if indicated. The primary outcomes were HPV prevalence and genotype distribution. Results In total, 1077 pregnant and 1077 non-pregnant women were enrolled. Compared with non-pregnant women, pregnant women had a higher prevalence of HPV (24.2% vs 14.8%), HR-HPV (20.2% vs 11.7%), and LR-HPV (8% vs 4.5%) infection. In pregnant women, the most prevalent HPV genotypes were HPV-52 (6.0%), -16 (3.5%), -58 (2.6%), -53 (2.5%), and -51 (2.5%), while in non-pregnant women the most prevalent genotypes were HPV-52 (3.6%), -81 (1.9%), -51 (1.8%), -68 (1.4%), and -16 (1.3%). In women aged ≥35 years, HR-HPV (P=0.002) and LR-HPV (P=0.001) prevalence were significantly higher in pregnant women. However, in women aged <35 years, only HR-HPV prevalence was higher in pregnant women. Pregnant and non-pregnant women with HPV-16 and HPV-58 infection had a high prevalence of high-grade squamous intra-epithelial lesions (HSIL) (HPV-16: P<0.001 and P=0.005, HPV-58: P=0.043 and P=0.005); but with other HR-HPV genotypes, only non-pregnant women had an increased HSIL prevalence. Conclusion In China, the HPV prevalence is higher in pregnant women than that in non-pregnant women and is also age- and genotype-dependent. HPV-infected pregnant women aged ≥35 years and those with HPV-16 should be closely monitored to enable rapid clinical intervention.
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Affiliation(s)
- Dandan Luo
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Meilian Peng
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Xizhen Wei
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Diling Pan
- Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Huifeng Xue
- Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Yuying Xu
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Binhua Dong
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
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Sociodemographic Correlates of Human Papillomavirus Vaccine Uptake: Opportunistic and Catch-Up Vaccination in Norway. Cancers (Basel) 2021; 13:cancers13143483. [PMID: 34298696 PMCID: PMC8307029 DOI: 10.3390/cancers13143483] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
Simple Summary HPV vaccination protects against virus that may cause cervical cancer. Opportunistic HPV vaccination (i.e., vaccination at a citizens’ own initiative and cost) has been available in Norway since the first HPV vaccine was licensed in 2006. A routine HPV vaccination program targeting 12-year-old girls was introduced in 2009. A delayed catch-up vaccination program was initiated in 2016, offering HPV vaccination free-of-charge to women born in 1991 and later who had not previously been vaccinated in the routine program. The aim of this study was to assess sociodemographic correlates of opportunistic and catch-up HPV vaccine uptake among women in Norway. We found inequalities in both self-paid opportunistic and free-of-charge catch-up HPV vaccine uptake among adolescents and adult women, with particularly low uptake among women with two immigrant parents and among women with a low household income. Abstract Achieving equity in human papillomavirus (HPV) vaccination has high priority. In this nationwide registry-based study, we aimed to investigate sociodemographic correlates of HPV vaccine uptake among women who were vaccinated opportunistically at their own initiative and cost during October 2006–June 2018, and among women who were vaccinated free-of-charge in a catch-up vaccination program during November 2016–June 2018. For 840,328 female residents born in Norway between 1975 and 1996, we retrieved HPV vaccination and sociodemographic data from national registries. We used separate models to analyze the sociodemographic correlates of the initiation and completion of HPV vaccination in opportunistic and catch-up vaccination settings. Overall initiation rate for opportunistic HPV vaccination was 2.2%. Uptake increased consistently with birth year, maternal education level, and household income. Having two immigrant parents or a mother working in a lower prestige occupation was strongly associated with low opportunistic vaccination uptake. Similar but weaker inequities were observed in catch-up HPV vaccination. Initiation rate during the first 20 months of the catch-up program was 46.2%. Completion rate was 72.1% and 73.0% for opportunistic or catch-up vaccination, respectively, with small inequities. In conclusion, HPV vaccine uptake was strongly associated with sociodemographic background both in opportunistic and catch-up vaccination settings, with particularly low uptake associated with having two immigrant parents and low household income.
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