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Luan H. Human papilloma virus infection and its associated risk for cervical lesions: a cross-sectional study in Putuo area of Shanghai, China. BMC Womens Health 2023; 23:28. [PMID: 36658539 PMCID: PMC9854058 DOI: 10.1186/s12905-023-02166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the human papilloma virus (HPV) infection status, main subtypes and age distribution characteristics of women in the Putuo area of Shanghai. METHODS A total of 13,936 subjects were enrolled in this study. These subjects were 15-89 years old, with a mean age of 41.68. Real-time fluorescence quantitative polymerase chain reaction technology was used to detect 21 types of HPV. RESULTS A total of 2,500 subjects with HPV infections were detected in 13,936 cervical exfoliated cell specimens (total infection rate 17.9%). There were 15 people aged below 20,486 people aged 21-30,876 people aged 31-40,484 people aged 41-50, 338 people aged 51-60, and 301 people aged > 60. In total, 1,893 (75.7%) subjects had a single type of HPV infection, 424 (16.9%) had a double infection, and 183 had triple or more infections (7.4%). The top 6 subtypes of HPV infection in the Shanghai Putuo District were HPV 52 (3.81%), HPV 58 (2.46%), HPV 16 (2.43%), HPV 53 (2.30%), HPV 81 (1.74%) and HPV 39 (1.5%). The number of high-risk HPV infections was 1,978, and the total infection rate was 14.19%. The number of intermediate-risk HPV infections was 578, and the total infection rate was 4.15%. The number of low-risk HPV infections was 338, and the total infection rate was 2.43%. CONCLUSION The top 3 populations with HPV infection rates in the Putuo District, Shanghai, were ≤ 20 years old, older than 60, and 21-30 years old. The infection rate of HPV in cervical outpatient clinics was significantly higher than that of other departments. The 9-valent vaccine is recommended for HPV vaccination in this area.
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Affiliation(s)
- Haiping Luan
- Department of Laboratory, Putuo District Maternal and Child Health Hospital, No. 517 of Tongpu Street, Putuo District, Shanghai, 200062 China
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Koc S, Yuksel D, Kinay T, Burkankulu D, Kayikcioglu F. Histologıcal results of HPV genotyping from a colposcopy center. Arch Gynecol Obstet 2022; 308:193-200. [PMID: 36543966 DOI: 10.1007/s00404-022-06879-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the role of partial human papillomavirus (HPV) genotyping tests in predicting the diagnosis of high-grade cervical intraepithelial lesion and cancer (HSIL +) as a result of colposcopic histopathology. MATERIALS AND METHODS The study included 2872 patients who presented at our colposcopy unit between January 1, 2015 and December 31, 2019 and underwent colposcopy for the first time. The patients were compared in terms of HSIL + results as HPV 16/18 and HPV other type positive groups. RESULTS HSIL + was determined at the rate of 22.3% in the HPV 16/18 group and at 7.0% in the HPV Other group, and the difference was statistically significant (p = 0.000). HPV 16/18 types were found to be responsible for 84.8% of cervical cancers and 83.5% of HSIL and worse cases. CONCLUSION Partial HPV 16/18 genotyping is an effective strategy in the triage of HPV-positive women. HPV type identification consistent with the epidemiology of HPV types in HSIL + cases in the screened population, and the age-appropriate use of primary HPV tests will determine the sensitivity and cost effectiveness of screening.
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Piyathilake CJ, Badiga S, Simons JL, Bell WC, Jolly PE. HPV E1 qPCR, a Low-Cost Alternative Assay to Roche Diagnostic Linear Array is Effective in Identifying Women at Risk for Developing Cervical Cancer. Int J Womens Health 2022; 14:257-266. [PMID: 35221728 PMCID: PMC8865867 DOI: 10.2147/ijwh.s347546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/04/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Since a quantitative polymerase chain reaction (qPCR) assay targeting the E1 region of HPV genome is cost-effective/simple to perform, we evaluated the agreement between the Roche Diagnostics Linear Array (RDLA) genotyping test and qPCR-based E1 assay to detect HR-HPV genotypes that are included or not included in HPV vaccines and compared their accuracy to detect CIN 2+. METHODS Study population included 257 African American (AA) and 266 Caucasian American (CA) diagnosed with intraepithelial neoplasia (CIN) grades ≤CIN 1 or ≥CIN 2 (CIN 2+) and tested for HPV by the RDLA and E1 assay. The concordance was determined using Gwet's AC1. The calculated positive predictive value (PPV) and negative predictive value (NPV) of the two assays were used to determine their suitability to detect CIN lesions. RESULTS Overall, the E1 assay showed substantial agreement with the RDLA assay to detect any HR-HPV genotype and the agreement was higher in women diagnosed with CIN 2+ than ≤CIN 1. The concordance was largely higher in Cas than in Aas. The NPV and PPV values to detect CIN lesions were similar between the two assays. CONCLUSION Utilization of the HPV E1 assay as a tool for CC screening could be a cost-effective approach that applies to both vaccinated and unvaccinated populations.
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Affiliation(s)
- Chandrika J Piyathilake
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Suguna Badiga
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Janice L Simons
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Walter C Bell
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Pauline E Jolly
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Dong B, Zou H, Mao X, Su Y, Gao H, Xie F, Lv Y, Chen Y, Kang Y, Xue H, Pan D, Sun P. Effect of introducing human papillomavirus genotyping into real-world screening on cervical cancer screening in China: a retrospective population-based cohort study. Ther Adv Med Oncol 2021; 13:17588359211010939. [PMID: 33995595 PMCID: PMC8107662 DOI: 10.1177/17588359211010939] [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: 10/24/2020] [Accepted: 03/25/2021] [Indexed: 12/27/2022] Open
Abstract
Background: China’s Fujian Cervical Pilot Project (FCPP) transitioned cervical cancer screening from high-risk human papillomavirus (HR-HPV) nongenotyping to genotyping. We investigated the clinical impact of this introduction, comparing performance indicators between HR-HPV genotyping combined with cytology screening (HR-HPV genotyping period) and the previous HR-HPV nongenotyping combined with cytology screening (HR-HPV nongenotyping period). Methods: A retrospective population-based cohort study was performed using data from the FCPP for China. We obtained data for the HR-HPV nongenotyping period from 1 January 2012 to 31 December 2013, and for the HR-HPV genotyping period from 1 January 2014 to 31 December 2016. Propensity score matching was used to match women from the two periods. Multivariable Cox regression was used to assess factors associated with cervical intraepithelial neoplasia of grade 2 or worse (CIN2+). The primary outcome was the incidence of CIN2+ in women aged ⩾25 years. Performance was assessed and included consistency, reach, effectiveness, adoption, implementation and cost. Results: Compared with HR-HPV nongenotyping period, in the HR-HPV genotyping period, more CIN2+ cases were identified at the initial screening (3.06% versus 2.32%; p < 0.001); the rate of colposcopy referral was higher (10.87% versus 6.64%; p < 0.001); and the hazard ratio of CIN2+ diagnosis was 1.64 (95% confidence interval, 1.43–1.88; p < 0.001) after controlling for health insurance status and age. The total costs of the first round of screening (US$66,609 versus US$65,226; p = 0.293) were similar during the two periods. Higher screening coverage (25.95% versus 25.19%; p = 0.007), higher compliance with age recommendations (92.70% versus 91.69%; p = 0.001), lower over-screening (4.92% versus 10.15%; p < 0.001), and reduced unqualified samples (cytology: 1.48% versus 1.73%, p = 0.099; HR-HPV: 0.57% versus 1.34%, p < 0.001) were observed in the HR-HPV genotyping period. Conclusions: Introduction of an HR-HPV genotyping assay in China could detect more CIN2+ lesions at earlier stages and improve programmatic indicators. Evidence suggests that the introduction of HR-HPV genotyping is likely to accelerate the elimination of cervical cancer in China.
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Affiliation(s)
- Binhua Dong
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, P.R. China
| | - Xiaodan Mao
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, P.R. China
| | - Hangjing Gao
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Fang Xie
- Department of Obstetrics and Gynecology, Mindong Hospital of Fujian Medical University, Fuan, Fujian, P.R. China
| | - Yuchun Lv
- Department of Obstetrics and Gynecology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, P.R. China
| | - Yaojia Chen
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Yafang Kang
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. 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, P.R. China
| | - Diling Pan
- Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Pengming Sun
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, Fujian 350001, P.R. China
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Wang Z, Liu T, Wang Y, Gu Y, Wang H, Liu J, Cui B, Yang X. Risk of cervical lesions in high-risk HPV positive women with normal cytology: a retrospective single-center study in China. Infect Agent Cancer 2020; 15:34. [PMID: 32477424 PMCID: PMC7240930 DOI: 10.1186/s13027-020-00291-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/01/2020] [Indexed: 01/30/2023] Open
Abstract
Background To investigate high-risk HPV (hr-HPV) genotype distributions and the association between hr-HPV infection with severity of the cervical lesions in women with normal cytology. Methods In this cross-sectional study, the result of the hr-HPV test and biopsy of colposcopy of women with normal cytology from January 2012 to January 2019 were analyzed. The detection rate of high-grade squamous intraepithelial lesion (HSIL) and cervical cancer were calculated among different hr-HPV genotypes, viral load group, and age groups. Results Five thousand eight hundred eighty women were enrolled in this study. Overall, 59.97% had normal histological results, 19.32% had HSIL, and 1.07% had cervical cancer. The detection rate of HSIL or worse (HSIL+) in women with single HPV16(34.00%), HPV31(27.50%), HPV33(25.58%), and HPV52(20.88%) infection were higher significantly than single HPV18 (15.59%) infection, respectively. The HSIL+ detection rate between HPV16 single infection and multiple infections (excluding HPV18) was no significant difference (34% vs 35.47%, P = 0.638), contrary to HPV18(12.59% vs 21.67%, P = 0.022). In women without HPV16/18 infections, HSIL+ detection rates for single, double, and triple or more hr-HPV infections were 12.28, 20.31, and 37.50%, the risk of detection of HSIL+ significantly increasing. With the hr-HPV DNA load increases, the risk of detection of HSIL+ (χ2 = 91.01, P < 0.0001) and invasive cervical cancer (χ2 = 5.757, P = 0.016) increase. In age < 30, 31–40, 41–50, 51–60, > 60 group, HSIL+ detection rate were 24.80%、22.10%、19.59%、14.29, and 12.61%, respectively. Conclusion Women who have normal cytology with HPV 16/18/31/33/52/58 infections, multiple HPV infections and high viral load, have a higher detection rate of HSIL+.
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Affiliation(s)
- Zhiling Wang
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Ting Liu
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Yunjian Wang
- 2West China School of Medicine, Sichuan University, Chengdu, China
| | - Ying Gu
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Hui Wang
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Jingkang Liu
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Baoxia Cui
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Xingsheng Yang
- 1Department of Gynecology, Qilu Hospital of Shandong University, Jinan, China
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Gu L, Hong Z, Gao H, Qiu L, Di W. Incidence of cervical high-grade squamous intraepithelial lesions and squamous cell carcinoma in women with high-risk human papillomavirus and normal cervical cytology: A retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype. Cytopathology 2019; 30:419-425. [PMID: 31069857 DOI: 10.1111/cyt.12717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 04/09/2019] [Accepted: 04/23/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To retrospectively analyse the incidence of high-grade squamous intraepithelial lesions (HSILs) and squamous cell carcinoma (SCC) in women of different ages with high-risk (HR) human papillomavirus (HPV) but with normal cytology test results stratified by age and HPV genotype. METHODS In total, 1858 women with HR-HPV infection but with a normal smear who received a colposcopy and biopsy between 2015 and 2016 at our institution were included. The pathological results were retrospectively analysed after stratifying by age and HPV genotype. RESULTS Among the 1858 cases, the HSIL% in women aged 21-29 years (10.54%) was significantly different from that in women aged 40-49 years (19.85%; P < 0.05), whereas there was no significant difference in the HSIL% among women aged 21-29 years and those in the other age groups (P > 0.05). In total, 295 cases had single HPV16 infection. The HSIL% in patients with HPV16/18 infection was >15%, and the 40-49-year age group had the highest percentage at 48.48%. For other HR-HPV infections, the HSIL and SCC incidence rate was 10.41%, and there was no significant difference among the age groups; thus, women with other types of viral infections, regardless of age, should be referred to colposcopy. CONCLUSIONS Although HPV16 is the HPV with the highest risk, other HR-HPV infections can also cause a high percentage of HSILs and SCC in women with normal cytology. Therefore, it is necessary to refer HR-HPV-infected women aged ≥21 years for colposcopy in a timely manner to exclude potential cervical intraepithelial neoplasia and cervical cancer.
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Affiliation(s)
- Liying Gu
- Department of Obstetrics and Gynecology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.,Shanghai Key Laboratory of Gynecologic Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zubei Hong
- Department of Obstetrics and Gynecology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.,Shanghai Key Laboratory of Gynecologic Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Hua Gao
- Department of Obstetrics and Gynecology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.,Shanghai Key Laboratory of Gynecologic Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Lihua Qiu
- Department of Obstetrics and Gynecology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.,Shanghai Key Laboratory of Gynecologic Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wen Di
- Department of Obstetrics and Gynecology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.,Shanghai Key Laboratory of Gynecologic Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.,State Key Laboratory of Oncogenes and Related Genes, School of Medicine, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
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Ki EY, Lee YK, Lee A, Park JS. Comparison of the PANArray HPV Genotyping Chip Test with the Cobas 4800 HPV and Hybrid Capture 2 Tests for Detection of HPV in ASCUS Women. Yonsei Med J 2018; 59:662-668. [PMID: 29869464 PMCID: PMC5990676 DOI: 10.3349/ymj.2018.59.5.662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study aimed to evaluate the performance of the PANArray human papilloma virus (HPV) test, a PCR-based DNA microarray assay, in detecting HPV from patient samples and its concordance with the cobas 4800 HPV and Hybrid Capture 2 (HC2) tests. MATERIALS AND METHODS The PANArray HPV, cobas 4800 HPV, and HC2 tests were performed on 504 cervical swab samples from patients with atypical cells of undetermined significance at five hospitals. The samples that were interpreted as 'HPV-other' type positive in the PANArray HPV test were confirmed by direct sequencing. RESULTS The concordance rates were 80.8% between the cobas 4800 HPV and PANArray HPV tests [κ=0.59, 95% confidence interval (CI) 0.52-0.66] and 80.2% (κ=0.6, 95% CI 0.55-0.68) between the HC2 and PANArray HPV tests. Among the 62 patients negative on PANArray HPV (defined as the absence of high risk HPV), but positive on both cobas 4800 HPV and HC2 tests, 42 (67.7%) tested positive for 'HPV-other' types on the PANArray HPV test, and 31 (50.0%) had gray zone results [relative light unit/control (RLU/CO), 1.4-9.25] in the HC2 test. Of the patients deemed positive by the PANArray HPV test, 43 tested positive for high-risk (HR) HPV in cobas 4800 HPV and HC 2 tests. Among them, 58.2% showed HR HPV, including HPV 16, by direct sequencing, of which 25% had gray results. CONCLUSION Results classified as 'HPV-other' type by the PANArray HPV test, or gray zone results by HC2 (RLU/CO ratio level 1-10) should be carefully interpreted using comprehensive clinical information.
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Affiliation(s)
- Eun Young Ki
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Yoon Kyung Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Jong Sup Park
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Robadi IA, Pharaon M, Ducatman BS. The Importance of High-Risk Human Papillomavirus Types Other Than 16 and 18 in Cervical Neoplasia. Arch Pathol Lab Med 2018; 142:693-695. [PMID: 29848032 DOI: 10.5858/arpa.2017-0563-ra] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT - Types 16 and 18 are the most widely studied high-risk types of human papillomavirus (HPV). However, other high-risk HPV types (HPV non-16/18) also play a significant role in cervical neoplasia. Currently, screening and management algorithms separate out HPV 16/18 from all other HPV non-16/18 types. In addition, most of the previously vaccinated population has only been vaccinated for these high-risk types, so many women are still vulnerable to HPV non-16/18 infections. OBJECTIVE - To review the prevalence and role of HPV non-16/18 neoplasia and to review current surveillance, management, and vaccination strategies in view of these findings. DATA SOURCES - The study comprised a review of the literature. CONCLUSIONS - Although HPV non-16/18 types are less frequently associated with cervical intraepithelial neoplasia and cancer, they are nonetheless a significant cause of disease. Further stratification of higher-risk HPV non-16/18 may be necessary to improve prevention and management, however, regional prevalence differences may make a unified approach difficult. As HPV 16/18 infections decrease owing to vaccination of at-risk women, the relative frequency of HPV non-16/18 will increase, although the latest vaccine covers several more high-risk types.
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Affiliation(s)
| | | | - Barbara S Ducatman
- From the Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University School of Medicine, Morgantown. Dr Pharaon is currently in the Department of Pathology, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania. Dr Ducatman is currently in the Department of Pathology, Beaumont Health and Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
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