title: Human papillomavirus infection, risk for subsequent development of cervical neoplasia and associated population attributable fraction.
abstract: BACKGROUND
  Human papillomavirus (HPV) is the major cause of cervical neoplasia but estimates of the population attributable fraction (PAR%), of HPV vary. PAR% has not been derived from longitudinal studies although assessment of HPV exposure prior to the neoplasia diagnosis should increase validity of such estimates.
  
  
  OBJECTIVE
  Systematic review and meta-analysis of longitudinal studies on HPV associated relative risk (RR) for and PAR% of HPV16 in cervical neoplasia.
  
  
  METHODS
  Pertinent data from longitudinal studies was made available through Medline and substituted by various hand searches. HPV associated weighted mean RR, with 95% confidence interval (CI) of cervical neoplasia, and the PAR% of HPV16 in cervical carcinoma were estimated both for unselected and low HPV prevalence populations.
  
  
  RESULTS
  HPV associated RR of cervical carcinoma in PCR-based studies was 17 (95% CI 8.2-33). HPV16 associated RRs in seroepidemiological studies were 3.3 (95% CI 2.2-4.9) for the unselected population, HPV16 seroprevalence 11.0%, and 12.5 (95% CI 5.5-29) for a population with low HPV16 seroprevalence of 5.3%. Corresponding PAR% estimates of HPV16 were 27 and 44%, respectively.
  
  
  CONCLUSIONS
  Protective vaccination against HPV16 infection would prevent up to 44% of cervical carcinoma.
authors: National Public Health, Institute, FIN 00300, Helsinki, Finland. llmale@uta.fi
authors: M
authors: M
authors: Lehtinen
authors: T
authors: T
authors: Luukkaala
authors: K L
authors: KL
authors: Wallin
authors: J
authors: J
authors: Paavonen
authors: S
authors: S
authors: Thoresen
authors: J
authors: J
authors: Dillner
authors: M
authors: M
authors: Hakama
mesh_terms: D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D015201:Meta-Analysis as Topic; D027383:Papillomaviridae / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014412:Tumor Virus Infections / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000821:virology*
chemical_list: D004279:DNA, Viral