title: Distribution of human papillomavirus types in cervical cancers in Hong Kong: current situation and changes over the last decades.
abstract: Human papillomavirus (HPV) type distribution among cervical cancers and its possible changes over time are key issues that determine the cost-effectiveness of HPV vaccines. Cervical cancers diagnosed during 3 periods (1997-2007, N = 280; 1984-1986, N = 74; 1972-1973, N = 81) in Hong Kong were examined for HPV type distribution using sensitive broad-catching methods. The results showed a variation in HPV distribution between histological groups. Among cervical squamous cell carcinoma (SCC) cases diagnosed over the past 10 years, HPV16 was most commonly found (61.2%), followed by HPV18 (17.7%), HPV52 (14.7%) and HPV58 (9.9%), whereas adeno/adenosquamous cell carcinoma was dominated by HPV18 (56.3%) and HPV16 (50.0%). The proportion of HPV16-positive SCC showed a significant linear trend of increase with time (45.2% for 1972-1973, 58.8% for 1984-1986, 61.2% for 1997-2007; p(Trend) = 0.023), whereas HPV52-positive SCC decreased with time (30.1% for 1972-1973; 29.4% for 1984-1986, 14.7% for 1997-2007; p(Trend) = 0.001). Vaccines comprising HPV16/18 cover 62.6% of SCC and 93.8% of adeno/adenosquamous carcinoma in Hong Kong, and inclusion of HPV52 and HPV58 can increase the coverage by 18.4% for SCC and 4.1% for adeno/adenosquamous cell carcinoma. HPV type distribution may change over time. Further investigations to reveal the determinants for such changes and continuous monitoring for possible type replacement as a result of widespread long-term use of HPV vaccines are warranted. Multiple infections are commonly revealed by sensitive broad-catching methods such as those used in this study. However, their implication on vaccine efficacy and cost-effective analyses should be taken cautiously.
authors.affiliation: Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China. paulkschan@cuhk.edu.hk
authors.forename: Paul K S
authors.initials: PK
authors.lastname: Chan
authors.forename: Wendy C S
authors.initials: WC
authors.lastname: Ho
authors.forename: Mei-Yung
authors.initials: MY
authors.lastname: Yu
authors.forename: Wai-Mei
authors.initials: WM
authors.lastname: Pong
authors.forename: Alexander C L
authors.initials: AC
authors.lastname: Chan
authors.forename: Amanda K C
authors.initials: AK
authors.lastname: Chan
authors.forename: Tak-Hong
authors.initials: TH
authors.lastname: Cheung
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: To
authors.forename: Ho-Keung
authors.initials: HK
authors.lastname: Ng
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000821:virology; D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000145:classification* / Q000276:immunology; D044466:Asian People / Q000706:statistics & numerical data; D018196:Carcinoma, Adenosquamous / Q000453:epidemiology / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000821:virology; D016009:Chi-Square Distribution; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000821:virology*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D011230:Precancerous Conditions / Q000453:epidemiology / Q000821:virology; D014412:Tumor Virus Infections / Q000150:complications* / Q000517:prevention & control / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines; C510352:human papillomavirus vaccine, L1 type 16, 18