title: The potential impact of human papillomavirus vaccination in contemporary cytologically screened populations may be underestimated: an observational retrospective analysis of invasive cervical cancers.
abstract: The aim of this study was to determine the proportion of invasive cervical cancers attributable to human papillomavirus (HPV) types 16 and 18 in a contemporary, cytologically well-screened UK population. This was achieved in a retrospective observational analysis by HPV typing 453 archival invasive cervical cancers diagnosed between January 1, 2000 and September 1, 2006. Pathological material was collected from 9 hospitals across Wales (UK), and HPV typing and pathology review was conducted at a central laboratory. Genotyping for high-risk HPV DNA was performed by PCR-enzyme immunoassay using the GP5+/6+ primer set. DNA was successfully extracted from 297 cases. Two hundred and eighty cases were included in the final analysis. The proportion of cases which had only HPV 16 and/or 18 was 219 of 280 (78.2%, 95% CI = 73.0-82.7); the proportion of cases which had HPV 16 or 18 and another HPV type was 230 of 280 (82.1%, 95% CI = 77.2-86.2). The proportion of cervical cancers associated with infection with HPV types 16 and 18 has previously been estimated at around 70%. The appropriate figure for a cytologically well-screened UK population appears to be approximately 80%. Hence, the potential impact of the current vaccination programme may be underestimated.
authors: HPV Research Group, Department of Obstetrics and Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom. powellng@cf.ac.uk
authors: Ned
authors: N
authors: Powell
authors: Adam
authors: A
authors: Boyde
authors: Amanda
authors: A
authors: Tristram
authors: Sam
authors: S
authors: Hibbitts
authors: Alison
authors: A
authors: Fiander
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D000293:Adolescent; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics; D052161:Human papillomavirus 18 / Q000235:genetics; D006801:Humans; D008403:Mass Screening; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D014852:Wales / Q000453:epidemiology
chemical_list: D004279:DNA, Viral; D053918:Papillomavirus Vaccines