Multi-site study of HPV type-specific prevalence in women with cervical cancer, intraepithelial neoplasia and normal cytology, in England.
BACKGROUND
Knowledge of the prevalence of type-specific human papillomavirus (HPV) infections is necessary to predict the expected, and to monitor the actual, impact of HPV immunisation and to design effective screening strategies for vaccinated populations.


METHODS
Residual specimens of cervical cytology (N=4719), CIN3/CGIN and cervical cancer biopsies (N=1515) were obtained from sites throughout England, anonymised and tested for HPV DNA using the Linear Array typing system (Roche).


RESULTS
The prevalence of HPV 16 and/or 18 (with or without another high-risk (HR) type) was 76% in squamous cell carcinomas, 82% in adeno/adenosquamous carcinomas and 63% and 91% in CIN3 and CGIN, respectively. Of all HR HPV-infected women undergoing cytology, non-vaccine HPV types only were found in over 60% of those with mild dyskaryosis or below, and in <20% of those with cancer. In women of all ages undergoing screening, HR HPV prevalence was 16% and HPV 16 and/or 18 prevalence was 5%.


CONCLUSIONS
Pre-immunisation, high-grade cervical disease in England was predominantly associated with HPV 16 and/or 18, which promises a high impact from HPV immunisation in due course. Second-generation vaccines and screening strategies need to consider the best ways to detect and prevent disease due to the remaining HR HPV types.
Howell-Jones
R
R
HIV & STI Department, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
Bailey
A
A
Beddows
S
S
Sargent
A
A
de Silva
N
N
Wilson
G
G
Anton
J
J
Nichols
T
T
Soldan
K
K
Kitchener
H
H
D000230:Adenocarcinoma / Q000821:virology; D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000821:virology*; D004739:England / Q000453:epidemiology; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D053918:Papillomavirus Vaccines; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000821:virology*
D053918:Papillomavirus Vaccines