title: Prevalence of human papillomavirus types in high-grade cervical intraepithelial neoplasia and cancer in Italy.
abstract: BACKGROUND
  The aim of this multicentric study was to identify human papillomavirus (HPV) type distribution in invasive cervical cancer and high-grade cervical intraepithelial neoplasia 2/3 (CIN2/3) in Italy.
  
  
  METHODS
  Cases were sampled through the electronic databases at the pathology units of eight centers in six regions from central and southern Italy. HPV types were detected from paraffin-embedded tissue samples and cervical specimens through amplification of HPV DNA with GP5+/GP6+ primers, followed by genotyping with reverse line blot (RLB). Untyped HPV-positive samples were sequenced. HPV-negative samples underwent nested PCR, followed by either RLB or sequencing. Finally, the remaining HPV-negative samples were amplified with primers targeting the virus E6 to E7 regions.
  
  
  RESULTS
  From 1,162 cases initially selected, 722 samples were further analyzed: 144 CIN2, 385 CIN3, 157 invasive squamous carcinomas, and 36 adenocarcinomas. Samples (6.9%) were HPV negative. The proportion of HPV16/18 was 60.8%, 76.6%, and 78.8% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.004). There was a significant decreasing trend of HPV16/18 with age in invasive cancers, going from 92% in women <35 years to 73% in women >55 years (P = 0.036). The proportion of coinfections was 16.8%, 15.5%, and 10.0% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.07).
  
  
  CONCLUSIONS
  The proportion of invasive cancers caused by HPV16/18 decreases with age at diagnosis.
  
  
  CONCLUSIONS
  The absolute risk of an invasive cancer due to non-HPV16/18 in women under 35 is extremely low. This finding might prompt us to rise the age at which public HPV screening for vaccinated women should start.
authors.affiliation: ISPO, Florence, Italy.
authors.forename: Francesca M
authors.initials: FM
authors.lastname: Carozzi
authors.forename: Maria L
authors.initials: ML
authors.lastname: Tornesello
authors.forename: Elena
authors.initials: E
authors.lastname: Burroni
authors.forename: Giovanna
authors.initials: G
authors.lastname: Loquercio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carillo
authors.forename: Claudio
authors.initials: C
authors.lastname: Angeloni
authors.forename: Aurora
authors.initials: A
authors.lastname: Scalisi
authors.forename: Rosalba
authors.initials: R
authors.lastname: Macis
authors.forename: Francesco
authors.initials: F
authors.lastname: Chini
authors.forename: Franco M
authors.initials: FM
authors.lastname: Buonaguro
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
mesh_terms: D000328:Adult; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*