title: Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe.
abstract: Knowledge of differences in human papillomavirus (HPV)-type prevalence between high-grade cervical intraepithelial neoplasia (HG-CIN) and invasive cervical cancer (ICC) is crucial for understanding the natural history of HPV-infected cervical lesions and the potential impact of HPV vaccination on cervical cancer prevention. More than 6,000 women diagnosed with HG-CIN or ICC from 17 European countries were enrolled in two parallel cross-sectional studies (108288/108290). Centralised histopathology review and standardised HPV-DNA typing were applied to formalin-fixed paraffin-embedded cervical specimens dated 2001-2008. The pooled prevalence of individual HPV types was estimated using meta-analytic methods. A total of 3,103 women were diagnosed with HG-CIN and a total of 3,162 with ICC (median ages: 34 and 49 years, respectively), of which 98.5 and 91.8% were HPV-positive, respectively. The most common HPV types in women with HG-CIN were HPV16/33/31 (59.9/10.5/9.0%) and in ICC were HPV16/18/45 (63.3/15.2/5.3%). In squamous cell carcinomas, HPV16/18/33 were most frequent (66.2/10.8/5.3%), and in adenocarcinomas, HPV16/18/45 (54.2/40.4/8.3%). The prevalence of HPV16/18/45 was 1.1/3.5/2.5 times higher in ICC than in HG-CIN. The difference in age at diagnosis between CIN3 and squamous cervical cancer for HPV18 (9 years) was significantly less compared to HPV31/33/'other' (23/20/17 years), and for HPV45 (1 year) than HPV16/31/33/'other' (15/23/20/17 years). In Europe, HPV16 predominates in both HG-CIN and ICC, whereas HPV18/45 are associated with a low median age of ICC. HPV18/45 are more frequent in ICC than HG-CIN and associated with a high median age of HG-CIN, with a narrow age interval between HG-CIN and ICC detection. These findings support the need for primary prevention of HPV16/18/45-related cervical lesions.
authors: Department of Gynecology and Gynecologic Oncology, University Hospital Antwerpen, University of Antwerp, Antwerpen, Belgium. wiebren.tjalma@uza.be
authors: Wiebren A
authors: WA
authors: Tjalma
authors: Alison
authors: A
authors: Fiander
authors: Olaf
authors: O
authors: Reich
authors: Ned
authors: N
authors: Powell
authors: Andrzej M
authors: AM
authors: Nowakowski
authors: Benny
authors: B
authors: Kirschner
authors: Robert
authors: R
authors: Koiss
authors: John
authors: J
authors: O'Leary
authors: Elmar A
authors: EA
authors: Joura
authors: Mats
authors: M
authors: Rosenlund
authors: Brigitte
authors: B
authors: Colau
authors: Doris
authors: D
authors: Schledermann
authors: Kersti
authors: K
authors: Kukk
authors: Vasileia
authors: V
authors: Damaskou
authors: Maria
authors: M
authors: Repanti
authors: Radu
authors: R
authors: Vladareanu
authors: Larisa
authors: L
authors: Kolomiets
authors: Alevtina
authors: A
authors: Savicheva
authors: Elena
authors: E
authors: Shipitsyna
authors: Jaume
authors: J
authors: Ordi
authors: Anco
authors: A
authors: Molijn
authors: Wim
authors: W
authors: Quint
authors: Alice
authors: A
authors: Raillard
authors: Dominique
authors: D
authors: Rosillon
authors: Sabrina Collas
authors: SC
authors: De Souza
authors: David
authors: D
authors: Jenkins
authors: Katsiaryna
authors: K
authors: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral