title: HPV type distribution in invasive cervical cancers in Italy: pooled analysis of three large studies.
abstract: OBJECTIVE
  The aim of this study is to describe the prevalence of HPV types in invasive cervical cancers in Italy from 1996 to 2008.
  
  
  METHODS
  A pooled analysis of the three largest case series typed to date was performed. HPV typing was performed on paraffin-embedded slices. Molecular analyses were performed in four laboratories. Multivariate analyses were performed to test the associations between calendar time, age, and geographical area and the proportion of types 16/18.
  
  
  RESULTS
  Out of 574 cancers, 24 (4.2%) were HPV negative. HPV 16 and 18 were responsible for 74.4% (378/508) and 80.3% (49/61) of the squamous cancers and adenocarcinomas, respectively. Other frequent types were 31 (9.5%),  45 (6.4%), and 58 (3.3%) for squamous cancers and 45 (13.3%), 31, 35, and 58 (5.0%) for adenocarcinomas. The proportion of HPV 16 and/or 18 decreased with age (p-value for trend <0.03), while it increased in cancers diagnosed in more recent years (p-value for trend < 0.005).
  
  
  CONCLUSIONS
  The impact of HPV 16/18 vaccine on cervical cancer will be greater for early onset cancers. In vaccinated women, screening could be started at an older age without reducing protection.
authors.affiliation: AUSL Reggio Emilia, via Amendola 2, Reggio Emilia, 42122, Italy. paolo.giorgirossi@ausl.re.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.forename: Mario
authors.initials: M
authors.lastname: Sideri
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Carozzi
authors.forename: Amina
authors.initials: A
authors.lastname: Vocaturo
authors.forename: Franco Maria
authors.initials: FM
authors.lastname: Buonaguro
authors.forename: Maria Lina
authors.initials: ML
authors.lastname: Tornesello
authors.forename: Elena
authors.initials: E
authors.lastname: Burroni
authors.forename: Luciano
authors.initials: L
authors.lastname: Mariani
authors.forename: Sara
authors.initials: S
authors.lastname: Boveri
authors.forename: Leandra Maria
authors.initials: LM
authors.lastname: Zaffina
authors.forename: Francesco
authors.initials: F
authors.lastname: Chini