title: Cervical intraepithelial neoplasia grade 2 or worse in Galicia, Spain: HPV 16 prevalence and vaccination impact.
abstract: BACKGROUND
  The etiology of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) can influence the efficacy of Public Health preventive strategies. This study aimed to determine the high-risk papillomavirus (HR-HPV) prevalence in CIN2+ cases in unvaccinated women in Galicia (Spain), the expected impact of bivalent vaccination, and the distribution of HPV 16 in squamous lesions.
  
  
  METHODS
  Ninety-four histologically confirmed cases of CIN2+ (2009-2010) were retrospectively studied: 23 CIN2, 58 CIN3- squamous carcinoma in situ (CIN3-CIS), 5 adenocarcinoma in situ (AIS), and 8 invasive squamous cervical cancer (SCC). Linear Array HPV Genotyping Test (Roche Diagnostics, Mannheim, Germany) was performed on the cervical specimens. Bivalent vaccination impact was calculated, based on regional vaccination coverage data, local HR-HPV prevalence, and reported efficacy (direct and cross-protection) of the vaccine.
  
  
  RESULTS
  HR-HPV prevalence was 96.8%. The most frequent genotypes were HPV 16 (48.8-58.2%) and HPV 31 (9.3%-12.1%), considering single infections or single-multiple infections, respectively (hierarchical attribution). In squamous lesions, HPV 16 prevalence in women younger than 45 years of age increased in severe lesions (CIN3-CIS/SCC, OR 4.2), and was higher than in older women (OR 5.5). The vaccine could reduce the cumulative incidence of CIN2+ by 50.6% (direct protection), or by 62.7% (direct and cross-protection).
  
  
  CONCLUSIONS
  HPV vaccination could have a great impact in women younger than 45 years of age due to the high prevalence of HPV 16 in their lesions.
authors.affiliation: Department of Microbiology, University Hospital of Vigo, Vigo, Pontevedra, Spain. Electronic address: sonia.perez.castro@sergas.es.
authors.forename: Sonia
authors.initials: S
authors.lastname: Pérez-Castro
authors.affiliation: Department of Pathology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Lorenzo-Mahía
authors.affiliation: Department of Gynecology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Iñarrea Fernández
authors.affiliation: Department of Gynecology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Lamas-González
authors.affiliation: Department of Gynecology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Sarán-Díez
authors.affiliation: Department of Microbiology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Rubio-Alarcón
authors.affiliation: Department of Gynecology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: María Consuelo
authors.initials: MC
authors.lastname: Reboredo-Reboredo
authors.affiliation: Department of Pathology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Mosteiro-Lobato
authors.affiliation: Department of Microbiology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: López-Miragaya
authors.affiliation: Department of Microbiology, University Hospital of Vigo, Vigo, Pontevedra, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Torres-Piñón
authors.affiliation: Department of Virology, University Hospital of Asturias, Oviedo, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Melón-García
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014611:Vaccination; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines
keywords: Displasia uterina cervical; HPV 16; HPV 31; Prevalence; Prevalencia; Uterine cervical dysplasia; Vaccination; Vacuna