title: Comparison of HPV genotypes and viral load between different sites of genital tract: the significance for cervical cancer screening.
abstract: OBJECTIVE
  To compare the consistency of HPV genotype and viral loads among different sites within the female genital tract, and to correlate these with clinical outcomes.
  
  
  METHODS
  2646 previously unscreened rural women were enrolled in this population-based, cross-sectional study between May 2006 and April 2007. Physician-collected samples from lower vagina, upper vagina, cervix, and one self-collected sample were taken from each woman. Viral load was assessed by HC2 using the relative light unit/cutoff ratio (RLU/CO), and HPV genotyping was tested by Linear Array.
  
  
  RESULTS
  The low risk HPV positive rate was highest in lower vagina samples and lowest in cervix samples. Overall kappa values of high risk HPV types between various anatomic sampling sites showed substantial or almost perfect agreement among women with normal pathology, CIN1, and CIN2+. In the CIN2+ population, high risk HPV viral load for cervix samples (557.25 RLU/CO) were much higher than upper vagina samples (96.43 RLU/CO, P<0.001), lower vagina samples (36.51 RLU/CO, P<0.001), and self-collected (206.83RLU/CO, P=0.003) samples.
  
  
  CONCLUSIONS
  Although the distribution of high risk HPV genotypes was fairly equivalent across different genital sites, particularly for CIN2+ lesions, viral loads were largely variable. The findings may affect the cervical cancer screening methods using self-collected samples, particularly in resource-challenged areas.
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Shao-Kai
authors: SK
authors: Zhang
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Pu-Wa
authors: PW
authors: Ci
authors: Merck Sharp and Dohme, Whitehouse Station, NJ, USA.
authors: Christine
authors: C
authors: Velicer
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Le-Ni
authors: LN
authors: Kang
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Bin
authors: B
authors: Liu
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Jian-Feng
authors: JF
authors: Cui
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Feng
authors: F
authors: Chen
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Xun
authors: X
authors: Zhang
authors: University of Miami Miller School of Medicine, Miami, FL, USA.
authors: Irene J
authors: IJ
authors: Chang
authors: Merck Sharp and Dohme, Whitehouse Station, NJ, USA.
authors: Christine C
authors: CC
authors: Roberts
authors: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors: Jennifer S
authors: JS
authors: Smith
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: chenwen@cicams.ac.cn.
authors: Wen
authors: W
authors: Chen
authors: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: qiaoy@cicams.ac.cn.
authors: You-Lin
authors: YL
authors: Qiao
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D005836:Genitalia, Female / Q000473:pathology / Q000821:virology; D005838:Genotype; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology
keywords: Genital tract; Genotype; Human papillomavirus; Intraepithelial neoplasia; Viral load