title: Meta-analysis on prevalence and attribution of human papillomavirus types 52 and 58 in cervical neoplasia worldwide.
abstract: OBJECTIVE
  To estimate the prevalence and attribution of two non-vaccine-covered HPV types (HPV52 and HPV58) across the world.
  
  
  METHODS
  Meta-analysis on studies reported in English and Chinese between 1994 and 2012.
  
  
  RESULTS
  The pooled prevalence and attribution rates of HPV52 and HPV58 in invasive cervical cancers were significantly higher in Eastern Asia compared to other regions (HPV52 prevalence: 5.7% vs. 1.8-3.6%, P<0.001; HPV52 attribution: 3.7% vs. 0.2-2.0%; HPV58 prevalence: 9.8% vs. 1.1-2.5%, P<0.001; HPV58 attribution: 6.4% vs. 0.7-2.2%, P<0.001). Oceania has an insufficient number of studies to ascertain the prevalence of HPV52. Within Eastern Asia, the attribution of HPV58 to invasive cervical cancer was 1.8-fold higher than that of HPV52. Similarly, HPV52 and HPV58 shared a higher prevalence and attribution among cervical intraepithelial neoplasia in Eastern Asia. In contrast to the classical high-risk type, HPV16, the prevalence and attribution of HPV52 and HPV58 decreased with increasing lesion severity. Thus, HPV52 and HPV58 behave as an "intermediate-risk" type.
  
  
  CONCLUSIONS
  The attribution of HPV52 and HPV58 to cervical intraepithelial neoplasia and invasive cancer in Eastern Asia were respectively 2.5-2.8 and 3.7-4.9 folds higher than elsewhere. Changes in the attributed disease fraction can serve as a surrogate marker for cross-protection or type replacement following widespread use of HPV16/18-based vaccines. This unique epidemiology should be considered when designing HPV screening assays and vaccines for Eastern Asia.
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Paul K S
authors.initials: PK
authors.lastname: Chan
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Wendy C S
authors.initials: WC
authors.lastname: Ho
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Martin C W
authors.initials: MC
authors.lastname: Chan
authors.affiliation: Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Apple C M
authors.initials: AC
authors.lastname: Yeung
authors.affiliation: Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Josette S Y
authors.initials: JS
authors.lastname: Chor
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.
authors.forename: Mamie
authors.initials: M
authors.lastname: Hui
mesh_terms: D016208:Databases, Factual; D005260:Female; D014943:Global Health; D006801:Humans; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000145:classification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology*; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000209:etiology / Q000473:pathology