title: Human papillomavirus prevalence and type-distribution in cervical glandular neoplasias: Results from a European multinational epidemiological study.
abstract: Cervical glandular neoplasias (CGN) present a challenge for cervical cancer prevention due to their complex histopathology and difficulties in detecting preinvasive stages with current screening practices. Reports of human papillomavirus (HPV) prevalence and type-distribution in CGN vary, providing uncertain evidence to support prophylactic vaccination and HPV screening. This study [108288/108290] assessed HPV prevalence and type-distribution in women diagnosed with cervical adenocarcinoma in situ (AIS, N = 49), adenosquamous carcinoma (ASC, N = 104), and various adenocarcinoma subtypes (ADC, N = 461) from 17 European countries, using centralised pathology review and sensitive HPV testing. The highest HPV-positivity rates were observed in AIS (93.9%), ASC (85.6%), and usual-type ADC (90.4%), with much lower rates in rarer ADC subtypes (clear-cell: 27.6%; serous: 30.4%; endometrioid: 12.9%; gastric-type: 0%). The most common HPV types were restricted to HPV16/18/45, accounting for 98.3% of all HPV-positive ADC. There were variations in HPV prevalence and ADC type-distribution by country. Age at diagnosis differed by ADC subtype, with usual-type diagnosed in younger women (median: 43 years) compared to rarer subtypes (medians between 57 and 66 years). Moreover, HPV-positive ADC cases were younger than HPV-negative ADC. The six years difference in median age for women with AIS compared to those with usual-type ADC suggests that cytological screening for AIS may be suboptimal. Since the great majority of CGN are HPV16/18/45-positive, the incorporation of prophylactic vaccination and HPV testing in cervical cancer screening are important prevention strategies. Our results suggest that special attention should be given to certain rarer ADC subtypes as most appear to be unrelated to HPV.
authors.affiliation: Global Health Economics, GSK Vaccines, Wavre, Belgium.
authors.forename: Katsiaryna
authors.initials: K
authors.lastname: Holl
authors.affiliation: First Department of Oncologic Gynaecology and Gynaecology, Medical University of Lublin, Poland.|Department of Gynaecology and Oncologic Gynaecology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Andrzej M
authors.initials: AM
authors.lastname: Nowakowski
authors.affiliation: Institute of Cancer and Genetics, HPV Research Group, Cardiff University School of Medicine, Cardiff, Wales, United Kingdom.
authors.forename: Ned
authors.initials: N
authors.lastname: Powell
authors.affiliation: Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom.
authors.forename: W Glenn
authors.initials: WG
authors.lastname: McCluggage
authors.affiliation: Department of Pathology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, NY.
authors.forename: Edyta C
authors.initials: EC
authors.lastname: Pirog
authors.affiliation: 4Clinics, Biostatistics, Paris, France (at the time of study).
authors.forename: Sabrina
authors.initials: S
authors.lastname: Collas De Souza
authors.affiliation: Multidisciplinary Breast Clinic-Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Antwerp University Hospital, University of Antwerp, Antwerpen, Belgium.
authors.forename: Wiebren A
authors.initials: WA
authors.lastname: Tjalma
authors.affiliation: IMS Health, Stockholm, Sweden.|Center for Pharmacoepidemiology, Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Rosenlund
authors.affiliation: Institute of Cancer and Genetics, HPV Research Group, Cardiff University School of Medicine, Cardiff, Wales, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Fiander
authors.affiliation: Obstetrics and Gynaecology Department, University Hospital Puerto De Hierro Majadahonda, Madrid, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Castro Sánchez
authors.affiliation: Department of Anatomical Pathology, General Hospital of Patras, Achaia, Greece.
authors.forename: Vasileia
authors.initials: V
authors.lastname: Damaskou
authors.affiliation: Comprehensive Cancer Center, Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Elmar A
authors.initials: EA
authors.lastname: Joura
authors.affiliation: Department of Obstetrics and Gynaecology, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark.
authors.forename: Benny
authors.initials: B
authors.lastname: Kirschner
authors.affiliation: Department of Obstetrics and Gynecologic Oncology, St. Stephan Hospital, Budapest, Hungary.
authors.forename: Robert
authors.initials: R
authors.lastname: Koiss
authors.affiliation: CERVIVA Research Consortium, Funded by the Health Research Board Ireland, Based at the Department of Pathology, The Coombe Women and Infants University Hospital and Trinity College, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: O'Leary
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Quint
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
authors.forename: Olaf
authors.initials: O
authors.lastname: Reich
authors.affiliation: Hospital Clinic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Aureli
authors.initials: A
authors.lastname: Torné
authors.affiliation: Department of Oncology, University of Sheffield Medical School, Sheffield, England, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Wells
authors.affiliation: University Hospital Motol, Prague, Czech Republic.
authors.forename: Lukas
authors.initials: L
authors.lastname: Rob
authors.affiliation: Institute of Oncology of RAMS Siberian Branch, Tomsk, Russia.
authors.forename: Larisa
authors.initials: L
authors.lastname: Kolomiets
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, The Netherlands.
authors.forename: Anco
authors.initials: A
authors.lastname: Molijn
authors.affiliation: Laboratory of Microbiology, DO Ott Research Institute of Obstetrics and Gynaecology, St. Petersburg, Russia.
authors.forename: Alevtina
authors.initials: A
authors.lastname: Savicheva
authors.affiliation: Laboratory of Microbiology, DO Ott Research Institute of Obstetrics and Gynaecology, St. Petersburg, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Shipitsyna
authors.affiliation: Epidemiology Department, GlaxoSmithKline Vaccines, Wavre, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Rosillon
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, The Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Jenkins
mesh_terms: D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000453:epidemiology* / Q000821:virology; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology
keywords: adenocarcinoma in situ; adenosquamous carcinoma; cervical adenocarcinoma; cervical glandular neoplasia; human papillomavirus