title: Human papillomavirus genotype attribution for HPVs 6, 11, 16, 18, 31, 33, 45, 52 and 58 in female anogenital lesions.
abstract: OBJECTIVE
  Human papillomavirus (HPV) vaccines can potentially control cervical cancer and help to reduce other HPV-related cancers. We aimed to estimate the relative contribution (RC) of the nine types (HPVs 16/18/31/33/45/52/58/6/11) included in the recently approved 9-valent HPV vaccine in female anogenital cancers and precancerous lesions (cervix, vulva, vagina and anus).
  
  
  METHODS
  Estimations were based on an international study designed and coordinated at the Catalan Institute of Oncology (Barcelona-Spain), including information on 10,575 invasive cervical cancer (ICC), 1709 vulvar, 408 vaginal and 329 female anal cancer cases and 587 Vulvar Intraepitelial Neoplasia grade 2/3 (VIN2/3), 189 Vaginal Intraepitelial Neoplasia grade 2/3 (VaIN2/3) and 29 Anal Intraepitelial Neoplasia grade 2/3 (AIN2/3) lesions. Consecutive histologically confirmed paraffin-embedded cases were obtained from hospital pathology archives from 48 countries worldwide. HPV DNA-detection and typing was performed by SPF10-DEIA-LiPA25 system and RC was expressed as the proportion of type-specific cases among HPV positive samples. Multiple infections were added to single infections using a proportional weighting attribution.
  
  
  RESULTS
  HPV DNA prevalence was 84.9%, 28.6%, 74.3% and 90.0% for ICC, vulvar, vaginal and anal cancers, respectively, and 86.7%, 95.8% and 100% for VIN2/3, VaIN2/3 and AIN2/3, respectively. RC of the combined nine HPV types was 89.5% (95% confidence interval (CI): 88.8-90.1)-ICC, 87.1% (83.8-89.9)-vulvar, 85.5% (81.0-89.2)-vaginal, 95.9% (93.0-97.9)-female anal cancer, 94.1% (91.7-96.0)-VIN2/3, 78.7% (71.7-84.2)-VaIN2/3 and 86.2% (68.3-96.1)-AIN2/3. HPV16 was the most frequent type in all lesions. Variations in the RC of HPVs 31/33/45/52/58 by cancer site were observed, ranging from 7.8% (5.0-11.4)-female anal cancer to 20.5% (16.1-25.4)-vaginal cancer.
  
  
  CONCLUSIONS
  The addition of HPVs 31/33/45/52/58 to HPV types included in current vaccines (HPV16/18) could prevent almost 90% of HPV positive female anogenital lesions worldwide. Taking into account that most HPV-related cancers are ICC ones, the 9-valent HPV vaccine could potentially avoid almost 88% of all female anogenital cancers.
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: bscarro@iconcologia.net.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Serrano
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address: s.sanjose@iconcologia.net.
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: stous@iconcologia.net.
authors.forename: Sara
authors.initials: S
authors.lastname: Tous
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: bquiros@iconcologia.net.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Quiros
authors.affiliation: National Institute of Cancer, Bogotá, Colombia. Electronic address: nubia.munoz@free.fr.
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: x.bosch@iconcologia.net.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address: lalemany@iconcologia.net.
authors.forename: Laia
authors.initials: L
authors.lastname: Alemany
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000276:immunology; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D053918:Papillomavirus Vaccines / Q000276:immunology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D014625:Vaginal Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D053918:Papillomavirus Vaccines
keywords: Anus neoplasms; Human papillomavirus; Papillomavirus vaccines; Precancerous conditions; Uterine cervical neoplasms; Vaginal neoplasms; Vulvar neoplasms