title: HPV genotype distribution in older Danish women undergoing surgery due to cervical cancer.
abstract: BACKGROUND
  The prevalence of human papillomavirus (HPV)16/18 in cervical cancer may decrease with age. This study aimed to describe the HPV genotype distribution in Danish women aged 55 years or older with cervical cancer.
  
  
  METHODS
  In this cross-sectional study we identified 153 cases of cervical cancer diagnosed at Aarhus University Hospital, Denmark (1990-2012) and Copenhagen University Hospital Herlev, Denmark (2007-2012). All women had surgery to treat the disease. HPV genotyping was performed on cervical cancer tissue using the INNO LiPA HPV genotyping extra (Fujirebio, Belgium) at the Department of Pathology, Aarhus University Hospital, Denmark. The main outcome was to estimate the age-specific prevalence of high-risk HPV genotypes included in the bivalent, the quadrivalent, and the nonavalent vaccine.
  
  
  RESULTS
  Of 121 cases of cervical cancer included in this study, 113 were HPV-positive (93.4%). Although HPV16 and 18 were the most common genotypes overall, the prevalence of HPV16/18 decreased significantly from 78.1% in women aged 55-59 years to 45.5% in women aged 75 or older (p < 0.001), whereas the prevalence of other HPV types and HPV-negative cases tended to increase with age (p = 0.1). The prevalence of HPV types included in the nonavalent vaccine was stable around 90% until the age of 75 years and then dropped to 63%.
  
  
  CONCLUSIONS
  In the absence of waning immunity, the nonavalent HPV vaccine would be predicted to reduce cervical cancer burden in Denmark across a broader age-range compared with the reduced type-spectrum vaccines.
authors: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.|Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors: Anne
authors: http://orcid.org/0000-0002-4616-9827
authors: A
authors: Hammer
authors: Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
authors: Else
authors: http://orcid.org/0000-0003-2714-2394
authors: E
authors: Mejlgaard
authors: Department of Pathology, University of New Mexico, Albuquerque, NM, USA.
authors: Patti
authors: http://orcid.org/0000-0002-3007-3425
authors: P
authors: Gravitt
authors: Department of Pathology, Copenhagen University Hospital, Herlev, Denmark.
authors: Estrid
authors: http://orcid.org/0000-0003-4689-5658
authors: E
authors: Høgdall
authors: Department of Pathology, Copenhagen University Hospital, Herlev, Denmark.
authors: Pernille
authors: http://orcid.org/0000-0002-6216-3644
authors: P
authors: Christiansen
authors: Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.|Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
authors: Torben
authors: http://orcid.org/0000-0001-5689-3555
authors: T
authors: Steiniche
authors: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.|Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors: Jan
authors: http://orcid.org/0000-0003-3726-0589
authors: J
authors: Blaakaer
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery / Q000821:virology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery / Q000821:virology; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology*; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000821:virology*
keywords: Cervical cancer; genotypes; human papillomavirus; human papillomavirus vaccine; older women