title: Human Papillomavirus Genotype Distribution in Invasive Cervical Cancer in Pakistan.
abstract: Few studies have assessed the burden of human papillomavirus (HPV) infection in Pakistan. We aim to provide specific information on HPV-type distribution in invasive cervical cancer (ICC) in the country. A total of 280 formalin-fixed paraffin-embedded tissue blocks were consecutively selected from Shaukat Khanum Memorial Cancer Hospital and Research Centre (Lahore, Pakistan). HPV-DNA was detected by SPF10 broad-spectrum PCR followed by DNA enzyme immunoassay and genotyping by LiPA25. HPV-DNA prevalence was 87.5% (95%CI: 83.0-91.1), with 96.1% of cases histologically classified as squamous cell carcinoma. Most of the HPV-DNA positive cases presented single infections (95.9%). HPV16 was the most common type followed by HPV18 and 45. Among HPV-DNA positive, a significantly higher contribution of HPV16/18 was detected in Pakistan (78.4%; 72.7-83.3), compared to Asia (71.6%; 69.9-73.4) and worldwide (70.8%; 69.9-71.8) and a lower contribution of HPVs31/33/45/52/58 (11.1%; 7.9-15.7 vs. 19.8%; 18.3-21.3 and 18.5%; 17.7-19.3). HPV18 or HPV45 positive ICC cases were significantly younger than cases infected by HPV16 (mean age: 43.3, 44.4, 50.5 years, respectively). A routine cervical cancer screening and HPV vaccination program does not yet exist in Pakistan; however, the country could benefit from national integrated efforts for cervical cancer prevention and control. Calculated estimations based on our results show that current HPV vaccine could potentially prevent new ICC cases.
authors.affiliation: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Punjab 54000, Pakistan. asifloya@skm.org.pk.
authors.forename: Asif
authors.initials: A
authors.lastname: Loya
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain. crc3@skm.org.pk.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Serrano
authors.affiliation: Clinical Research Office, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Punjab 54000, Pakistan. bscarro@iconcologia.net.
authors.forename: Farah
authors.initials: F
authors.lastname: Rasheed
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain. crc@skm.org.pk.
authors.forename: Sara
authors.initials: S
authors.lastname: Tous
authors.affiliation: Clinical Research Office, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Punjab 54000, Pakistan. stous@iconcologia.net.
authors.forename: Mariam
authors.initials: M
authors.lastname: Hassan
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Omar
authors.initials: O
authors.lastname: Clavero
authors.affiliation: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Punjab 54000, Pakistan. drrazamuhammadi@gmail.com.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Raza
authors.affiliation: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiolog&#237;a y Salud P&#250;blica (CIBERESP). Madrid, Spain. 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, Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: F Xavier
authors.initials: FX
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, Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiolog&#237;a y Salud P&#250;blica (CIBERESP). Madrid, Spain. lalemany@iconcologia.net.
authors.forename: Laia
authors.initials: L
authors.lastname: Alemany
keywords: Pakistan; cervical cancer; epidemiology; genotype; human papillomavirus; human papillomavirus vaccines