title: Distinctive distribution of HPV genotypes in cervical cancers in multi-ethnic Suriname: implications for prevention and vaccination.
abstract: Suriname is ranked as high-risk country for cervical cancer, but recent national data of HPV prevalence and distribution in cervical cancer is scarce. In a retrospective cross-sectional study, cervical cancer incidence, HPV prevalence and HPV-type-specific distribution were investigated in all cervical cancer cases (n = 111), diagnosed in two consecutive years. HPV presence and type-specific prevalence were determined in paraffin-embedded biopsies utilizing master-nested multiplex PCR assays, targeting 14 HPV types. The age-standardized incidence rate of cervical cancer was 22·4/100 000 women, justifying revision of the current international ranking of Suriname. Eleven HPV types were detected, with the most common types in descending order of frequency: 16, 18, 45, 66, 58/52/35. HPV16 was predominant, although with markedly low presence (25%). HPV16 or 18 infections were detected in 43% of the cases, while 28% were untyped, implicating a divergent HPV-type distribution in Suriname with significant variation in the prevalence of less common high-risk virus types and/or presence of HPV16 variants. HPV-type distribution differed between ethnic groups. A vaccination efficacy of just 28-30% was anticipated, next to an uneven vaccination impact in different ethnic groups, cautioning Suriname and other multi-ethnic countries to tailor the information presented to different ethnic communities.
authors.affiliation: 'Prof. Dr. Paul C. Flu' Institute for Biomedical Sciences, Paramaribo, Suriname.
authors.forename: M G
authors.initials: MG
authors.lastname: Grunberg
authors.affiliation: Department of Pathology, Academic Hospital Paramaribo, Paramaribo, Suriname.
authors.forename: M
authors.initials: M
authors.lastname: Chan
authors.affiliation: Department of Biochemistry, Faculty of Medical Sciences, Anton de Kom Universiteit van Suriname, Paramaribo, Suriname.
authors.forename: M R
authors.identifier: http://orcid.org/0000-0002-2001-9994
authors.initials: MR
authors.lastname: Adhin
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D053918:Papillomavirus Vaccines / Q000276:immunology*; D012189:Retrospective Studies; D013532:Suriname / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Human papilloma virus (HPV); incidence; vaccine policy development