Human papillomavirus types in 115,789 HPV‐positive women: A meta‐analysis from cervical infection to cancer

By P. Guan, R. Howell-Jones, Ni Li, L. Bruni, S. de Sanjosé, Silvia Franceschi, G. Clifford. International Journal of Cancer, 2012

906 citations recorded by the source corpus.

Genotyping may improve risk stratification of high‐risk (HR) human papillomavirus (HPV)‐positive women in cervical screening programs; however, prospective data comparing the natural history and carcinogenic potential of individual HR types remain limited. A meta‐analysis of cross‐sectional HR HPV‐type distribution in 115,789 HPV‐positive women was performed, including 33,154 normal cytology, 6,810 atypical squamous cells of undetermined significance (ASCUS), 13,480 low‐grade squamous intraepithelial lesions (LSIL) and 6,616 high‐grade SIL (HSIL) diagnosed cytologically, 8,106 cervical intraepithelial neoplasia grade 1 (CIN1), 4,068 CIN2 and 10,753 CIN3 diagnosed histologically and 36,374 invasive cervical cancers (ICCs) from 423 PCR‐based studies worldwide. No strong differences in HPV‐type distribution were apparent between normal cytology, ASCUS, LSIL or CIN1. However, HPV16 positivity increased steeply from normal/ASCUS/LSIL/CIN1 (20–28%), through CIN2/HSIL (40/47%) to CIN3/ICC (58/63%). HPV16, 18 and 45 accounted for a greater or equal proportion of HPV infections in ICC compared to normal cytology (ICC:normal ratios = 3.07, 1.87 and 1.10, respectively) and to CIN3 (ICC:CIN3 ratios = 1.08, 2.11 and 1.47, respectively). Other HR types accounted for important proportions of HPV‐positive CIN2 and CIN3, but their contribution dropped in ICC, with ICC:normal ratios ranging from 0.94 for HPV33 down to 0.16 for HPV51. ICC:normal ratios were particularly high for HPV45 in Africa (1.85) and South/Central America (1.79) and for HPV58 in Eastern Asia (1.36). ASCUS and LSIL appear proxies of HPV infection rather than cancer precursors, and even CIN3 is not entirely representative of the types causing ICC. HPV16 in particular, but also HPV18 and 45, warrant special attention in HPV‐based screening programs.

Subfields: Epidemiology, Microbiology, Surgery

View Paper: https://www.semanticscholar.org/paper/bad15b2f3d59c796ccc92975be3c7ba19c5f8942

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Citations in the corpus

Worldwide burden of cancer attributable to HPV by site, country and HPV type (2017, background): “However, estimates of the relative contribution of HPV types suffer from uncertainty in multiple-type infections.(22) The combined contribution of many HPV types may be over-estimated by highly sensitive HPV assays, which may detect HPV types that are present but not clinically relevant.”
US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. (2015, result): “The finding that nearly 10% of all cervical cancers tested negative for HPV and that the proportion of cervical tissue testing negative for HPV increased with age is consistent with findings other studies (32,33).”
Human papillomavirus molecular biology and disease association (2015, background): “In CIN2, there is 85% positivity for HPV and in CIN3 and invasive cervical cancer; the positivity rises to between 90% and 100% [38].”
Global burden of human papillomavirus and related diseases. (2012, background): “[3] Guan P, Howell-Jones R, Li N, Bruni L, de Sanjosé S, Franceschi S, et al.”