Data on human papillomavirus (HPV) type distribution in invasive and pre-invasive cervical cancer is essential to predict the future impact of HPV16/18 vaccines and HPV-based screening tests. A meta-analyses of HPV type distribution in invasive cervical cancer (ICC) and high-grade squamous intraepithelial lesions (HSIL) identified a total of 14,595 and 7,094 cases, respectively. In ICC, HPV16 was the most common, and HPV18 the second most common, type in all continents. Combined HPV16/18 prevalence among ICC cases was slightly higher in Europe, North America and Australia (74-77%) than in Africa, Asia and South/Central America (65-70%). The next most common HPV types were the same in each continent, namely HPV31, 33, 35, 45, 52 and 58, although their relative importance differed somewhat by region. HPV18 was significantly more prevalent in adeno/adenosquamous carcinoma than in squamous cell carcinoma, with the reverse being true for HPV16, 31, 33, 52 and 58. Among HSIL cases, HPV16/18 prevalence was 52%. However, HPV 16, 18 and 45 were significantly under-represented, and other highrisk HPV types significantly over-represented in HSIL compared to ICC, suggesting differences in type-specific risks for progression. Data on HPV-typed ICC and HSIL cases were particularly scarce from large regions of Africa and Central Asia. ' 2007 Wiley-Liss, Inc.Key words: human papillomavirus; genotype; cervical cancer; highgrade squamous intraepithelial lesions; meta-analysis; epidemiology Data on human papillomavirus (HPV) type distribution in women with invasive cervical cancer (ICC) and its precursor lesions are essential to predict the potential worldwide impact of new prophylactic vaccines against HPV16/18, 1,2 as well as to determine priorities for the inclusion of HPV types in future HPV vaccines and HPV-based screening tests.A standardised pooled analysis of 3,607 ICC cases 3 and a wider meta-analysis of 10,058 ICC cases 4 both confirmed that a majority of worldwide ICC cases are associated with HPV16/18. They also suggested some geographical variation in the importance of specific HPV types, 3,4 although data were limited or missing from many regions in Africa and Asia.A further meta-analysis in 4,338 high-grade squamous intraepithelial lesions (HSIL) showed that the most common HPV types in HSIL were broadly similar, but not identical, to those in ICC. 5 The purpose of the present publication is to update previous meta-analyses of HPV type distribution in ICC and HSIL with studies published between January 2002 and January 2006, including many from previously under-studied regions, and to identify remaining worldwide epidemiological data gaps prior to HPV vaccine implementation. Material and methodsThe detailed methods used for this meta-analysis of type-specific HPV prevalence have been reported previously, and are similar for both ICC and HSIL. 4,5 In brief, Medline was employed to search for citations published from January 2002 to January 2006 using the following MeSH terms: ''cervical cancer'', ''cervical intraepit...

No abstract

No abstract

No abstract

Summary 1.Over the past two decades, Ixodes scapularis, the primary tick vector of the Lyme disease pathogen Borrelia burgdorferi in North America has expanded its range northward from the USA to colonize new regions in southern Canada. We have previously projected range increases for I. scapularis based on temperature suitability, but to what extent this is matched by actual tick range expansion is unknown. 2. Since 1990, I. scapularis ticks have been collected across Canada offering a unique opportunity to track the range expansion of an arthropod vector. We used these data to model time-to-establishment for tick populations across Canada to identify factors influencing the rate of spread. 3. Our results point to both long-distance dispersal of ticks by migratory birds and local dispersal by resident hosts as important potential mechanisms underlying patterns of tick range expansion. 4. Temperature (accumulated degree days > 0°C) was the most important determinant of environmental suitability for tick population establishment, suggesting that climate warming may facilitate range expansion. 5. Model projections suggest that I. scapularis range will expand c. 46 km year )1 in the coming decade, with climate warming expected to increase the rate of spread. This expansion is likely to result in a substantial increase in human Lyme disease risk, with the proportion of the human population of eastern Canada inhabiting areas with established tick populations increasing from 18% in 2010 to over 80% by 2020. 6. This first empirical model of I. scapularis invasion supports theoretical range projections based on climate suitability and provides a unique data-driven estimate of the speed of northward range expansion for I. scapularis at the continental scale. 7. Synthesis and applications. By tracking I. scapularis invasion in Canada over the past two decades, we show that I. scapularis is rapidly expanding its range and is likely to colonize the most densely populated areas of southern Canada in the coming decade. These projections suggest that prompt action is necessary to prepare the Canadian public for a likely epidemic of Lyme disease, with emphasis on focusing surveillance activities to confirm the locations of emerging Lyme disease risk.