A Prospective Study of Age Trends in Cervical Human Papillomavirus Acquisition and Persistence in Guanacaste, Costa Rica

Castle, Philip E.; Schiffman, Mark; Herrero, Rolando; Hildesheim, Allan; Rodríguez, Ana Cecilia; Bratti, M. Concepción; Sherman, Mark E.; Wacholder, Sholom; Tarone, Robert E.; Burk, Robert D.

doi:10.1086/428779

Cited by 367 publications

(326 citation statements)

References 30 publications

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“…This decrease may be related to several factors that have been discussed in detail in the literature (Jacobs et al, 2000b;Castle et al, 2006). The observed relationship between hrHPV prevalence and age is in agreement with data from several European and North American studies (Jacobs et al, 2000a;Sellors et al, 2000;de Sanjose et al, 2003;Castle et al, 2005;Ronco et al, 2005;Manhart et al, 2006). In our large data set, we did not find a second hrHPV peak at age beyond 45 years as detected in several Latin American countries (Franceschi et al, 2006).…”

Section: Discussionsupporting

confidence: 92%

Age-dependent prevalence of 14 high-risk HPV types in the Netherlands: implications for prophylactic vaccination and screening

et al. 2008

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We determined the prevalence of type-specific hrHPV infections in the Netherlands on cervical scrapes of 45 362 women aged 18 -65 years. The overall hrHPV prevalence peaked at the age of 22 with peak prevalence of 24%. Each of the 14 hrHPV types decreased significantly with age (P-values between 0.0009 and 0.03). The proportion of HPV16 in hrHPV-positive infections also decreased with age (OR ¼ 0.76 (10-year scale), 95% CI ¼ 0.67 -0.85), and a similar trend was observed for HPV16 when selecting hrHPV-positive women with cervical intraepithelial neoplasia grade 2 or worse (CIN2 þ ) (OR ¼ 0.76, 95% CI ¼ 0.56 -1.01). In women eligible for routine screening (age 29 -61 years) with confirmed CIN2 þ , 65% was infected with HPV16 and/or HPV18. When HPV16/18-positive infections in women eligible for routine screening were discarded, the positive predictive value of cytology for the detection of CIN2 þ decreased from 27 to 15%, the positive predictive value of hrHPV testing decreased from 26 to 15%, and the predictive value of a double-positive test (positive HPV test and a positive cytology) decreased from 54 to 41%. In women vaccinated against HPV16/18, screening remains important to detect cervical lesions caused by non-HPV16/18 types. To maintain a high-positive predictive value, screening algorithms must be carefully re-evaluated with regard to the screening modalities and length of the screening interval. British Journal of Cancer (2008) . Prophylactic vaccines are now available that are effective against incident and persistent HPV16 and 18 infections (Koutsky et al, 2002;Munoz et al, 2003;Harper et al, 2006; Villa et al, 2006). Mass vaccination can have a substantial impact on the cervical cancer incidence, even in developed countries where the incidence is already low because of implementation of organised cervical screening. To make a well-judged decision about the future role of both vaccination and screening in cervical cancer prevention, detailed information about type-specific hrHPV distribution is required. Data on hrHPV prevalence and type distribution in the Netherlands have been reported previously, but only for a relatively small cohort of 3305 women (Jacobs et al, 2000a;Clifford et al, 2005). To obtain reliable estimates of the hrHPV type distribution in relation to age, both for women with normal and for women with abnormal cytology, data from a far larger cohort are needed. In this study, we determined the age-dependent prevalence of 14 hrHPV types and the age-dependent type distribution within hrHPV-positive women from a cohort of 45 362 women in the Netherlands aged 18 -65 years. The results from the current study give an impression of the potential benefits that can be achieved from HPV16/18 vaccination. They can also be used to gain insight into the effects of partial cross-protection against HPV types 31 and 45 (Harper et al, 2006). Furthermore, the figures will serve as inputs for simulation models in which different vaccination and screening strategies will be compared. MATERIALS AND METHOD...

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Section: Discussionsupporting

confidence: 92%

Age-dependent prevalence of 14 high-risk HPV types in the Netherlands: implications for prophylactic vaccination and screening

et al. 2008

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“…In his Meta analysis, Smith (2008) showed that such pattern was common in countries with low HPV prevalence and attributed it in a large part to the HPV persistence or the high rate of reactivation of HPV infection. Other authors suggested the role of new infection acquisition after the age of 30 years (Castle et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Pre-vaccination Prevalence and Genotype Distribution of Human Papillomavirus Infection among Women from Urban Tunis: a Cross-sectional Study

Guettiti¹,

Ennaifer²,

Attia³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To estimate the pre-vaccination distribution of human papillomavirus (HPV) types among women from urban Tunis. Materials and Methods: A total of 611 women aged 18-69 years were enrolled in three local gynaecological outpatient departments. All underwent a gynaecological examination with Pap test and dry swab for HPV detection and typing performed by linear array genotyping test (Roche). Cytological examination was conducted on conventional Pap smears. Results: HPV DNA was found in 6.5% of the women; the most frequent HPV types were HPV 16 and HPV 11 at 3.27% and 1.96%, respectively. The second most frequent high risk (HR) HPV type was HPV 58 (0.82%) followed by HPV 18, HPV 31 and HPV 33 found in only 0.33% of women. Single infections with HPV types, targeted by the quadrivalent vaccine (6, 11, 16, and 18), were detected in 3.6 % of the study patients (55% of positive women). HPV infection was found in 3.83% of women with normal cytology and in 47.4% of women with cytological abnormalities. No statistically significant trend in prevalence by age group emerged for any HPV type or for high or low risk types. Conclusions: These data show a relatively low prevalence of HPV infection in women from urban Tunis with a high proportion of HPV16 and HPV58. This should be considered in the upcoming screening programs and vaccination strategy.

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“…HPV16/18 prevalence, however, was highest among older women. HPV16/18 infections in older women are more likely to represent persistent infections [26] and are more likely to progress to cancer than other high-risk types [27].…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus infection in women with and without cervical cancer in Nepal

Sherpa

Clifford

Vaccarella

et al. 2009

Cancer Causes Control

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Objectives Cervical cancer is the most common malignancy among Nepalese women. Rational prevention measures are informed by epidemiological data on human papillomavirus (HPV) prevalence. Methods Cervical specimens were obtained from 932 married women aged 15-59 years from the general population of Bharatpur, Nepal, as well as from 61 locally diagnosed invasive cervical cancers (ICC). HPV was detected using a GP5?/6? PCR-based assay. Results Among the general population, the overall prevalence of HPV was 8.6% (6.1% for high-risk types). Prevalence of abnormal Pap smears was 3.6%, including five high-grade squamous intraepithelial lesions. Residence in slum housing, lower education level, C3 sexual partners in a woman's lifetime, and husband's extramarital affairs were significantly associated with HPV positivity. HPV prevalence was relatively constant across all age groups. HPV16 was the most common type, both among the general population (1.9%) and among 54 women with HPVpositive ICC (68.5%). HPV18 (22.2%) and 45 (5.6%) were also common in ICC. Conclusions Nepal has an intermediate burden of HPV infection, lower than many areas in India and China. Approximately 80% of cervical cancer in Nepal is theoretically preventable by HPV16/18 vaccines. In the meantime, screen-and-treat approaches should be encouraged to overcome difficulties that were encountered to recall women with screening-positive findings.

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A Prospective Study of Age Trends in Cervical Human Papillomavirus Acquisition and Persistence in Guanacaste, Costa Rica

Abstract: Newly apparent infections decreased, whereas persistence increased, with age; this latter tendency supports the utility of HPV screening in older women.

Cited by 367 publications

References 30 publications

Age-dependent prevalence of 14 high-risk HPV types in the Netherlands: implications for prophylactic vaccination and screening

Age-dependent prevalence of 14 high-risk HPV types in the Netherlands: implications for prophylactic vaccination and screening

Pre-vaccination Prevalence and Genotype Distribution of Human Papillomavirus Infection among Women from Urban Tunis: a Cross-sectional Study

Human papillomavirus infection in women with and without cervical cancer in Nepal

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