Human Papillomavirus Genotypes in High-Grade Cervical Lesions in the United States

Abstract

Age and racial/ethnic differences in HPV type distribution may have implications for vaccine impact and should be considered in monitoring trends.

Individual and geographic disparities in human papillomavirus types 16/18 in high‐grade cervical lesions

“…All models included terms for measures previously shown to be associated with HPV 16/18, including age and diagnosis grade, thereby producing adjusted effect estimates that were controlled for potential confounding. 19 First, a full model was run that included the 2 individual and 3 area measures. Then, backward selection of variables was conducted by removing the least Original Article significant variables one at a time, and repeating this process until all variables remaining in the model were statistically significant at P < .05.…”

“…16,17 Although reasons for the association with younger age are less clear, this finding may be related to the hypothesis that HPV 16/18-associated lesions progress more rapidly. 29 A nonavalent vaccine is currently in development that protects against additional types (HPV types 31, 33, 45, 52, and 58) and holds promise for greater protection that may provide additional benefits for the groups that are disproportionately impacted by types other than HPV 16/18 (as described elsewhere 19 ). 30,31 In the meantime, widespread vaccination programs that increase uptake and completion rates of the 3-dose series can benefit all women, including racial/ethnic minority and low-income populations who have higher cervical cancer incidence and mortality, by protecting those who would acquire infections caused by HPV 16/18.…”

“…19 Briefly, DNA was extracted using DNeasy (Qiagen, Valencia, Calif) and tested immediately or stored at 220 C. Extracted DNA was tested with the Linear Array HPV Genotyping Assay (LA; Roche Diagnostics, Indianapolis, Ind). This assay detects 37 HPV types (6, 11, 16, 18, 26, 31, …”

HPV Type Attribution in High-Grade Cervical Lesions: Assessing the Potential Benefits of Vaccines in a Population-Based Evaluation in the United States

“…As in invasive cancers, HPV 16 and 18 are the most commonly detected types in high-grade cervical lesions; however, there is more heterogeneity in HPV type distribution in high-grade lesions. Studies have shown that HPV 16 and 18 account for a lower proportion of high-grade cervical lesions in Africa and South America compared with North America and Europe and in racial minorities in the United States (10)(11)(12).…”

“…Although currently available HPV vaccines have shown some cross-protective efficacy against nonvaccine oncogenic types (13-15), a substantial proportion of high-grade cervical lesions are caused by types against which current vaccines have not shown any degree of efficacy (11,16,17). Vaccines that target a wider array of oncogenic HPV types such as a candidate vaccine against 6/11/16/18 and 5 additional oncogenic types (31/33/45/52/58) could provide additional protection against precancerous lesions that require treatment.…”