The role of human papillomaviruses in anogenital cancers

Melbye, Mads; Frisch, Mørten

doi:10.1006/scbi.1998.0081

Cited by 70 publications

(48 citation statements)

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“…Sexual behaviour and smoking are risk factors (Daling et al, 1992;Frisch et al, 1997). A high proportion of anal tumours are associated with human papillomavirus (HPV) infection (Melbye and Frisch, 1998). HPV 16 DNA has been reported in up to 93% of invasive squamous anal tumours and 69% of anal carcinoma in situ (Tilston, 1997).…”

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Human papillomavirus infection as a risk factor for anal and perianal skin cancer in a prospective study

et al. 2002

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Human papillomavirus has emerged as the leading infectious cause of cervical and other anogenital cancers. We have studied the relation between human papillomavirus infection and the subsequent risk of anal and perianal skin cancer. A case -cohort study within two large Nordic serum banks to which about 760 000 individuals had donated serum samples was performed. Subjects who developed anal and perianal skin cancer during follow up (median time of 10 years) were identified by registry linkage with the nationwide cancer registries in Finland and Norway. Twenty-eight cases and 1500 controls were analysed for the presence of IgG antibodies to HPV 16, 18, 33 or 73, and odds ratios of developing anal and perianal skin cancer were calculated. There was an increased risk of developing anal and perianal skin cancer among subjects seropositive for HPV 16 (OR=3.0; 95%CI=1.1 -8.2) and HPV 18 (OR=4.4; 95%CI=1.1 -17). The highest risks were seen for HPV 16 seropositive patients above the age of 45 years at serum sampling and for patients with a lag time of less than 10 years. This study provides prospective epidemiological evidence of an association between infection with HPV 16 and 18 and anal and perianal skin cancer. Anal epidermoid carcinoma is a rare tumour, but its incidence has increased over the past 30 years (Goldman et al, 1989;Frisch et al, 1993;Melbye et al, 1994). Sexual behaviour and smoking are risk factors (Daling et al, 1992;Frisch et al, 1997). A high proportion of anal tumours are associated with human papillomavirus (HPV) infection (Melbye and Frisch, 1998). HPV 16 DNA has been reported in up to 93% of invasive squamous anal tumours and 69% of anal carcinoma in situ (Tilston, 1997).Most epidemiological studies on HPV infection and anal cancer have been case -series and case -control studies using samples taken after the cancer has been diagnosed. Such studies may be subject to differential misclassification related to the presence of the disease, and provide no information on the temporal order of events. Prospective studies are generally considered crucial for causality inference. As primary prevention of HPV infection by vaccination is being evaluated, it is important to establish which cancers are likely to be amenable to prevention. Prospective seroepidemiological studies have linked HPV to vulvar, vaginal and to a subset of head and neck cancers (Bjørge et al, 1997a;Mork et al, 2001).HPV serology, using capsids of HPV 16, 18 and 33, has been validated as a type-restricted marker of past or present HPV infection (Dillner, 1999). A serologic association of HPV 16 with incident anal cancer has been shown (Heino et al, 1995). In a study of the role of HPV in non-cervical anogenital cancers, we found that HPV 16 seropositivity conferred an increased risk for noncervical anogenital cancers, but not for anal cancer (Bjørge et al, 1997a). This was in spite of the fact that the proportion of anal cancer cases (25%) being HPV 16 seropositive was higher than for other non-cervical anogenital cancers (24%). This...

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Human papillomavirus infection as a risk factor for anal and perianal skin cancer in a prospective study

et al. 2002

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“…Infection with high-risk types of human papillomavirus (HPV) is the major cause of cervical cancer and its precursor lesions (Schiffman et al, 1993;Walboomers et al, 1999;Bosch et al, 2002;Munoz et al, 2003). Human papillomavirus has also been linked to cancers of the vulva, vagina, anus, and penis (IARC 1995;Melbye and Frisch, 1998). Genital HPV types are transmitted sexually and the risk of infection has been associated with numerous parameters involving sexual behaviour (Franco et al, 1995;Bosch et al, 1996;Kjaer et al, 2001).…”

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“…Human papillomavirus has also been linked to cancers of the vulva, vagina, anus, and penis (IARC 1995;Melbye and Frisch, 1998). Genital HPV types are transmitted sexually and the risk of infection has been associated with numerous parameters involving sexual behaviour (Franco et al, 1995;Bosch et al, 1996;Kjaer et al, 2001).…”

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HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

et al. 2005

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We earlier demonstrated, in a randomised clinical trial, that the regression time of flat penile lsions in male sexual partners of women with cervical intraepithelial neoplasia (CIN) was shorter in men who used condoms compared to those who did not. To further evaluate this finding, we examined whether the effect of condom use on the regression of flat penile lesions depends on the presence of human papillomavirus (HPV) type concordance in sexual couples, as determined in cervical and penile scrapes by GP5 þ /6 þ PCR testing. A Cox model with time-dependent covariates showed a beneficial effect of condoms on regression of flat penile lesions in concordant couples (hazard ratio 2.63, 95% CI 1.07 -6.48) but not in those who were nonconcordant. When both partners harboured different HPV types, no effect of condoms was found (hazard ratio 0.90, 95% CI 0.27 -2.96). Delayed regression of flat penile lesions was associated with either stable lesions or with new penile lesions developing at sites surrounding pre-existing lesions suggesting reinfection of the penile epithelium. We conclude that condom use blocks sexual HPV transmission by preventing reinfection and development of new penile lesions in men who are susceptible to the same type as present in the female partner. Infection with high-risk types of human papillomavirus (HPV) is the major cause of cervical cancer and its precursor lesions (Schiffman et al, 1993;Walboomers et al, 1999;Bosch et al, 2002;Munoz et al, 2003). Human papillomavirus has also been linked to cancers of the vulva, vagina, anus, and penis (IARC 1995;Melbye and Frisch, 1998). Genital HPV types are transmitted sexually and the risk of infection has been associated with numerous parameters involving sexual behaviour (Franco et al, 1995;Bosch et al, 1996;Kjaer et al, 2001).Partner studies have shown that penile lesions are found in more than half of the male partners of women with cervical intraepithelial neoplasia (CIN) (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Bleeker et al, 2002). Flat lesions are reported as the most prevalent lesion type and their relationship with HPV has been established (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Hippelainen MI et al, 1993b;Bleeker et al, 2002). Since flat penile lesions are only well visible after acetowhitening, their presence remains often unnoticed. This explains why the natural history of penile lesions and HPV infection in men has not been studied extensively and is largely unknown.We have recently shown that the presence of penile HPV is associated with delayed regression whereas condom use revealed accelerated regression . The beneficial effect of condom intervention on regression of penile lesions suggests that a sexual transmittable factor, that is, most likely cervical HPV, influences the clinical course of these lesions. To evaluate this hypothesis, the effect of condom use on regression of flat penile lesions was studied in relation to the presence of HPV type concordance between sexual part...

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“…HPV has also been closely linked with other anogenital cancers, including anal cancer and certain penile cancers [4][5][6]. HPV infection in men is over- whelmingly subclinical, which has resulted in a potentially large number of asymptomatic carriers who serve as reservoirs and vectors for the virus.…”

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Human Papillomavirus Infection in Men Attending a Sexually Transmitted Disease Clinic

et al. 2003

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Human papillomavirus (HPV) is the main etiologic agent of anogenital cancers, including cervical cancer, but little is known about the type-specific prevalence of HPV in men. Participants were men aged 18-70 years attending a sexually transmitted disease clinic. Penile skin swabs were assessed for HPV DNA using polymerase chain reaction with reverse line-blot genotyping. Of 436 swabs collected, 90.1% yielded sufficient DNA for HPV analysis. Men with inadequate swab samples were significantly more likely to be white and circumcised than men with adequate swab samples. The prevalence of HPV was 28.2%. Oncogenic HPV types were found in 12.0% of participants, nononcogenic types were found in 14.8% of participants, multiple types were found in 6.1% of participants, and unknown types were found in 5.9% of participants. The most prevalent subtypes were nononcogenic 6, 53, and 84. HPV positivity was not associated with age. These results indicate that HPV infection among men at high risk is common but that characteristics of male HPV infection may differ from those of female infection.Human papillomavirus (HPV) infection is the necessary, sexually transmitted cause of invasive cervical cancer and its precursor lesion, cervical intraepithelial neoplasia [1][2][3]. HPV has also been closely linked with other anogenital cancers, including anal cancer and certain penile cancers [4][5][6]. HPV infection in men is over- whelmingly subclinical, which has resulted in a potentially large number of asymptomatic carriers who serve as reservoirs and vectors for the virus.Although HPV has been studied extensively in women, data on male infection are limited. Studies of HPV in men are necessary to improve our understanding of HPV transmission and HPV-related carcinogenesis and to prevent disease in both men and women. The success of future cancer prevention strategies, such as prophylactic HPV vaccination, will be limited without a basic epidemiological understanding of HPV in men.Earlier studies of papillomavirus infection in men used a variety of clinical and histological techniques to establish a diagnosis of HPV, but polymerase chain reaction (PCR) has emerged as the most sensitive method available for the detection of latent HPV [7][8][9]. Among studies that have used PCR to detect penile HPV DNA in healthy men, sampling methodologies have been inconsistent. Nonetheless, results from these diverse investigations have suggested that penile HPV in sexually active men is at least as prevalent as cervical HPV is among women [10][11][12][13][14][15].HPV prevalence in men has been shown to vary by

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The role of human papillomaviruses in anogenital cancers

Cited by 70 publications

References 0 publications

Human papillomavirus infection as a risk factor for anal and perianal skin cancer in a prospective study

Human papillomavirus infection as a risk factor for anal and perianal skin cancer in a prospective study

HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

Human Papillomavirus Infection in Men Attending a Sexually Transmitted Disease Clinic

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