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Age-specific HPV type distribution in high-grade cervical disease in screened and unvaccinated women.
Aro, Karoliina; Nieminen, Pekka; Louvanto, Karolina; Jakobsson, Maija; Virtanen, Seppo; Lehtinen, Matti; Dillner, Joakim; Kalliala, Ilkka.
Afiliação
  • Aro K; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: karoliina.aro@helsinki.fi.
  • Nieminen P; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: pekka.nieminen@hus.fi.
  • Louvanto K; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: karoyt@utu.fi.
  • Jakobsson M; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: maija.jakobsson@hus.fi.
  • Virtanen S; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: seppo.virtanen@hus.fi.
  • Lehtinen M; Department of Laboratory Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden. Electronic address: matti.lehtinen@tuni.fi.
  • Dillner J; Department of Laboratory Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden. Electronic address: joakim.dillner@ki.se.
  • Kalliala I; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland. Electronic address: ilkka.kalliala@hus.fi.
Gynecol Oncol ; 154(2): 354-359, 2019 08.
Article em En | MEDLINE | ID: mdl-31176553
ABSTRACT
BACKGROUND AND

AIM:

Age-specific type-distribution of high-risk human papillomavirus (hrHPV) in cervical precancerous lesions is subject to change in the HPV vaccination era. Knowing the pre-vaccination type-distribution helps to anticipate changes induced by mass vaccination and optimize screening.

METHODS:

We recruited 1279 women referred to colposcopy for abnormal cytology into a population-based study on HPV type distribution in diagnostic cervical samples (ISRCTN10933736). The HPV genotyping findings were grouped as HPV16/18+, other hrHPV+ (HPV31/33/35/39/45/51/52/56/58/59/66/68), non-vaccine targeted hrHPV+ (HPV35/39/51/56/59/66/68), low-risk HPV, and HPV negative. We estimated the HPV group-specific prevalence rates according to diagnostic histopathological findings in the age groups of <30 (n = 339), 30-44.9 (n = 614), and ≥45 (n = 326).

RESULTS:

Altogether 503 cases with high grade squamous intraepithelial lesion or worse (HSIL+) were diagnosed. More than half, 285 (56.7%) of HSIL+ cases were associated with HPV16/18 64.3% (101/157) in women <30 years (reference group), 58.4% (157/269) in women 30-44.9 years (risk ratio (RR) 0.91, 95% confidence interval (95% CI) 0.78-1.06), and 35.1% (27/77) in women ≥45 years of age (RR 0.55, 95% CI 0.39-0.75). Conversely, other hrHPV's were associated with 191 (38.0%) of HSIL+ 31.9% (50/157) in women <30, 36.8% (99/269) in women 30-44.9 years, 54.6% (42/77) and in women ≥45 (RR 1.71, 95% CI 1.26-2.33). The proportion of non-vaccine targeted hrHPV and HPV negative HSIL+ increased with advancing age.

CONCLUSIONS:

Pre-vaccination HPV type distribution in HSIL+ was distinctly polarised by age with HPV16/18 attributed disease being markedly more prevalent in women aged <30. In the older women the other hrHPV types, however, dominated suggesting a need for more age-dependent screening strategies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Papillomaviridae / Infecções por Papillomavirus / Células Escamosas Atípicas do Colo do Útero / Lesões Intraepiteliais Escamosas Cervicais Tipo de estudo: Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Papillomaviridae / Infecções por Papillomavirus / Células Escamosas Atípicas do Colo do Útero / Lesões Intraepiteliais Escamosas Cervicais Tipo de estudo: Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article