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Saeki Y, Saito M, Irie T, Itoh F, Enatsu A, Komura H, Fujii M, Fujii R, Hidaka N, Maehama T, Shirasu N, Waseda T, Shibata T, Takada E, Mibe K, Sakamoto J, Yamada S, Takakura M, Sasagawa T. Effectiveness of prophylactic HPV vaccines against cervical abnormalities and HPV infection in Japan: The J-HERS 2021 multicenter study. J Med Virol 2024; 96:e29413. [PMID: 38314927 DOI: 10.1002/jmv.29413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
This study investigated the efficacy of the prophylactic human papillomavirus (HPV) vaccine, which was initiated between 2009 and 2013 in Japan. The study involved 1529 eligible women aged 16-39 years who visited 11 outpatient clinics in Japan for various reasons. These patients underwent HPV genotype analysis and a Pap test of cervical cell samples. A total of 299 women (19.6%) had received the prophylactic HPV vaccine (bivalent:quadrivalent vaccine ratio = 2:1). Of the 5062 participants in the Japanese Human Papillomavirus Disease Education and Research Survey (J-HERS 2011), which was conducted in the pre-vaccination era, 3236 eligible participants were included as controls. In this study (J-HERS 2021), the highest rate of HPV vaccination (53%) was observed in patients aged 22-27 years. Vaccinated individuals exhibited a 49% rate of protection against low-grade intraepithelial lesions (LSILs) and atypical squamous cells, not excluding high-grade squamous intraepithelial lesions (ASCH) or worse (LSIL/ASCH+), and a 100% rate of protection against high-grade squamous intraepithelial lesions (HSILs) or worse (HSIL+). Significant reductions in HPV16 (95%) and HPV18 (100%) infections were noted, but no differences were observed in HPV6 and HPV11 infections. The prevalences of HPV51 and HPV59 increased with vaccination, although these changes were not confirmed in the comparative study with J-HERS 2011. Comparing the prevaccination (J-HERS 2011) and postvaccination (J-HERS 2021) periods, 43%, 51%, 88%, and 62% reductions in HPV16, HPV18, HPV16/18, and HPV31/58 infection rates were observed, respectively. Similarly, 62% and 71% reductions in LSIL/ASCH+ and HSIL+ rates were noted, respectively. There were 88% and 87% reductions in LSIL/ASCH+ and HSIL+ rates in 16-21- and 28-33-year-old patients, respectively. Bivalent or quadrivalent vaccines provided 100% protection against high-grade squamous cell lesions (suggestive of CIN2 or CIN3) in young women aged <39 years at 9-12 years after initiation of Japan's first nationwide HPV vaccination program. Cross-protection against HPV31 and HPV58 is likely to occur, although some HPV-type replacements are inconsistent across vaccination regimens. This demonstrates the effectiveness of the HPV vaccine. However, continuous monitoring of cervical cancer and precancer is necessary in younger generations (born 1997-2007), who were rarely vaccinated due to the prolonged suspension of the vaccine recommendations in Japan.
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Affiliation(s)
- Yoshihiko Saeki
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | - Mayumi Saito
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | | | | | | | | | - Miho Fujii
- Caress Sapporo Tokeidai Memorial Hospital, Hokkaido, Japan
| | | | | | | | | | | | - Takeo Shibata
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | - Emi Takada
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | - Kazuki Mibe
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | - Jinichi Sakamoto
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | - Sousuke Yamada
- Department of Clinical Pathology, Kanazawa Medical University, Kanazawa, Japan
| | - Masahiro Takakura
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
| | - Toshiyuki Sasagawa
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kanazawa, Japan
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Gong L, Tang Y, Xie H, Zhang L, Sun Y. Predicting cervical intraepithelial neoplasia and determining the follow-up period in high-risk human papillomavirus patients. Front Oncol 2024; 13:1289030. [PMID: 38298438 PMCID: PMC10827855 DOI: 10.3389/fonc.2023.1289030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024] Open
Abstract
Purpose Despite strong efforts to promote human papillomavirus (HPV) vaccine and cervical cancer screening, cervical cancer remains a threat to women's reproductive health. Some high-risk HPV types play a crucial role in the progression of cervical cancer and precancerous lesions. Therefore, HPV screening has become an important means to prevent, diagnose, and triage cervical cancer. This study aims to leverage artificial intelligence to predict individual risks of cervical intraepithelial neoplasia (CIN) in women with high-risk HPV infection and to recommend the appropriate triage strategy and follow-up period according to the risk level. Materials and methods A total of 475 cases were collected in this study. The sources were from the Department of Gynecology and Obstetrics in a tertiary hospital, a case report on HPV from the PubMed website, and clinical data of cervical cancer patients from The Cancer Genome Atlas (TCGA) database. Through in-depth study of the interaction between high-risk HPV and its risk factors, the risk factor relationship diagram structure was constructed. A Classification of Lesion Stages (CLS) algorithm was designed to predict cervical lesion stages. The risk levels of patients were analyzed based on all risk factors, and follow-up periods were formulated for each risk level. Results Our proposed CLS algorithm predicted the probability of occurrence of CIN3-the precancerous lesion stage of cervical cancer. This prediction was based on patients' HPV-16 and -18 infection status, age, presence of persistent infection, and HPV type. Follow-up periods of 3-6 months, 6-12 months, and 3- to 5-year intervals were suggested for high-risk, medium-risk, and low-risk patients, respectively. Conclusion A lesion prediction model was constructed to determine the probabilities of occurrence of CIN by analyzing individual data, such as patient lifestyle, physical assessments, and patient complaints, in order to identify high-risk patients. Furthermore, the potential implications of the calculated features were mined to devise prevention strategies.
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Affiliation(s)
- Ling Gong
- Department of Nursing, School of Nursing, Beihua University, Jilin, China
| | - Yingxuan Tang
- Department of Computer Science and Technology, School of Computer Science, Northeast Electric Power University, Jilin, China
| | - Hua Xie
- Department of Gynecology, Jilin Central General Hospital, Jilin, China
| | - Lu Zhang
- Department of Gynecology, Jilin Central General Hospital, Jilin, China
| | - Yali Sun
- Department of Nursing, School of Nursing, Beihua University, Jilin, China
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Hideshima M, Hashiguchi M, Honda A, Umezaki Y, Okuma R, Hikari T, Fukuda A, Okugawa K, Yokoyama M. Are HPV-negative lesions concerned for the introduction of primary HPV testing for cervical cancer screening in Japan? J Obstet Gynaecol Res 2023; 49:2860-2867. [PMID: 37667616 DOI: 10.1111/jog.15784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
AIM In Japan, primary human papilloma virus (HPV) testing has not been introduced for cervical cancer screening due to concerns that HPV-negative lesions may be missed and a lack of Japanese data. The purpose of this study was to evaluate the validity of primary HPV testing in Japan by analyzing cervical intraepithelial neoplasia 2 (CIN2) or more/high-risk HPV- (CIN2+/hrHPV-) cases in cervical cancer screening. METHODS Data from 35 525 cervical cancer screenings with HPV testing and cervical cytology from 2011 to 2019 in Saga City, Japan, were reviewed. The cases with low-grade squamous intraepithelial lesion (LSIL+)/hrHPV- were analyzed in detail. RESULTS The results of the 35 525 examinees were as follows: 31 123 were negative for intraepithelial lesion or malignancy (NILM)/hrHPV-, 2612 were NILM/hrHPV+, 262 were atypical squamous cells of undetermined significance (ASC-US)/hrHPV-, 213 were ASC-US/hrHPV+, 291 were LSIL+/hrHPV-, and 1024 were LSIL+/hrHPV+. Of the 256 LSIL+/hrHPV- examinees for whom histology was available, CIN2+ were CIN2 9.4% (24/256), CIN3 3.9% (10/256), cervical adenocarcinoma 0.4% (1/256), uterine corpus cancer 1.2% (3/256), and uterine sarcoma 0.4% (1/256). Overall, the rate of LSIL+/hrHPV- was 0.82% (291/35.525), 0.1% (36/35525) of which were cervical lesions with CIN2+. Only one cervical adenocarcinoma was detected, but gastric-type adenocarcinoma was not included. CONCLUSION HPV-negative CIN2+ or cervical adenocarcinoma is not a concern for the introduction of primary HPV screening in Japan. Primary HPV testing in cervical cancer screening is considered a feasible method that can be used in Japan, although an algorithm suitable for Japan and a national-level management system need to be established.
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Affiliation(s)
- Misako Hideshima
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Mariko Hashiguchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | | | - Yasushi Umezaki
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Ryoichi Okuma
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Takako Hikari
- Department of Obstetrics and Gynecology, Saga Prefectural Medical Center, Saga, Japan
| | - Asako Fukuda
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Kaoru Okugawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
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Mogi K, Koya Y, Yoshihara M, Sugiyama M, Miki R, Miyamoto E, Fujimoto H, Kitami K, Iyoshi S, Tano S, Uno K, Tamauchi S, Yokoi A, Shimizu Y, Ikeda Y, Yoshikawa N, Niimi K, Yamakita Y, Tomita H, Shibata K, Nawa A, Tomoda Y, Kajiyama H. 9-oxo-ODAs suppresses the proliferation of human cervical cancer cells through the inhibition of CDKs and HPV oncoproteins. Sci Rep 2023; 13:19208. [PMID: 37932321 PMCID: PMC10628276 DOI: 10.1038/s41598-023-44365-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Mucosal human papillomavirus (HPV) subtypes 16 and 18 are causative agents of cervical cancer, a leading cause of cancer-related deaths among women worldwide. In Japan, eggplant calyx is a folk remedy used to treat common warts. 9-oxo-(10E,12E)-octadecadienoic acid, isolated from eggplant calyx, may have antitumor effects. This study investigated the antitumor effects of 9-oxo-(10E, 12Z)-octadecadienoic acid and 9-oxo-(10E,12E)-octadecadienoic acid (9-oxo-ODAs) on human cervical cancer cells. 9-oxo-ODAs suppressed the proliferation of human cervical cancer cell lines (HeLa, and SiHa) in a concentration-dependent manner (IC50 = 25-50 µM). FCM analysis revealed that 9-oxo-ODAs induced apoptosis. Transcriptome, proteomics, and enrichment analyses revealed that treatment with 9-oxo-ODAs significantly altered the cell cycle and p53 pathways and decreased cyclin-dependent kinase 1 (CDK1) protein expression. Real-time PCR analysis demonstrated that 9-oxo-ODAs reduced CDK1 mRNA expression in a concentration-dependent manner. In vitro, 9-oxo-ODAs reduced the HPV oncoprotein expression. In ex vivo human cervical cancer tissues, 9-oxo-ODAs decreased CDK1 expression and increased cleaved caspase 3, an apoptosis marker. Further, 9-oxo-ODAs showed the potential to suppressed metastatic formation and growth of cervical cancer in vivo. These findings suggest that 9-oxo-ODAs induce cell cycle arrest and apoptosis in HPV-positive human cervical cancer cells, and this process involves CDK1. Consequently, 9-oxo-ODAs may be potential therapeutic agents for cervical cancer.
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Affiliation(s)
- Kazumasa Mogi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Yoshihiro Koya
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan.
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan.
| | - Mai Sugiyama
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Rika Miki
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Emiri Miyamoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Hiroki Fujimoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Kazuhisa Kitami
- Department of Obstetrics and Gynecology, Kitazato University, Kanagawa, Japan
| | - Shohei Iyoshi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Spemann Graduate School of Biology and Medicine, University of Freiburg, Breisgau, Germany
- Institute for Advanced Research, Nagoya University, Nagoya, Aichi, Japan
| | - Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Kaname Uno
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Satoshi Tamauchi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Akira Yokoi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
- Institute for Advanced Research, Nagoya University, Nagoya, Aichi, Japan
| | - Yusuke Shimizu
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Yoshiki Ikeda
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Yoshihiko Yamakita
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kiyosumi Shibata
- Department of Obstetrics and Gynecology, Bantane Hospital, Fujita Health University, Nagoya, Aichi, Japan
| | - Akihiro Nawa
- Bell Research Center Obstetrics and Gynecology Academic Research & Industrial - Academia Collaboration Nagoya University Graduate School of Medicine, Nagoya University, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
| | | | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-Cho 65, Showa-Ku, Nagoya, Aichi, Japan
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Sakai M, Ohara T, Suzuki H, Kadomoto T, Inayama Y, Shitanaka S, Sumitomo M, Matsumura N, Yamanoi K. Clinical impact of age‑specific distribution of combination patterns of cytology and high‑risk HPV status on cervical intraepithelial neoplasia grade 2 or more. Oncol Lett 2023; 26:384. [PMID: 37559589 PMCID: PMC10407864 DOI: 10.3892/ol.2023.13970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 06/29/2023] [Indexed: 08/11/2023] Open
Abstract
To the best of our knowledge, the present study is the first to elucidate the significance of cytology and high-risk human papillomavirus (hrHPV) status in different age groups for the detection of cervical intraepithelial neoplasia (CIN)2, CIN3 and squamous cell carcinoma (SCC). There were 12 combinations based on cytology and hrHPV status [cytology: Atypical squamous cells (ASC) of undetermined significance, low-grade squamous intraepithelial lesion, ASC not excluding high-grade squamous intraepithelial lesion (HSIL) and HSIL; hrHPV status: HPV16/18-positive (16/18+), hrHPV positive for subtypes other than 16/18 (others+) and hrHPV-negative (hrHPV-)]. All patients were categorized into four groups based on age (18-29, 30-39, 40-49 and ≥50 years). For patients with CIN2, CIN3 and SCC (CIN2+) (n=107), the distribution of cytology and hrHPV was investigated in each age group. In addition, for all patients (n=446), the occurrence of CIN2+ in each of the 12 combinations was investigated in each age group. In the 18-29-year age group, the most common combination was HSIL and 16/18+, followed by HSIL and others+, which accounted for 73% of CIN2+ cases. The occurrence of HSIL and 16/18+ decreased with increasing age, and no cases occurred in the 50-year age group. In the 18-29-year age group, all patients with HSIL and 16/18+ were diagnosed with CIN2+. CIN2+ was predominantly detected in patients with HSIL in the 18-29-year age group, as well as hrHPV- and others+. This definite distinction was not observed in any other age group. For CIN2+, the distribution patterns of cytology and hrHPV status combinations varied significantly among different age groups. Accordingly, the clinical impact of the combination of cytological findings and hrHPV status can vary among age groups.
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Affiliation(s)
- Mie Sakai
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Shiga General Hospital, Moriyama, Shiga 524-8524, Japan
| | - Tsutomu Ohara
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Haruka Suzuki
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Tatsuki Kadomoto
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
| | - Yoshihide Inayama
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Shimpei Shitanaka
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Masahiro Sumitomo
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
| | - Noriomi Matsumura
- Department of Obstetrics and Gynecology, Kindai University Graduate School of Medicine, Osakasayama, Osaka 589-8511, Japan
| | - Koji Yamanoi
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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Sakakibara A, Nakayama T, Uchida H, Odagiri Y, Ito Y, Katayama T, Ueda Y, Higuchi T, Terakawa K, Matsui K, Miyazaki K, Konishi I. Trends and future projections of cervical cancer-related outcomes in Japan: What happens if the HPV vaccine program is not implemented? Int J Cancer 2023; 152:1863-1874. [PMID: 36468173 DOI: 10.1002/ijc.34391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/24/2022] [Accepted: 11/08/2022] [Indexed: 12/09/2022]
Abstract
Contrary to other developed countries, in Japan, recent years have seen increases in cervical cancer incidence and mortality among young people. However, the human papillomavirus (HPV) vaccine program, a key measure for avoiding cervical cancer, has been virtually suspended. Temporal changes in cervical cancer profiles in this unique situation have not been fully investigated epidemiologically. Our study aimed to determine the current status and future trends of the incidence and mortality of cervical cancer and precancerous lesions in Japan. Mortality rates of cervical cancer during 1975 to 2016 and incidence rates of cervical cancer and cervical intraepithelial neoplasia (CIN) 3 during 1975 to 2013 were examined using vital statistics and population-based cancer registry data in Japan. Bayesian age-period-cohort analyses were performed to analyze temporal changes of the three cervical cancer-related outcomes. We also calculated projections to 2028 for the three outcomes, assuming that HPV vaccination coverage and screening rates in Japan would be maintained at the current level after the resumption of the national vaccination program. The risk of occurrence of the three outcomes showed similar changes by birth cohort, peaking in the mid-1890s to 1900s birth cohorts, declining sharply in the 1940s birth cohort, and persistently increasing in the 1950s and later birth cohorts. Projections to 2028 show increases in cervical cancer incidence and mortality in the 30 to 69 age group, with a particular increase in CIN3 incidence in the 25 to 49 age group, if HPV vaccine programs and screening are not effectively implemented. These findings revealed an increasing cervical disease burden among reproductive age females in Japan.
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Affiliation(s)
- Atsuko Sakakibara
- Department of Preventive Medicine, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Hiroyuki Uchida
- Division of Clinical Dietetics and Human Nutrition Graduate School of Pharmaceutical Sciences, Josai University, Saitama, Japan
| | - Youichi Odagiri
- Graduate School of Nursing, Yamanashi Prefectural University, Yamanashi, Japan
| | - Yuri Ito
- Department of Medical Statistics Research & Development Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Toshiro Katayama
- Department of Medical Engineering, Morinomiya University of Medical Sciences, Osaka, Japan.,Help Center of Medical Research, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toshihiro Higuchi
- Department of Gynecology and Obstetrics, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Koichi Terakawa
- Department of Gynecology, Kansai Electric Power Hospital, Osaka, Japan
| | - Kunihiko Matsui
- Department of Community Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Kikuko Miyazaki
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.,National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Machida H, Matsuo K, Tanaka M, Kitatani K, Takase A, Yokoyama K, Kajiwara H, Yasaka M, Ikeda M, Yoshida H, Hirasawa T, Mikami M. ROS1 as a possible prognostic biomarker of cervical adenocarcinoma: An exploratory analysis with next-generation sequencing. Gynecol Oncol 2023; 171:59-66. [PMID: 36804622 DOI: 10.1016/j.ygyno.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVES Given the differences in clinical and biological characteristics between cervical adenocarcinoma and squamous cell carcinoma, this study aimed to conduct an exploratory analysis to examine the molecular characteristics of cervical adenocarcinoma in a Japanese population. METHODS This study explored the simultaneous testing of multiple mutations targeting cervical adenocarcinoma using next-generation sequencing (NGS). The following genes were analyzed: BCAR4, CD274, PDCD1LG2, KRAS, ARID1A, PTEN, ALK, EGFR, ROS1, BRAF, PIK3CA, EP300, EBXW7, SHCBP1, TGFBR2, SMAD4, ERBB2, ERBB3, and KLF5. Tumor tissue and blood samples were obtained at the time of primary treatment. The NGS-based molecular profiles obtained from Tokai University (49 specimens) were compared with the registered data in The Cancer Genome Atlas (TCGA) database (133 specimens). RESULTS The study cohort had higher rates of adenocarcinoma than the TCGA cohort (44.9% vs. 18.0%; P = 0.001). The adenocarcinomas in the study cohort had more alterations in ROS1, EGFR, EP300, SHCBP1, ALK, and PIK3CA than those in the TCGA cohort. Among them, ROS1 had the highest number of gene alterations (median, 7.00 ± 2.63). In the study cohort, patients with a high number of ROS1 alterations had a significantly higher recurrence rate (5-year recurrence rate, 48.8% vs. 14.6%; hazard ratio [HR], 4.32; 95% confidence interval [CI], 1.20-15.50; P = 0.014) and lower overall survival than those with low alterations (5-year survival rate, 70.7% vs. 93.1%; HR, 7.15; 95% CI, 1.08-58.22; P = 0.032). CONCLUSION The current exploratory analysis suggests that ROS1 gene alteration may be a prognostic biomarker in cervical adenocarcinoma in Japanese patients.
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Affiliation(s)
- Hiroko Machida
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan.
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Masayuki Tanaka
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Kanae Kitatani
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Akinori Takase
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Keiko Yokoyama
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Hiroshi Kajiwara
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Miwa Yasaka
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Masae Ikeda
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroshi Yoshida
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Takeshi Hirasawa
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
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8
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Mekonnen AG, Mittiku YM. Early-onset of sexual activity as a potential risk of cervical cancer in Africa: A review of literature. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000941. [PMID: 36962975 PMCID: PMC10032528 DOI: 10.1371/journal.pgph.0000941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023]
Abstract
Introduction In most African countries, cervical cancer is the most common cancer among women, both in terms of incidence and fatality. In the existing literature, age is risk factor for developing cervical cancer since it occurs mainly after the middle life of women. However, there have been contradictory findings in the literature on whether early sexual intercourse is linked to cervical cancer, with some studies indicating no relationship and others reporting an increased risk. Hence, this review analyzed data from recently published studies on cervical cancer. Methods Seven databases (MEDLINE via PubMed, Google Scholar, Scopus, Medscape, EMBASE, African Journals Online and Science Direct) were searched for papers published from January 2000 to March 2022 in English. Ten studies were included in analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger’s test. The pooled estimates of odds ratios were calculated by a random-effects model. Results In the subgroup analysis, there was no significant association between early sexual activity and cervical cancer. However, the overall pooled analysis of these ten studies revealed that there is an association between early sexual debut and cervical cancer. In the random effect model, we found a pooled odds ratio of 2.95 (95% CI = 1.06, 4.83), indicating that women who began sexual intercourse before the age of 18 had a higher risk of getting cervical cancer than adult women. Conclusion In this analysis, women who began having early sexual debut had a greater risk of developing cervical cancer than those who initiated sexual intercourse later in life. Delaying the age of first sexual activity among adolescents could help prevent the occurrence of cervical cancer.
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Affiliation(s)
- Alemayehu Gonie Mekonnen
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Amara Regional State, Ethiopia
- * E-mail:
| | - Yohannes Moges Mittiku
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Amara Regional State, Ethiopia
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9
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Kitamura T, Suzuki M, Shigehara K, Fukuda K, Matsuyama T, Kume H. Prevalence of Human Papillomavirus Types 16/18 and Effect of Vaccination among Japanese Female General Citizens in the Vaccine Crisis Era. Viruses 2023; 15:159. [PMID: 36680199 PMCID: PMC9863140 DOI: 10.3390/v15010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
The Japanese government withdrew its recommendation for human papillomavirus (HPV) vaccination in June 2013 and resumed it in April 2022. This period is known as the vaccine crisis in Japan. This study aimed to elucidate the prevalence and genotype distribution of HPV among Japanese female citizens, and the effect of vaccination against HPV-16/18 in the era of the vaccine crisis. We recruited Japanese female citizens and asked them to provide self-collected samples from the vaginal wall using cotton swabs for HPV genotyping. Furthermore, we collected the participants' characteristics, including lifestyle and experience of vaccination against HPV, to determine the significant association with HPV infection. HPV-16/18 positivity was found in 5.6% (115/2044) of participants. The highest vaccination rate was observed in the age group of 20-24 years (60.6%), whereas the lowest HPV-16/18 positivity was observed in the age group of 45-49 years (2.8%), followed by the age group of 20-24 years (4.0%). Experience with HPV vaccination significantly reduced the risk of HPV-16/18 infection (adjusted odds ratio, 0.047; 95% confidence interval, 0.011-0.196). Vaccinated women were much less likely to be infected by HPV-16/18, regardless of the HPV vaccine type or the vaccination dose.
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Affiliation(s)
- Tadaichi Kitamura
- Japanese Foundation of Sexual Health Medicine, Tokyo 113-0034, Japan
| | - Motofumi Suzuki
- Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-8575, Japan
| | - Kazuyoshi Shigehara
- Department of Urology, Faculty of Medicine, Kanazawa University, Kanazawa 920-8641, Japan
| | - Kazuko Fukuda
- Japanese Foundation of Sexual Health Medicine, Tokyo 113-0034, Japan
| | - Taeko Matsuyama
- Department of Nursing, Tachikawa Faculty of Nursing, Tokyo Healthcare University, Tachikawa 190-8590, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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10
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The Prevalence, Genotype Distribution and Risk Factors of Human Papillomavirus in Tunisia: A National-Based Study. Viruses 2022; 14:v14102175. [PMID: 36298732 PMCID: PMC9611589 DOI: 10.3390/v14102175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/28/2022] Open
Abstract
There are limited national population-based studies on HPV genotypes distribution in Tunisia, thus making difficult an assessment of the burden of vaccine-preventable cervical cancer. In this context, we conducted a national survey to determine the HPV prevalence and genotypes distribution and the risk factors for HPV infections in Tunisian women. This is a cross-sectional study performed between December 2012 and December 2014. A liquid-based Pap smear sample was obtained from all women and samples' DNAs were extracted. Only women with betaglobin-positive PCR were further analysed for HPV detection and typing by a nested-PCR of the L1 region followed by next-generation sequencing. A multiple logistic regression model was used for the analysis of associations between the variables. A total of 1517 women were enrolled in this study, and 1229 out of the 1517 cervical samples were positive for the betaglobin control PCR and tested for HPV. Overall HPV infection prevalence was measured to be 7.8% (96/1229), with significant differences between the grand regions, ranging from 2% in the North to 13.1% in Grand Tunis. High-risk HPV genotypes accounted for 5% of the infections. The most prevalent genotypes were HPV 31 (1%), 16 (0.9%), 59 (0.7%). HPV18 was detected only in four cases of the study population. Potential risk factors were living in Grand Tunis region (OR: 7.94 [2.74-22.99]), married status (OR: 2.74 [1.23-6.13]), smoking habit (OR: 2.73 [1.35-5.51]), occupation (OR: 1.81 [1.09-3.01]) and women with multiple sexual partners (OR: 1.91 [1.07-3.39]). These findings underscore the need to evaluate the cost effectiveness of HPV vaccine implementation, contribute to the evidence on the burden of HPV infections, the critical role of sexual behaviour and socioeconomic status, and call for increased support to the preventive program of cervical cancer in Tunisia.
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11
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Palmer M, Katanoda K, Saito E, Acuti Martellucci C, Tanaka S, Ikeda S, Sakamoto H, Machelek D, Ml Brotherton J, Hocking JS. Genotype prevalence and age distribution of human papillomavirus from infection to cervical cancer in Japanese women: A systematic review and meta-analysis. Vaccine 2022; 40:5971-5996. [PMID: 36085257 DOI: 10.1016/j.vaccine.2022.07.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/31/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND National HPV vaccination coverage in Japan is less than one percent of the eligible population and cervical cancer incidence and mortality are increasing. This systematic review and meta-analysis aimed to provide a comprehensive estimate of HPV genotype prevalence for Japan. METHODS English and Japanese databases were searched to March 2021 for research reporting HPV genotypes in cytology and histology samples from Japanese women. Summary estimates were calculated by disease stage from cytology only assessment - Normal, ASCUS, LSIL, HSIL and from histological assessment - CIN1, CIN2, CIN3/AIS, ICC (ICC-SCC, and ICC-ADC), and other. A random-effects meta-analysis was used to calculate summary prevalence estimates of any-HPV, high-risk (HR) and low-risk (LR) vaccine types, and vaccine genotypes (bivalent, quadrivalent, or nonavalent). This study was registered with PROSPERO: CRD42018117596. RESULTS A total of 57759 women with normal cytology, 1766 ASCUS, 3764 LSIL, 2017 HSIL, 3130 CIN1, 1219 CIN2, 869 CIN3/AIS, and 4306 ICC (which included 1032 ICC-SCC, and 638 ICC-ADC) were tested for HPV. The summary estimate of any-HPV genotype in women with normal cytology was 15·6% (95% CI: 12·3-19·4) and in invasive cervical cancer (ICC) was 85·6% (80·7-89·8). The prevalence of HR-HPV was 86·0% (95% CI: 73·9-94·9) for cytological cases of HSIL, 76·9% (52·1-94·7) for histological cases of CIN3/AIS, and 75·7% (68·0-82·6) for ICC. In women with ICC, the summary prevalence of bivalent vaccine genotypes was 58·5% (95% CI: 52·1-64·9), for quadrivalent genotypes was 58·6% (52·2-64·9) and for nonavalent genotypes was 71·5% (64·9-77·6), and of ICC cases that were HPV positive over 90% of infections are nonavalent vaccine preventable. There was considerable heterogeneity in all HPV summary estimates and for ICC, this heterogeneity was not explained by variability in study design, sample type, HPV assay type, or HPV DNA detection method, although studies published in the 1990s had lower prevalence estimates of any-HPV and HR HPV genotypes. INTERPRETATIONS HPV prevalence is high among Japanese women. The nonavalent vaccine is likely to have the greatest impact on reducing cervical cancer incidence and mortality in Japan.
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Affiliation(s)
- Matthew Palmer
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne Australia; Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
| | - Kota Katanoda
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health Medicine, Tokyo, Japan
| | | | - Shiori Tanaka
- Department of Global Health Policy, Graduate School of Medicine, The University of Teokyo, Tokyo, Japan; Division of Prevention, Center for Public Health Sciences, National Cancer Center, Japan
| | - Sayaka Ikeda
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, The University of Teokyo, Tokyo, Japan
| | | | - Julia Ml Brotherton
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne Australia; Australian Centre for the Prevention of Cervical Cancer, Carlton, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne Australia
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12
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Tsukamoto K, Inoue M, Mori H, Matsumaru N. [Establishment of Mono-scaled Benefit/Risk Analysis of HPV Vaccine]. YAKUGAKU ZASSHI 2022; 142:1399-1407. [PMID: 36156032 DOI: 10.1248/yakushi.22-00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Decisions concerning approval of human papillomavirus (HPV) vaccines and their use are based on expert evaluation of the vaccines. However, the quantitative differences between vaccine benefits and risks are difficult for non-experts to understand. In this study, we developed a new method to calculate the benefits and risks of the HPV vaccines using disability-adjusted life year (DALY) as the mono-scaled weight for various benefits and risks relevant to the vaccines. We evaluated benefits as a gain of DALY values for cervical cancer and risks as the loss of DALY values for various adverse events by the vaccination. To calculate the loss of DALY values, we integrated all adverse events in the International Classification of Diseases chapters. The novel method reflected the men-women ratio of this epidemiological disease to a certain extent. Among the vaccinated women, 111,372 and 477,190 received a bivalent and quadrivalent vaccine, respectively. The DALY rate of cervical cancer was 148.7. The calculated benefit for the bivalent and quadrivalent vaccines was 149.1 and 638.8, respectively, and set as the theoretical maximum. The risk was calculated as 129.3 and 49.6 in the bivalent and quadrivalent vaccines, respectively. Since HPV vaccines prevent several other cancers, the benefit of the vaccination extends beyond the risk according to this new method.
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Affiliation(s)
| | - Manami Inoue
- Global Regulatory Science, Gifu Pharmaceutical University
| | - Hirohito Mori
- Global Regulatory Science, Gifu Pharmaceutical University
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13
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Changes in HPV16/18 Prevalence among Unvaccinated Women with Cervical Intraepithelial Neoplasia in Japan: Assessment of Herd Effects following the HPV Vaccination Program. Vaccines (Basel) 2022; 10:vaccines10020188. [PMID: 35214646 PMCID: PMC8875304 DOI: 10.3390/vaccines10020188] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
Since the human papillomavirus (HPV) vaccination program for Japanese girls aged 12–16 years began in 2010, vaccination uptake has been low in women born before 1993 but high (approximately 70%) in those born during 1994–1999. We previously compared the prevalence of vaccine types HPV16 and HPV18 in cervical intraepithelial neoplasia grade 1–3 (CIN1–3) or adenocarcinoma in situ (AIS) between vaccinated and unvaccinated cohorts and found direct protection effects among vaccinated women in Japan. In this study, we focused on changes in HPV16/18 prevalence among “unvaccinated” cohorts with CIN/AIS. We analyzed HPV16/18 prevalence among 5051 unvaccinated women aged <40 years, newly diagnosed with CIN/AIS during 2012–2021 for time trends. Declining trends in HPV16/18 prevalence over 9 years were observed in CIN1 (36.0–10.0%, Ptrend = 0.03) and CIN2–3/AIS (62.5–36.4%, Ptrend = 0.07) among women aged <25 years. HPV16/18 prevalence in CIN1 and CIN2–3/AIS diagnosed at age 20–24 years was lower in 1994–1999 birth cohorts compared with 1988–1993 birth cohorts (4.5% vs. 25.7% for CIN1 and 40.0% vs. 58.1% for CIN2–3/AIS, both p = 0.04). Significant reduction in HPV16/18 prevalence among young unvaccinated women with CIN1 and CIN2–3/AIS suggests herd effects of HPV vaccination in Japan.
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14
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Hiramatsu K, Ueda Y, Yagi A, Morimoto A, Egawa-Takata T, Nakagawa S, Kobayashi E, Kimura T, Kimura T, Minekawa R, Hori Y, Sato K, Morii E, Nakayama T, Tanaka Y, Terai Y, Ohmichi M, Ichimura T, Sumi T, Murata H, Okada H, Nakai H, Matsumura N, Mandai M, Saito J, Horikoshi Y, Takagi T, Enomoto T, Shimura K. The efficacy of human papillomavirus vaccination in young Japanese girls: the interim results of the OCEAN study. Hum Vaccin Immunother 2021; 18:1951098. [PMID: 34802371 PMCID: PMC8920229 DOI: 10.1080/21645515.2021.1951098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Human papillomavirus (HPV) vaccine has been used to prevent chronic HPV infection, which accounts for cervical cancer. Japanese Ministry of Health, Labor and Welfare (MHLW) conducted an HPV vaccination campaign in 2010 and the Obstetrical Gynecological Society of Osaka initiated a multicenter, prospective cohort study in Osaka, Japan – OCEAN (Osaka Clinical resEArch of HPV vacciNe) study – to investigate the oncogenic HPV prevalence and the long-term protection rate of HPV vaccine. A total of 2814 participants were enrolled on their visit for HPV vaccination between 12 and 18 years old. Among them, 102 participants received HPV/Pap co-test as primary cancer screening at the age of 20–21. We compared the prevalence in two groups (the vaccinated and the unvaccinated group). HPV infection ratio was significantly lower in the vaccinated group compared to the unvaccinated (12.9% vs. 19.7%; p = .04). In particular, HPV 16 and 18 were not detected in the vaccinated group, while 4.9% of participants in the unvaccinated group were infected (p = .001), suggesting that vaccination provided effective protection against high-risk types of HPV. The cross-protection effect of HPV vaccines was also observed against HPV 31, 45, and 52. Although HPV vaccines were not contributed to the reduction of cervical intraepithelial neoplasia 1 (CIN) (p = .28), CIN2 or worse was not observed in vaccinated group. Our research showed that at the age of 20–21, HPV vaccine inhibited the infection of high-risk HPV and had impacted on the development to CIN2 or worse in Japan.
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Affiliation(s)
- Kosuke Hiramatsu
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | - Yutaka Ueda
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | - Asami Yagi
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | | | - Tomomi Egawa-Takata
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | - Satoshi Nakagawa
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | - Eiji Kobayashi
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | - Toshihiro Kimura
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | - Tadashi Kimura
- Osaka University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | | | - Yumiko Hori
- Osaka University Graduate School of Medicine and Faculty of Medicine, Pathology
| | - Kazuaki Sato
- Osaka University Graduate School of Medicine and Faculty of Medicine, Pathology
| | - Eiichi Morii
- Osaka University Graduate School of Medicine and Faculty of Medicine, Pathology
| | - Tomio Nakayama
- National Cancer Center Japan, Center for Public Health Sciences Screening Assessment and Management
| | | | - Yoshito Terai
- Kobe University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
| | | | | | - Toshiyuki Sumi
- Osaka City University Faculty of Medicine, Obstetrics & Gynecology
| | | | | | - Hidekatsu Nakai
- Kindai University Faculty of Medicine, Obstetrics & Gynecology
| | | | - Masaki Mandai
- Kyoto University Graduate School of Medicine and Faculty of Medicine, Obstetrics & Gynecology
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15
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Cervical Cancer Protection in Japan: Where Are We? Vaccines (Basel) 2021; 9:vaccines9111263. [PMID: 34835194 PMCID: PMC8619953 DOI: 10.3390/vaccines9111263] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
In Japan, government subsidies for human papillomavirus (HPV) vaccination of girls aged 13–16 commenced in 2010. By early 2013, vaccination had become a widely accepted national immunization program. However, in June of 2013, the Ministry of Health, Labor, and Welfare (MHLW), the government’s lead agency, suspended its recommendation for vaccination in response to reports of adverse vaccine events. The rate of HPV vaccination quickly dropped from 70% to almost zero, where it has lingered for eight years. In 2020, a new 9-valent HPV vaccine was licensed in Japan. The momentum seemed to be building for the resumption of HPV vaccinations, yet Japanese mothers remain widely hesitant about vaccinating their daughters, despite the well-proven safety and efficacy of the HPV vaccines. The Japanese government and our educational and medical institutions must work harder as a team to inform our parents and their children about the life-saving benefits of the HPV vaccine, and at the same time, we must respond to all their concerns and questions. The vaccine hesitancy of unvaccinated women born in 2000 and thereafter is a natural consequence of the suspension of the government‘s recommendation. We must also take every possible measure to reduce the significant risk for cervical cancer these women have.
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16
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Kukimoto I, Matsumoto K, Takahashi F, Iwata T, Tanaka K, Yamaguchi-Naka M, Yamamoto K, Yahata H, Nakabayashi M, Kato H, Tsuda N, Onuki M, Yaegashi N. Human Papillomavirus (HPV) Genotyping Assay Suitable for Monitoring the Impact of the 9-Valent HPV Vaccine. TOHOKU J EXP MED 2021; 251:287-294. [PMID: 32759554 DOI: 10.1620/tjem.251.287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Japan, a bivalent human papillomavirus (HPV) vaccine against carcinogenic HPV16/18 was licensed in 2009, and a quadrivalent vaccines against HPV16/18 and non-carcinogenic HPV6/11 was licensed in 2011. Recently, the next-generation 9-valent vaccine targeting HPV6/11/16/18/31/33/45/52/58 has been approved. Accurate HPV genotyping is essential for HPV vaccine research and surveillance. The Roche Linear Array (LA) has long been a standard assay for HPV genotyping, but its recent product discontinuation notice has urged us to introduce an alternative assay with comparable performance. In the present study, an in-house HPV genotyping assay that employs PCR with PGMY09/11 primers and reverse blotting hybridization (PGMY-CHUV) was compared with LA to assess genotype-specific agreement. A total of 100 cervical precancer specimens were subjected to both PGMY-CHUV and LA. For detection of genotypes included in the 9-valent vaccine, PGMY-CHUV completely agreed with LA for detection of HPV6, HPV11, HPV16, HPV18, HPV33 and HPV45, and showed near-complete agreement for HPV31 and HPV58 (98% and 99%, respectively). Moreover, PGMY-CHUV detected a significantly higher prevalence of HPV52 than LA (22% vs. 14%, P = 0.008 by McNemar's exact test), with 92.0% overall agreement, 63.6% positive agreement and a kappa value of 0.73. Most (87.5%) of HPV52 discordant cases involved mixed infections with HPV35 or HPV58. In conclusion, while the two assays present equivalent data for assessing the effectiveness of the bivalent and quadrivalent vaccines, PGMY-CHUV is more suitable for evaluating the impact of the current 9-valent vaccine because of its superior detection of HPV52 in co-infection cases.
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Affiliation(s)
- Iwao Kukimoto
- Pathogen Genomics Center, National Institute of Infectious Diseases
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine
| | - Fumiaki Takahashi
- Division of Medical Engineering, Department of Information Science, Iwate Medical University
| | - Takashi Iwata
- Department of Obstetrics and Gynecology, Keio University School of Medicine
| | - Kohsei Tanaka
- Pathogen Genomics Center, National Institute of Infectious Diseases.,Department of Obstetrics and Gynecology, Keio University School of Medicine
| | - Mayuko Yamaguchi-Naka
- Pathogen Genomics Center, National Institute of Infectious Diseases.,Department of Obstetrics and Gynecology, Showa University School of Medicine
| | | | - Hideaki Yahata
- Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
| | | | | | - Naotake Tsuda
- Department of Obstetrics and Gynecology, Kurume University School of Medicine
| | - Mamiko Onuki
- Department of Obstetrics and Gynecology, Showa University School of Medicine
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine
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17
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Noji N, Okayama K, Oda M, Shimada A, Okodo M. Human papillomavirus infection status of single cells isolated from cervical cytology specimens by simple manual microdissection. J Med Virol 2021; 93:5084-5094. [PMID: 33599297 DOI: 10.1002/jmv.26888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 12/17/2022]
Abstract
Human papillomavirus (HPV) testing with cytology triage for cervical cancer screening has proven to be useful. It is considered that a significant percentage of HPV-positive women followed by reflex cytology have had multiple-type HPV infections rather than single-type infections. However, the effects of multiple-type infections on changes in the cytomorphology of exfoliated cervical cells have not been investigated. The aim of this study was to validate simple manual microdissection (MMD) maneuver and investigate the HPV infection status of single cells isolated from Papanicolaou (Pap) smears prepared from women with multiple-type infections. Using cytology samples from 90 patients with abnormal Pap smear results, we evaluated the efficiency of the MMD procedure and determined the HPV infection status of single squamous intraepithelial lesion (SIL) cells microdissected from patients with multiple-type infection. When validating the MMD procedure, the HPV-positive rate was 81.5% using 119 MMD samples from the Pap smear in 61 cases with single-type infection. This MMD procedure was able to efficiently collect single cells. Of 119 MMD samples from 29 cases with multiple-type infection, the HPV-positive rate was 42.9%, and most (96.1%) MMD samples exhibited only one genotype. Our MMD maneuver successfully identified HPV genotypes using single cells isolated from cytology specimens. A majority of single SIL cells prepared from multiple-type infection cases turned out to contain only one genotype. In the future, the MMD method could be applied while studying the relationship between the morphological changes exhibited by SIL cells on Pap smear and the infected HPV genotype.
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Affiliation(s)
- Natsumi Noji
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, Mitaka-shi, Tokyo, Japan
| | - Kaori Okayama
- Department of Medical Technology, Faculty of Health Science, Gunma Paz University, Takasaki-shi, Gunma, Japan
| | - Mizue Oda
- Department of Gynecology, Genki Plaza Medical Center for Health Care, Chiyoda-ku, Tokyo, Japan
| | - Atsuyoshi Shimada
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, Mitaka-shi, Tokyo, Japan
| | - Mitsuaki Okodo
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, Mitaka-shi, Tokyo, Japan
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18
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Yamaguchi M, Sekine M, Hanley SJB, Kudo R, Hara M, Adachi S, Ueda Y, Miyagi E, Enomoto T. Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women. Sci Rep 2021; 11:2898. [PMID: 33536516 PMCID: PMC7858628 DOI: 10.1038/s41598-021-82354-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 01/05/2021] [Indexed: 11/09/2022] Open
Abstract
In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. Although vaccine opponents claim modifying sexual behavior can prevent cervical cancer, no comprehensive data exist on sexual behavior and the risk of high-grade cervical disease in a Japanese population. This study investigates sexual behavior and the risk of HPV infection and cervical disease in 3968 women aged 20–41 yrs undergoing cervical screening between April 2014 and March 2016. Mean age at first intercourse was 18.4 yrs ± 2.8 and 32% of women reported ≥ 6 lifetime sexual partners. In regression analyses, number of partners was a significant risk factor for HPV infection. However, for high-grade disease (CIN2+), when HPV genotype was adjusted for, number of partners was not statistically significant. The greatest risk factor was an HPV16/18 infection (adjusted odds ratio 113.7, 95% CI: 40.8–316.9). In conclusion, we found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately.
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Affiliation(s)
- Manako Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan.
| | - Sharon J B Hanley
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Risa Kudo
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Sosuke Adachi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ward, Niigata, 951-8510, Japan
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Ikeda S, Ueda Y, Hara M, Yagi A, Kitamura T, Kitamura Y, Konishi H, Kakizoe T, Sekine M, Enomoto T, Sobue T. Human papillomavirus vaccine to prevent cervical intraepithelial neoplasia in Japan: A nationwide case-control study. Cancer Sci 2020; 112:839-846. [PMID: 33040433 PMCID: PMC7893998 DOI: 10.1111/cas.14682] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022] Open
Abstract
Cervical cancer remains among the most common cancers in women worldwide and can be prevented by vaccination. The Ministry of Health, Labour and Welfare of Japan suspended active recommendation of regular human papillomavirus (HPV) vaccines in 2013 because of various symptoms including chronic pain and motor impairment. This nationwide case-control study from April 2013 to March 2017 targeted women aged 20-24 years old at cervical screening. We compared HPV vaccination exposure between those with abnormal and normal cytology. Abnormal cytology was classified based on the results of histological test and we calculated the odds ratio (OR) and 95% confidence interval (CI) of the above endpoints and vaccination exposure using the conditional logistic regression model and estimated vaccine effectiveness using the formula (1 - OR) × 100. A total of 2483 cases and 12 296 controls (one-to-five matching) were eligible in 31 municipalities in Japan. The distribution of histological abnormalities among cases was 797 CIN1 (including dysplasia) (32.1%), 165 CIN2 (6.7%), 44 CIN3 (1.8%), and eight squamous cell carcinoma (SCC) (0.3%). The OR of HPV vaccination compared with no vaccination for abnormal cytology, CIN1+, CIN2+, and CIN3+ versus controls was 0.42 (95% CI, 0.34-0.50), 0.42 (95% CI, 0.31-0.58), 0.25 (95% CI, 0.12-0.54), and 0.19 (95% CI, 0.03-1.15), respectively, equating to a vaccine effectiveness of 58.5%, 57.9%, 74.8%, and 80.9%, respectively. Eight patients had SCC, none was vaccinated. This nationwide case-control study in Japan demonstrated a substantial risk reduction in abnormal cytology and CIN among women who did versus those who did not receive HPV vaccination.
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Affiliation(s)
- Sayaka Ikeda
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Asami Yagi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuri Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | | | | | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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Correlation between Human Papillomavirus Codetection Profiles and Cervical Intraepithelial Neoplasia in Japanese Women. Microorganisms 2020; 8:microorganisms8121863. [PMID: 33255811 PMCID: PMC7761012 DOI: 10.3390/microorganisms8121863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 01/02/2023] Open
Abstract
Human papillomavirus (HPV) infection is thought to be strongly associated with the precarcinomatous state cervical intraepithelial neoplasia (CIN) and cervical carcinoma. To accurately assess the correlation between HPV detection profiles and CIN, the uniplex E6/E7 polymerase chain reaction (PCR) method was used. We detected HPV (37 genotypes) in 267 CIN cases. The detection of a single high-risk HPV genotype occurred in 69.7% of CIN1 and worse than CIN1 (CIN1+) cases whereas other types were detected in 11.6% of cases. Codetection of high-risk HPV genotypes occurred in 4.9% of CIN1+ cases. The high-risk genotype HPV16 was the most frequently detected genotype in CIN1+ lesions; the genotype HPV34 (not a high-risk type) was detected in some CIN3 cases. Furthermore, HPV codetection may not be associated with CIN grades. These results suggest that various HPV genotypes are associated with CIN across all analyzed cases.
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Xu Y, Qiu Y, Yuan S, Wang H. Prognostic implication of human papillomavirus types in cervical cancer patients: a systematic review and meta-analysis. Infect Agent Cancer 2020; 15:66. [PMID: 33292343 PMCID: PMC7648311 DOI: 10.1186/s13027-020-00332-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022] Open
Abstract
Background To estimate the prognostic relevance of human papillomavirus (HPV) 16 and HPV 18 in patients with cervical cancer. Method We searched PubMed, EMBASE, American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO), CNKI, and Wanfang databases to search primary articles illustrating the survival outcomes in cervical cancer patients with or without HPV 16/18 infection. A meta-analysis was conducted to generate a combined hazard ratio (HR) with 95% confidence intervals (CI) for progression-free survival (PFS), disease free survival (DFS) and overall survival (OS). Results A total of 13 studies were included. Our meta-analysis revealed that HPV 16 positive did not have any impact on OS (HR, 0.76; 95% CI = 0.37–1.54; P = 0.44). Cervical cancer patiensts infected with HPV 18 had worse OS (HR, 1.66; 95% CI = 1.28–2.17; P = 0.0001), DFS (HR, 2.10; 95% CI = 1.73–2.54; P < 0.0001) and worse PFS (HR, 2.97; 95% CI = 1.69–5.23; P = 0.00012) compared with those not infected with HPV 18. cervical cancer patiensts infected with HPV 18 had worse PFS compared with those infected with HPV 16 ((HR, 1.34; 95% CI = 1.06–1.70; P = 0.01). Conclusion Cervical cancer patients infected with HPV 18 had worse survival compared with cervical cancer patients with HPV 16 infection.
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Affiliation(s)
- Yuanyuan Xu
- Department of Obstetrics and Gynecology, West China Second Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yichao Qiu
- Department of Obstetrics and Gynecology, West China Second Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Shuang Yuan
- Department of Obstetrics and Gynecology, West China Second Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hongjing Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No.20, Section 3, South People's Road, Chengdu, Sichuan, P.R. China.
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22
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Noguchi T, Zaitsu M, Oki I, Haruyama Y, Nishida K, Uchiyama K, Sairenchi T, Kobashi G. Recent Increasing Incidence of Early-Stage Cervical Cancers of the Squamous Cell Carcinoma Subtype among Young Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207401. [PMID: 33053616 PMCID: PMC7599510 DOI: 10.3390/ijerph17207401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Abstract
Few studies have reported on the increase in cervical cancer incidence in Japan. We aimed to determine the relevant trends in the metropolitan regions of Japan and to identify the population with the highest risk, based on histological subtype, cancer stage, and diagnostic processes. Using population-based data (2009–2013), we identified 2110 women, aged ≥20 years, with cervical cancer. We estimated the age-standardized and age-specific incidence rates of cervical cancer for the study period based on the 1985 national model population. The average annual percent change (AAPC) and 95% confidence interval (CI) were calculated using the joinpoint regression analysis. We stratified the analyses based on histological subtypes, stage, and diagnostic process via cancer screening. The increase in the overall age-standardized incidence was not significant. However, the increase was significant for women aged 30–39 years (AAPC 20.0%/year, 95% CI: 9.9–31.1), which was attributable to the increase in the incidence of the squamous cell carcinoma (SCC) subtype (AAPC 23.1%/year, 95% CI: 10.7–36.8). Among younger women, aged <50 years, further stratification showed an increase in the undiagnosed early-stage SCC subtype via cancer screening. In Japan, the incidence of HPV-related cervical cancer has been increasing in undiagnosed younger women.
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Affiliation(s)
- Takafumi Noguchi
- Department of Public Health, School of Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan; (M.Z.); (Y.H.); (T.S.); (G.K.)
- Department of Adult Nursing, Dokkyo Medical University School of Nursing, Mibu, Tochigi 321-0293, Japan
- Correspondence: ; Tel.: +81-282-87-2133
| | - Masayoshi Zaitsu
- Department of Public Health, School of Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan; (M.Z.); (Y.H.); (T.S.); (G.K.)
| | - Izumi Oki
- Division of Cancer Information and Prevention, Tochigi Cancer Center, Utsunomiya, Tochigi 320-0834, Japan;
| | - Yasuo Haruyama
- Department of Public Health, School of Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan; (M.Z.); (Y.H.); (T.S.); (G.K.)
| | - Keiko Nishida
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan;
| | - Koji Uchiyama
- Laboratory of International Environmental Health, Center for International Cooperation, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan;
| | - Toshimi Sairenchi
- Department of Public Health, School of Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan; (M.Z.); (Y.H.); (T.S.); (G.K.)
| | - Gen Kobashi
- Department of Public Health, School of Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan; (M.Z.); (Y.H.); (T.S.); (G.K.)
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23
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Dong B, Chen L, Lin W, Su Y, Mao X, Pan D, Ruan G, Xue H, Kang Y, Sun P. Cost-effectiveness and accuracy of cervical cancer screening with a high-risk HPV genotyping assay vs a nongenotyping assay in China: an observational cohort study. Cancer Cell Int 2020; 20:421. [PMID: 32868973 PMCID: PMC7453699 DOI: 10.1186/s12935-020-01512-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/21/2020] [Indexed: 11/25/2022] Open
Abstract
Background New screening techniques may affect the optimal approaches
for the prevention of cervical cancer. We evaluated the cost-effectiveness and accuracy of alternative screening strategies to provide evidence for cervical cancer screening guidelines in China. Methods In total, 32,306 women were enrolled. The current screening with Cervista® high-risk human papillomavirus (HR-HPV) nongenotyping and cytology cotesting (Cervista® cotesting) was compared with PCR-reverse dot blot HR-HPV genotyping and cytology cotesting (PCR-RDB cotesting). All eligible participants were divided into Arm 1, in which both HR-HPV assays were performed, and Arms 2 and 3, in which the PCR-RDB HPV or Cervista® HR-HPV assay, respectively, was performed. Outcome indicators included the cases, sensitivity, negative predictive value (NPV), colposcopy referral rate and cost of identifying cervical intraepithelial neoplasia of grade 2/3 or worse (CIN2+/CIN3+). Results Among the eligible participants, 18.4% were PCR-RDB HR-HPV-positive, while 16.9% were Cervista® HR-HPV-positive, which reflects good agreement (k = 0.73). PCR-RDB cotesting identified more CIN3+ cases than Cervista® cotesting in the first round of screening in Arm 1 (37 vs 32) and Arms 2/3 (252 vs 165). The sensitivity and NPV of PCR-RDB cotesting for identifying CIN3+ in Arm 1 (sensitivity: 94.9% vs 86.5%; NPV: 99.9% vs 99.7%) and Arms 2/3 (sensitivity: 95.1% vs 80.9%; NPV: 99.9% vs 99.6%) were higher than those of Cervista® cotesting, but the cost was similar. Conclusions The PCR-RDB HR-HPV genotyping and Cervista® HR-HPV assay results were consistent. PCR-RDB cotesting possesses optimal cost-effectiveness for cervical cancer screening in China, which has the highest number of cases globally but low screening coverage.
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Affiliation(s)
- Binhua Dong
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
| | - Lihua Chen
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China
| | - Wenyu Lin
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian China
| | - Xiaodan Mao
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
| | - Diling Pan
- Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
| | - Guanyu Ruan
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
| | - Huifeng Xue
- Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
| | - Yafang Kang
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
| | - Pengming Sun
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001 Fujian People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001 Fujian People's Republic of China
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Kurokawa T, Yoshida Y, Iwanari O, Oishi T, Kasai T, Hamada M, Fujita H, Fujiwara H, Yokoyama M, Sakuragi N, Kigawa J, Suzuki M. Implementation of primary HPV testing in Japan. Mol Clin Oncol 2020; 13:22. [PMID: 32765870 PMCID: PMC7403791 DOI: 10.3892/mco.2020.2092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 06/17/2020] [Indexed: 01/22/2023] Open
Abstract
Cervical cancer screening has been shifting from primary cytology to primary HPV testing worldwide as primary HPV testing is more sensitive than primary cytology. To the best of our knowledge, the current study is the first in Japan to examine the feasibility of primary HPV testing. One of the disadvantages of this shift is that hrHPV-/≥LSIL/CIN2+ (high-risk HPV negative cancers or pre-cancerous lesions with abnormal cytology results) can be missed. The objectives of the present study are to clarify in detail CIN2+ missed by this shift and to evaluate the feasibility of primary HPV testing in Japan. Data from 115,273 women who underwent co-testing with cytology and HPV testing in cancer screening were used in the current study. The cases with hrHPV-/≥LSIL (‘hrHPV-/≥L-SIL’ include CIN2-, in contrast, ‘hrHPV-/≥L-SIL/CIN2+’ doesn't include CIN2-) were analysed in detail. Women with hrHPV-/≥LSIL comprised 0.3% of the total. The prevalence of CIN2, CIN3, SCC or cervical adenocarcinomas in the lesions with HPV-/≥LSIL was 0.03% in the cancer screening group. Only one case of 14 cervical adenocarcinomas in ≥LSIL was hrHPV-. The prevalence of cancer missed by the shift in patients >50 years of age was significantly higher compared with patients younger than 49 years. In conclusion, the prevalence of CIN2+, which might be missed by the shift from primary cytology to primary HPV testing, was remarkably low in this Japanese cancer screening. The data indicated that primary HPV testing, which was more sensitive for CIN2+ than primary cytology, was a feasible method that can be used in Japan. In particular, primary HPV testing should be introduced for women <50 years old.
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Affiliation(s)
- Tetsuji Kurokawa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Osamu Iwanari
- Department of Obstetrics and Gynecology, Shimane Prefectural Central Hospital, Izumo, Shimane 693-8555, Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Tottori University, Yonago, Tottori 683-8504, Japan
| | - Tokuzo Kasai
- Chiba Foundation for Health Promotion and Disease Prevention, Chiba 261-0002, Japan
| | | | | | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, University of Saga, Saga 849-8501, Japan
| | - Noriaki Sakuragi
- Department of Obstetrics and Gynecology, Otaru General Hospital, Otaru, Hokkaido 047-8550, Japan
| | - Junzo Kigawa
- Department of Obstetrics and Gynecology, Matsue City Hospital, Matsue, Shimane 690-8509, Japan
| | - Mitsuaki Suzuki
- Department of Obstetrics and Gynecology, Shinyurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
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Sekine M, Yamaguchi M, Kudo R, J. B. Hanley S, Hara M, Adachi S, Ueda Y, Miyagi E, Ikeda S, Yagi A, Enomoto T. Epidemiologic Profile of Type-Specific Human Papillomavirus Infection after Initiation of HPV Vaccination. Vaccines (Basel) 2020; 8:vaccines8030425. [PMID: 32751198 PMCID: PMC7563721 DOI: 10.3390/vaccines8030425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/23/2022] Open
Abstract
Organized human papillomavirus vaccination (OHPV) in Japan was introduced in 2010 for girls aged 12–16 years who were born in 1994 or later. The rate of OHPV coverage was 70–80%. However, after suspension of the government vaccination recommendation, the coverage dramatically decreased. We aim to investigate the change in prevalence of HPV infection after the initiation of HPV vaccination. We recruited females aged 20–21 years attending public cervical cancer screening from 2014 to 2017 fiscal years (April 2014 to March 2018). Residual Pap test specimens were collected for HPV testing. We compared the prevalence of HPV type-specific infection between women registered in 2014 (born in 1993–1994, including the pre-OHPV generation) and registered in 2015–2017 (born in 1994–1997, the OHPV generation). We collected 2379 specimens. The vaccination coverage figures were 30.7%, 86.6%, 88.4% and 93.7% (p < 0.01) from 2014 to 2017, respectively. The prevalence of HPV16/18 infection significantly decreased from 1.3% in 2014 to 0% in 2017 (p = 0.02). The three most prevalent types were HPV52, 16 and 56 in 2014, and HPV52, 58 and 56 in 2015–2017, respectively. HPV16 and 33 infection rates decreased. On the other hand, the HPV58 infection rate was obviously increased after OHPV from 0.3% to 2.1%. Our study demonstrates that the prevalence of HPV16/18 infection dramatically decreased and the profile of type-specific HPV infection was changed after OHPV.
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Affiliation(s)
- Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences 1-757 Asahimachi-dori, Chuo-ward, Niigata 951-8510, Japan; (M.Y.); (R.K.); (S.A.); (T.E.)
- Correspondence: ; Tel.: +81-25-227-2320
| | - Manako Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences 1-757 Asahimachi-dori, Chuo-ward, Niigata 951-8510, Japan; (M.Y.); (R.K.); (S.A.); (T.E.)
| | - Risa Kudo
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences 1-757 Asahimachi-dori, Chuo-ward, Niigata 951-8510, Japan; (M.Y.); (R.K.); (S.A.); (T.E.)
| | - Sharon J. B. Hanley
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan;
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan;
| | - Sosuke Adachi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences 1-757 Asahimachi-dori, Chuo-ward, Niigata 951-8510, Japan; (M.Y.); (R.K.); (S.A.); (T.E.)
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; (Y.U.); (A.Y.)
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan;
| | - Sayaka Ikeda
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan;
| | - Asami Yagi
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; (Y.U.); (A.Y.)
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences 1-757 Asahimachi-dori, Chuo-ward, Niigata 951-8510, Japan; (M.Y.); (R.K.); (S.A.); (T.E.)
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26
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Fang L, Lin X, Yang Y, Song Z, Ding X, Tan L, Gao P. Genetic variability, phylogeny and functional implication of the long control region in human papillomavirus type 16, 18 and 58 in Chengdu, China. Virol J 2020; 17:106. [PMID: 32677948 PMCID: PMC7364514 DOI: 10.1186/s12985-020-01349-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/03/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Long control region (LCR) of human papillomavirus (HPV) has shown multiple functions on regulating viral transcription. The variations of LCR related to different lineages/sub-lineages have been found to affect viral persistence and cervical cancer progression differently. In this study, we focused on gene polymorphism of HPV16/18/58 LCR to assess the effect variations caused on transcription factor binding sites (TFBS) and provided more data for further study of LCR in Southwest China. METHODS LCR of HPV16/18/58 were amplified and sequenced to do polymorphic and phylogenetic anlysis. Sequences of each type were aligned with the reference sequence by MEGA 6.0 to identify SNPs. Neighbor-joining phylogenetic trees were constructed using MEGA 6.0. Transcription factor binding sites were predicted by JASPAR database. RESULTS The prevalence of these three HPVs ranked as HPV16 (12.8%) > HPV58 (12.6%) > HPV18 (3.5%) in Chengdu, Southwest China. 59 SNPs were identified in HPV16-LCR, 18 of them were novel mutations. 30 SNP were found in HPV18-LCR, 8 of them were novel. 55 SNPs were detected in HPV58-LCR, 18 of them were novel. Also, an insertion (CTTGTCAGTTTC) was detected in HPV58-LCR between position 7279 and 7280. As shown in the neighbor-joining phylogenetic trees, most isolates of HPV16/18/58 were clustered into lineage A. In addition, one isolate of HPV16 was classified into lineage C and 3 isolates of HPV58 were classified as lineage B. JASPAR results suggested that TFBS were potentially influenced by 7/6 mutations on LCR of HPV16/18. The insertion and 5 mutations were shown effects in LCR of HPV58. CONCLUSION This study provides more data for understanding the relation among LCR mutations, lineages and carcinogenesis. It also helps performing further study to demonstrate biological function of LCR and find potential marker for diagnosis and therapy.
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Affiliation(s)
- Liyuan Fang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China
| | - Xiaoli Lin
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China
| | - Yasi Yang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China
| | - Zhilin Song
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China
| | - Xianping Ding
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China.
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China.
| | - Liping Tan
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China
| | - Peng Gao
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, People's Republic of China
- Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Chongqing, People's Republic of China
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27
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Aykut Tuncer H, Tuncer SF. The effect of age On cervical cancer screening in women aged 20-29. Acta Clin Croat 2020; 59:277-284. [PMID: 33456115 PMCID: PMC7808238 DOI: 10.20471/acc.2020.59.02.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
No definite consensus exists currently regarding the appropriate age at which to start cervical cancer screening. We analyzed the effectiveness of age in abnormal histology outcomes in women aged 20-29. Data on women aged 20-29 having undergone opportunistic cervical cancer screening with cytology during the 2014-2019 period were retrospectively reviewed. Based on cytology outcomes, human papillomavirus test results (if present), age and clinical decision, patients underwent either colposcopy or observation. The effects of age and other epidemiologic factors on histologic diagnoses of cervical intraepithelial neoplasia (CIN) or cancer [CIN (+)] were analyzed in univariate and binomial logistic regression analyses. Among 1649 women, CIN (+) lesions were observed in 61 (3.7%) women. The occurrence of CIN (+) lesions increased 1.149 times each year; thus, women aged 25-29 were more likely to have CIN (+) than those aged 20-24 (4.4% vs. 2.1%; p=0.019). A significant determinant of CIN (+) was the increase in age, i.e. women aged 20-29. Accordingly, considering age is crucial for the diagnosis of CIN (+) in cancer screening.
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Affiliation(s)
| | - Serap Fırtına Tuncer
- 1Department of Obstetrics and Gynecology, Division of Gynecological Oncology, Akdeniz University School of Medicine Hospital, Antalya, Turkey; 2Department of Obstetrics and Gynecology, Antalya Education & Research Hospital, Antalya, Turkey
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28
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Onuki M, Matsumoto K, Iwata T, Yamamoto K, Aoki Y, Maenohara S, Tsuda N, Kamiura S, Takehara K, Horie K, Tasaka N, Yahata H, Takei Y, Aoki Y, Kato H, Motohara T, Nakamura K, Ishikawa M, Kato T, Yoshida H, Matsumura N, Nakai H, Shigeta S, Takahashi F, Noda K, Yaegashi N, Yoshikawa H. Human papillomavirus genotype contribution to cervical cancer and precancer: Implications for screening and vaccination in Japan. Cancer Sci 2020; 111:2546-2557. [PMID: 32372453 PMCID: PMC7385338 DOI: 10.1111/cas.14445] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/24/2022] Open
Abstract
To obtain baseline data for cervical cancer prevention in Japan, we analyzed human papillomavirus (HPV) data from 5045 Japanese women aged less than 40 years and diagnosed with cervical abnormalities at 21 hospitals during 2012‐2017. These included cervical intraepithelial neoplasia grade 1 (CIN1, n = 573), CIN2‐3 (n = 3219), adenocarcinoma in situ (AIS, n = 123), and invasive cervical cancer (ICC, n = 1130). The Roche Linear Array was used for HPV genotyping. The HPV type‐specific relative contributions (RCs) were estimated by adding multiple infections to single types in accordance with proportional weighting attributions. Based on the comparison of type‐specific RCs between CIN1 and CIN2‐3/AIS/ICC (CIN2+), RC ratios were calculated to estimate type‐specific risks for progression to CIN2+. Human papillomavirus DNA was detected in 85.5% of CIN1, 95.7% of CIN2‐3/AIS, and 91.2% of ICC. Multiple infections decreased with disease severity: 42.9% in CIN1, 40.4% in CIN2‐3/AIS, and 23.7% in ICC (P < .0001). The relative risk for progression to CIN2+ was highest for HPV16 (RC ratio 3.78, 95% confidence interval [CI] 3.01‐4.98), followed by HPV31 (2.51, 1.54‐5.24), HPV18 (2.43, 1.59‐4.32), HPV35 (1.56, 0.43‐8.36), HPV33 (1.01, 0.49‐3.31), HPV52 (0.99, 0.76‐1.33), and HPV58 (0.97, 0.75‐1.32). The relative risk of disease progression was 1.87 (95% CI, 1.71‐2.05) for HPV16/18/31/33/35/45/52/58, but only 0.17 (95% CI, 0.14‐0.22) for HPV39/51/56/59/66/68. Human papillomavirus 16/18/31/33/45/52/58/6/11 included in a 9‐valent vaccine contributed to 89.7% (95% CI, 88.7‐90.7) of CIN2‐3/AIS and 93.8% (95% CI, 92.4‐95.3) of ICC. In conclusion, our data support the Japanese guidelines that recommend discriminating HPV16/18/31/33/35/45/52/58 genotypes for CIN management. The 9‐valent vaccine is estimated to provide over 90% protection against ICC in young Japanese women.
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Affiliation(s)
- Mamiko Onuki
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Takashi Iwata
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | | | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Shoji Maenohara
- Gynecology Service, NHO Kyushu Cancer Center, Fukuoka, Japan
| | - Naotake Tsuda
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Shoji Kamiura
- Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Koji Horie
- Department of Gynecology, Saitama Cancer Center, Saitama, Japan
| | - Nobutaka Tasaka
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hideaki Yahata
- Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuji Takei
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Takeshi Motohara
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Keiichiro Nakamura
- Department of Obstetrics and Gynecology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Kato
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine and Faculty of Medicine, Sapporo, Japan
| | - Hiroyuki Yoshida
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Noriomi Matsumura
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Shogo Shigeta
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Fumiaki Takahashi
- Division of Medical Engineering, Department of Information Science, Iwate Medical University, Morioka, Japan
| | | | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroyuki Yoshikawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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29
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Impact of HPV vaccine hesitancy on cervical cancer in Japan: a modelling study. LANCET PUBLIC HEALTH 2020; 5:e223-e234. [DOI: 10.1016/s2468-2667(20)30010-4] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/16/2019] [Accepted: 01/17/2020] [Indexed: 12/13/2022]
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30
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Kudo R, Yamaguchi M, Sekine M, Adachi S, Ueda Y, Miyagi E, Hara M, Hanley SJB, Enomoto T. Bivalent Human Papillomavirus Vaccine Effectiveness in a Japanese Population: High Vaccine-Type-Specific Effectiveness and Evidence of Cross-Protection. J Infect Dis 2019; 219:382-390. [PMID: 30299519 PMCID: PMC6325350 DOI: 10.1093/infdis/jiy516] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/03/2018] [Indexed: 01/22/2023] Open
Abstract
Background Proactive recommendations for human papillomavirus (HPV) vaccines in Japan have been suspended for 5 years because of safety concerns. While no scientific evidence exists to substantiate these concerns, one reason given for not reinstating recommendations is the lack of reliable vaccine effectiveness (VE) data in a Japanese population. This study reports the VE of the bivalent HPV vaccine in Japanese women aged 20–22 years. Methods During cervical screening between 2014 and 2016, women had Papanicolaou smears and HPV tests performed and provided data about their sexual history. Estimates of VE for vaccine-targeted HPV type 16 (HPV16) and 18 and cross-protection against other types were calculated. Results Overall, 2197 women were tested, and 1814 were included in the analysis. Of these, 1355 (74.6%) were vaccinated, and 1295 (95.5%) completed the 3-dose schedule. In women sexually naive at vaccination, the pooled VEs against HPV16 and 18 and for HPV31, 45, and 52 were 95.5% (P < .01) and 71.9% (P < .01), respectively. When adjusted for number of sex partners and birth year, pooled VEs were 93.9% (P = .01) and 67.7% (P = .01) for HPV16 and 18 and HPV31, 45, and 52, respectively. Conclusions The bivalent HPV vaccine is highly effective against HPV16 and 18. Furthermore, significant cross-protection against HPV31, 45, and 52 was demonstrated and sustained up to 6 years after vaccination. These findings should reassure politicians about the VE of bivalent HPV vaccine in a Japanese population.
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Affiliation(s)
- Risa Kudo
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Manako Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sosuke Adachi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Sharon J B Hanley
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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31
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Taniguchi M, Ueda Y, Yagi A, Ikeda S, Endo M, Tomimatsu T, Nakayama T, Sekine M, Enomoto T, Kimura T. Cervical cancer screening rate differs by HPV vaccination status: An interim analysis. Vaccine 2019; 37:4424-4426. [PMID: 31272873 DOI: 10.1016/j.vaccine.2019.06.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/27/2019] [Accepted: 06/19/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The incidence of cervical cancer has been increasing, especially in younger generation, in Japan. The females born between 1994 and 1999, who achieved rates of HPV vaccination approaching 70%, have become the target of cervical cancer screening programs. Here, we have analyzed the cervical cancer screening rates among the vaccinated and unvaccinated women. METHODS The survey data for cervical cancer screening at age 20 in FY 2015 was derived from two cities, Toyonaka and Iwaki. RESULTS Among 2,727 females, in Toyonaka and Iwaki, who were born in FY 1995 and targeted in FY 2015 at age 20 for cervical cancer screening, their HPV vaccination rate was 64.2% (1,753/2,727). The screening rate was 6.4% (112/1,753) in the vaccinated and 3.9% (38/974) in the unvaccinated. This difference was statistically significant (p < 0.01). CONCLUSIONS We have demonstrated that HPV-vaccinated females tended to be effectively protected from future cervical cancer than the unvaccinated.
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Affiliation(s)
- Mariko Taniguchi
- Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yutaka Ueda
- Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Asami Yagi
- Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Sayaka Ikeda
- Dept. of Gynecology, International University of Health and Werfare Mita Hospital, 1-4-3 Mita, Minato-ku Tokyo, 108-8329 Japan
| | - Masayuki Endo
- Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takuji Tomimatsu
- Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tomio Nakayama
- Center for Public Health Sciences, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Masayuki Sekine
- Dept. of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Takayuki Enomoto
- Dept. of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Tadashi Kimura
- Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
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32
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Karube A, Saito F, Nakamura E, Shitara A, Ono N, Konno M, Tamura D, Nagao D. Reduction in HPV 16/18 prevalence among young women following HPV vaccine introduction in a highly vaccinated district, Japan, 2008-2017. J Rural Med 2019; 14:48-57. [PMID: 31191766 PMCID: PMC6545435 DOI: 10.2185/jrm.2986] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/01/2018] [Indexed: 11/27/2022] Open
Abstract
Objective: Human papillomavirus (HPV) vaccination was introduced in Japan in
April 2013, as a national immunization program for girls aged 12–16 years, after an
initial introduction in 2010 as a public-aid program for girls aged 13–16 years. The
Yuri-Honjo district had the highest vaccine coverage among women aged 17–51 years in 2017,
due to the original public-aid program. The aim of this study was to evaluate the
differences in the vaccine types of HPV16/18 infections between 2008–2012 (pre-vaccine
era) and 2013–2017 (vaccine era). Materials and Methods: We evaluated whether HPV vaccination was associated
with a decrease in the prevalence of HPV16/18 and high-risk HPV and the incidence of
HPV-associated cervical lesions. A total of 1,342 women aged 18–49 years, covering both
the pre-vaccine and vaccine eras, who visited Yuri Kumiai General Hospital and underwent
HPV genotype tests from June 2008 to December 2017 were compared. Results: Among women aged 18–24 years with higher vaccine coverage (68.2%),
the prevalence of HPV16/18 and high-risk HPV decreased from 36.7% and 69.4%, respectively,
in the pre-vaccine era to 5.8% and 50.0%, respectively, in the vaccine era (p=0.00013 and
p=0.047, respectively). Among those with cervical intraepithelial neoplasia grade 2− and
grade 2+, HPV16/18 prevalence decreased from 30.0% to 2.7% (p=0.0018) and from 81.8% to
36.4% (p=0.030), respectively. In this age group, the rate of HPV16/18 positivity
decreased significantly. Among age groups with lower vaccine coverage, HPV prevalence did
not significantly differ between the two eras. Conclusion: The prevalence of HPV16/18 and high-risk HPV significantly
decreased in women aged 18–24 years, most of whom were vaccinated. HPV vaccination
effectively reduced the prevalence of HPV16/18 infections in the Yuri-Honjo district.
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Affiliation(s)
- Akihiro Karube
- Department of Obstetrics and Gynecology, Yuri Kumiai General Hospital, Japan
| | - Fumiko Saito
- Department of Obstetrics and Gynecology, Yuri Kumiai General Hospital, Japan
| | - Enami Nakamura
- Department of Obstetrics and Gynecology, Yuri Kumiai General Hospital, Japan
| | - Akihiro Shitara
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Natsuki Ono
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Megumi Konno
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Daisuke Tamura
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Daisuke Nagao
- Department of Obstetrics and Gynecology, Omagari Kosei Medical Center, Japan
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33
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Utada M, Chernyavskiy P, Lee WJ, Franceschi S, Sauvaget C, de Gonzalez AB, Withrow DR. Increasing risk of uterine cervical cancer among young Japanese women: Comparison of incidence trends in Japan, South Korea and Japanese-Americans between 1985 and 2012. Int J Cancer 2019; 144:2144-2152. [PMID: 30474210 PMCID: PMC7478999 DOI: 10.1002/ijc.32014] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/06/2018] [Accepted: 11/09/2018] [Indexed: 01/12/2023]
Abstract
In Japan, cervical cancer incidence has increased since the late 1990s especially among young women, despite a decreasing trend in most developed countries. Here, we examined age, period and birth cohort trends in cervical cancer incidence rates from 1985 to 2012. Incidence rates were ascertained using three population-based cancer registries and analyzed using Joinpoint regression and age-period-cohort models. We compared the findings in Japan to trends among Japanese-Americans in the Surveillance, Epidemiology, and End Results Registries and among women in South Korea using the Korea Central Registry. Age-standardized incidence rates in Japan decreased by 1.7% per year (95% confidence interval - 3.3%, 0.0%) until 1997 and thereafter increased by 2.6% per year (1.1%, 4.2%). Incidence rates increased among women under age 50, were stable among women aged 50-54, and decreased or remained stable among women aged 55 and over. The age-standardized incidence rate ratio by birth cohort showed a U-shaped pattern with the lowest rates in women born in the late 1930s and 1940s. In comparison, women born before 1920 and after 1970 had about double the incidence. Increasing risk in recent birth cohorts was not evident in Japanese-American or South Korean women. The trends in Japan may be attributable to increasing prevalence of human papillomavirus (HPV) infection among young women. Screening and vaccination have been shown to be highly effective and would help reverse these trends.
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Affiliation(s)
- Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Pavel Chernyavskiy
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Maryland, USA
- Department of Mathematics and Statistics, University of Wyoming, Wyoming, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | | | - Catherine Sauvaget
- Screening Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Amy Berrington de Gonzalez
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Maryland, USA
| | - Diana R. Withrow
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Maryland, USA
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Ikeda S, Ueda Y, Yagi A, Matsuzaki S, Kobayashi E, Kimura T, Miyagi E, Sekine M, Enomoto T, Kudoh K. HPV vaccination in Japan: what is happening in Japan? Expert Rev Vaccines 2019; 18:323-325. [PMID: 30768373 DOI: 10.1080/14760584.2019.1584040] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sayaka Ikeda
- a Department of Gynecology, Tama-Hokubu Medical Center , Tokyo Metropolitan Health and Medical Treatment Corporation , Higashimurayama, Tokyo , Japan
| | - Yutaka Ueda
- b Department of Obstetrics and Gynecology , Osaka University , Osaka , Japan
| | - Asami Yagi
- b Department of Obstetrics and Gynecology , Osaka University , Osaka , Japan
| | - Shinya Matsuzaki
- b Department of Obstetrics and Gynecology , Osaka University , Osaka , Japan
| | - Eiji Kobayashi
- b Department of Obstetrics and Gynecology , Osaka University , Osaka , Japan
| | - Tadashi Kimura
- b Department of Obstetrics and Gynecology , Osaka University , Osaka , Japan
| | - Etsuko Miyagi
- c Department of Obstetrics and Gynecology , Yokohama City University , Yokohama , Japan
| | - Masayuki Sekine
- d Department of Obstetrics and Gynecology , University of Niigata , Niigata , Japan
| | - Takayuki Enomoto
- d Department of Obstetrics and Gynecology , University of Niigata , Niigata , Japan
| | - Kazuya Kudoh
- a Department of Gynecology, Tama-Hokubu Medical Center , Tokyo Metropolitan Health and Medical Treatment Corporation , Higashimurayama, Tokyo , Japan
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35
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Konno R, Konishi H, Sauvaget C, Ohashi Y, Kakizoe T. Effectiveness of HPV vaccination against high grade cervical lesions in Japan. Vaccine 2018; 36:7913-7915. [PMID: 29778520 DOI: 10.1016/j.vaccine.2018.05.048] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 10/16/2022]
Abstract
The effectiveness of HPV vaccine against HSIL+ (pathologically diagnosed CIN2+) in the first cohort in Japan was investigated in 22,743 women aged 20 to 29 years (parts of national cervical cancer screening program of FY [fiscal year] 2015, the Japan Cancer Society). Vaccinated women had a statistically significant 69% lower risk of HSIL+ as compared to the unvaccinated women; the crude relative risk estimate was 0.31 (95% CI: 0.11-0.83; p-value = 0.013) by normal approximation and 0.31 (95% CI: 0.08-0.80; p-value = 0.009) by the exact Poisson regression. The effect of age was not significant (chisq = 7.7 (df = 9), p-value = 0.569) and the estimate of relative risk remained essentially intact after adjustment for age. This study brings scientific evidence on the effectiveness of HPV vaccine on development of cervical high grade lesions.
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Affiliation(s)
- Ryo Konno
- Department of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Omiya-ku, Saitama 330-8503, Japan.
| | | | - Catherine Sauvaget
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
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36
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Onuki M, Matsumoto K, Tenjimbayashi Y, Tasaka N, Akiyama A, Sakurai M, Minaguchi T, Oki A, Satoh T, Yoshikawa H. Human papillomavirus genotype and prognosis of cervical cancer: Favorable survival of patients with HPV16-positive tumors. PAPILLOMAVIRUS RESEARCH 2018; 6:41-45. [PMID: 30347290 PMCID: PMC6218653 DOI: 10.1016/j.pvr.2018.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/28/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022]
Abstract
The prognostic impact of human papillomavirus (HPV) type on invasive cervical cancer (ICC) was analyzed for 137 women treated for ICC at a single institution between 1999 and 2007. The study subjects were divided into three groups according to HPV genotype: HPV16-positive (n = 59), HPV18-positive (n = 33), and HPV16/18-negative ICC (non-HPV16/18, n = 45). The median follow-up time was 102.5 months (range, 5–179). The 10-year overall survival (10y-OS) rates in women with FIGO stage I/II disease were similar among HPV genotypes: 94.7% for HPV16 (n = 39), 95.2% for HPV18 (n = 26), and 96.4% for non-HPV16/18 (n = 29). However, the 10y-OS rates in women with FIGO stage III/IV tumors were 73.7% for HPV16 (n = 20), 45.7% for HPV18 (n = 7), and 35.7% for other types (n = 16), with significantly higher survival in HPV16-positive compared with HPV16-negative ICC (10y-OS; 73.7% vs. 39.5%, P = 0.04). This difference in FIGO stage III/IV tumors remained significant after adjusting for age and histology (hazard ratio 0.30, 95% confidence interval 0.09–0.86, P = 0.02). These results suggest that detection of HPV16 DNA may be associated with a favorable prognosis in patients with FIGO stage III/IV ICC. Given that most women with FIGO stage III/IV tumors received concurrent chemoradiotherapy, this finding may imply that HPV16-positive tumors are more chemoradiosensitive.
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Affiliation(s)
- Mamiko Onuki
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
| | - Yuri Tenjimbayashi
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Nobutaka Tasaka
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Azusa Akiyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Manabu Sakurai
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Takeo Minaguchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Akinori Oki
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan; Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hiroyuki Yoshikawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan; Ibaraki Prefectural Central Hospital, Kasama, Ibaraki 309-1793, Japan
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Tsedenbal B, Yoshida T, Enkhbat B, Gotov U, Sharkhuu E, Saio M, Fukuda T. Human papillomavirus genotyping among women with cervical abnormalities in Ulaanbaatar, Mongolia. Int J Infect Dis 2018; 77:8-13. [PMID: 30261268 DOI: 10.1016/j.ijid.2018.09.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 09/14/2018] [Accepted: 09/20/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Few studies on human papillomavirus (HPV) have been conducted in Mongolia. This study was performed to evaluate the prevalent HPV genotypes and their associations with cytology and demographic and behavioral characteristics in Mongolian women with cervical abnormalities. METHODS Exfoliated cell samples of 100 women who had a previous history of cervical abnormality were collected. Cytological interpretation was conducted microscopically and HPV genotyping was performed using the Roche Linear Array test. Study questionnaires were completed. RESULTS Overall, 25 HPV genotypes were detected in 47% of participants, and the most prevalent were HPV 16, 52, 58, and 33. Cytological examination revealed 12% of participants had atypical squamous cells of undetermined significance (ASC-US), 8% had low-grade squamous intraepithelial lesions (LSIL), 7% had high-grade squamous intraepithelial lesions (HSIL), and 14% had squamous cell carcinoma (SCC), while 59% of women had a normal cytology. HPV 16 was the most common type among women with a normal cytology and cervical cancer. However, women with cervical abnormalities including LSIL and HSIL were predominantly infected with HPV 52. Moreover, women aged <35 years had a significantly higher risk of HPV infection than those in the other age groups (p<0.05). CONCLUSIONS The prevalent trend of HPV genotypes observed in this cohort differs from that reported previously in Mongolia. These data may contribute to developing an effective strategy for cervical cancer prevention in Mongolia.
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Affiliation(s)
- Batchimeg Tsedenbal
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan; Mongolian National University of Medical Sciences, Jamyan St 3, Sukhbaatar District, Ulaanbaatar 14210, Mongolia.
| | - Tomomi Yoshida
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan.
| | - Bayarmaa Enkhbat
- Mongolian National University of Medical Sciences, Jamyan St 3, Sukhbaatar District, Ulaanbaatar 14210, Mongolia.
| | - Uyanga Gotov
- National Center for Pathology, Ministry of Health, 1st Khoroo, Sukhbaatar District, Ulaanbaatar 14210, Mongolia.
| | - Enkhtuya Sharkhuu
- Mongolian Association of Histopathology and Cytopathology, Nam Yan Ju Street, Bayanzurkh District, Ulaanbaatar 13374, Mongolia.
| | - Masanao Saio
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan.
| | - Toshio Fukuda
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan.
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38
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Sasazuki S, Inoue M, Shimazu T, Wakai K, Naito M, Nagata C, Tanaka K, Tsuji I, Sugawara Y, Mizoue T, Matsuo K, Ito H, Tamakoshi A, Sawada N, Nakayama T, Kitamura Y, Sadakane A, Tsugane S. Evidence-based cancer prevention recommendations for Japanese. Jpn J Clin Oncol 2018; 48:576-586. [PMID: 29659926 DOI: 10.1093/jjco/hyy048] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 03/23/2018] [Indexed: 12/19/2022] Open
Abstract
A comprehensive evidence-based cancer prevention recommendation for Japanese was developed. We evaluated the magnitude of the associations of lifestyle factors and infection with cancer through a systematic review of the literature, meta-analysis of published data, and pooled analysis of cohort studies in Japan. Then, we judged the strength of evidence based on the consistency of the associations between exposure and cancer and biological plausibility. Important factors were extracted and summarized as an evidence-based, current cancer prevention recommendation: 'Cancer Prevention Recommendation for Japanese'. The recommendation addresses six important domains related to exposure and cancer, including smoking, alcohol drinking, diet, physical activity, body weight and infection. The next step should focus on the development of effective behavior modification programs and their implementation and dissemination.
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Affiliation(s)
- S Sasazuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - M Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - T Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - K Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya
| | - M Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya
| | - C Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu
| | - K Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga
| | - I Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai
| | - Y Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai
| | - T Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - K Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute.,Department of Epidemiology, Nagoya University Graduate School of Medicine
| | - H Ito
- Department of Epidemiology, Nagoya University Graduate School of Medicine.,Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya
| | - A Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo
| | - N Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - T Nakayama
- Cancer Control Center, Osaka International Cancer Institute, Osaka
| | - Y Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita
| | - A Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - S Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
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Kurokawa T, Onuma T, Shinagawa A, Chino Y, Kobayashi M, Yoshida Y. The ideal strategy for cervical cancer screening in Japan: Result from the Fukui Cervical Cancer Screening Study. Cytopathology 2018; 29:361-367. [DOI: 10.1111/cyt.12576] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 02/02/2023]
Affiliation(s)
- T. Kurokawa
- Department of Gynecology and Obstetrics; Faculty of Medical Sciences; University of Fukui; Yoshida-Gun Japan
| | - T. Onuma
- Department of Gynecology and Obstetrics; Faculty of Medical Sciences; University of Fukui; Yoshida-Gun Japan
| | - A. Shinagawa
- Department of Gynecology and Obstetrics; Faculty of Medical Sciences; University of Fukui; Yoshida-Gun Japan
| | - Y. Chino
- Department of Gynecology and Obstetrics; Faculty of Medical Sciences; University of Fukui; Yoshida-Gun Japan
| | - M. Kobayashi
- Department of Tumor Pathology; Faculty of Medical Sciences; University of Fukui; Yoshida-Gun Japan
| | - Y. Yoshida
- Department of Gynecology and Obstetrics; Faculty of Medical Sciences; University of Fukui; Yoshida-Gun Japan
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40
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Aoyama-Kikawa S, Fujita H, Hanley SJB, Kasamo M, Kikuchi K, Torigoe T, Matsuno Y, Tamakoshi A, Sasaki T, Matsuura M, Kato Y, Dong P, Watari H, Saito T, Sengoku K, Sakuragi N. Comparison of human papillomavirus genotyping and cytology triage, COMPACT Study: Design, methods and baseline results in 14 642 women. Cancer Sci 2018; 109:2003-2012. [PMID: 29660849 PMCID: PMC5989866 DOI: 10.1111/cas.13608] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 04/06/2018] [Indexed: 01/12/2023] Open
Abstract
Although cytology‐based screening programs have significantly reduced mortality and morbidity from cervical cancer, the global consensus is that primary human papillomavirus (HPV) testing for cervical screening increases detection of high‐grade cervical intraepithelial neoplasia (CIN) and invasive cancer. However, the optimal triage strategy for HPV‐positive women to avoid over‐referral to colposcopy may be setting specific. As Japan requires data that have been generated domestically to modify screening guidelines, we conducted a 3‐year prospective study, COMparison of HPV genotyping And Cytology Triage (COMPACT), to evaluate the potential role of HPV16/18 partial genotyping and cytology for primary HPV screening. In total, 14 642 women aged 20 to 69 years undergoing routine screening at 3 centers in Hokkaido were enrolled. Conventional cytology and HPV testing were carried out. Women with abnormal cytology or HPV16/18 positivity underwent colposcopy. Those with 12 other high‐risk (hr) HPV types underwent repeat cytology after 6 months. Primary study endpoints were detection of high‐grade cervical disease defined as CIN2/CIN3 or greater as determined by consensus pathology. Prevalence of cytological abnormalities was 2.4%. hrHPV, HPV 16, and HPV 18 were detected in 4.6%, 0.9%, and 0.3% of women, respectively. HPV16/18 were detected in all (8/8) invasive cervical cancers and in all (2/2) adenocarcinomas in situ. Both cytological abnormalities and hrHPV positivity declined with increasing age. This is the first Japanese study to investigate the role of partial genotyping and cytology in an HPV‐based screening program. Results should help policy‐makers develop guidelines for future cervical screening programs and management of cervical abnormalities based on HPV genotype.
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Affiliation(s)
- Satomi Aoyama-Kikawa
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Women's Healthcare Center, Otaru General Hospital, Otaru, Japan
| | | | - Sharon J B Hanley
- Department of Women's Health Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | | | | | | | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Yasuhito Kato
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | - Peixin Dong
- Department of Women's Health Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Kazuo Sengoku
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | - Noriaki Sakuragi
- Women's Healthcare Center, Otaru General Hospital, Otaru, Japan.,Department of Women's Health Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan.,Department of Obstetrics and Gynecology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
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41
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Sasagawa T, Maehama T, Osaka Y, Sakamoto J, Shibata T, Fujita S, Takakura M, Takagi H. Comparison of the digene hybrid capture 2 and Roche cobas 4800 HPV tests for detection of CIN2+ in a referral population in Japan. J Med Virol 2018; 90:972-980. [PMID: 29315626 DOI: 10.1002/jmv.25025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/24/2017] [Indexed: 01/10/2023]
Abstract
To examine validity of the hybrid capture-2 and cobas 4800 HPV tests, 396 women including 188 women visiting for cancer screening, and 208 referral cases were examined with both HPV tests and the liquid-based cervical Pap test. Concordant results between the HPV assays were observed in 333 cases (coincident rates; 84.1%, kappa value; 0.682). The sensitivity for CIN2+ was 98.6% (69/70) and 82.9% (58/70) for HC2 and cobas 4800 (McNemar's test; P = 0.0026). The sensitivity for CIN3+ was 97.2% (35/36) and 83.3% (30/36) (Not significant, P = 0.0736). The specificities for CIN2+ or CIN3+ did not differ between the tests. The HPV16, 52, 18, 31, and 58 were the most common types in CIN2+ cases. Reasonable sensitivity for HPV52, and cross-hybridization with some probable high-risk HPV type such as HPV82 explain the higher sensitivity of HC2 than cobas 4800 in detection of CIN2+ in a referral population in Japan.
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Affiliation(s)
- Toshiyuki Sasagawa
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Toshiyuki Maehama
- Department of Obstetrics and Gynecology, Tomishiro Central Hospital, Tomishiro city, Okinawa, Japan
| | - Yasuhiro Osaka
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Jinichi Sakamoto
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Takeo Shibata
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Satoko Fujita
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Masahiro Takakura
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Hiroaki Takagi
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
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Okodo M, Okayama K, Teruya K, Sasagawa T. Uniplex E6/E7 PCR method detecting E6 or E7 genes in 39 human papillomavirus types. J Med Virol 2018; 90:981-988. [PMID: 29314149 DOI: 10.1002/jmv.25017] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/02/2018] [Indexed: 01/01/2023]
Abstract
We have developed a new human papillomavirus (HPV) assay using the uniplex E6/E7 polymerase chain reaction (PCR) method, which is able to detect E6 and E7 genes in 39 HPV types. We validated the assay for sensitivity and specificity using cloned HPV DNA and clinical samples. A comparative study using Genosearch-31 (GS-31) to determine HPV genotypes in clinical samples was also performed. E6 or E7 genes, measured by uniplex E6/E7 PCR, were detectable in 15 low-risk (HPV-6, -11, -40, -42, -44, -54, -55, -61, -62, -71, -74, -81, -84, -89, -90), 11 intermediate-risk (HPV-26, -30, -34, -53, -66, -67, -69, -70, -73, -82, -85), and 13 high-risk (HR) HPV types. The detection limit of this assay was 100 copies in all 39 HPV types and no cross-reactivity was observed with any type. This assay detected HPV in all 226 cervical cell samples, including 222 high-grade squamous intraepithelial lesions (HSIL) and 4 squamous cell carcinoma (SCC) cases, whereas GS-31 identified HPV in 99.6% (225/226) of the same samples. All SCC and 41.0% (90/222) of HSIL cases were infected with a single HPV type, while the remaining 59% of HSIL cases involved multiple HPV types. It was noted that high-risk and probably high-risk HPV types (HPV-66, -70 and -82) were identified, but no low-risk types were identified as a single-type infection in these HSIL and SCC cases. The uniplex E6/E7 PCR assay has high sensitivity, and can be useful tool in epidemiological studies or clinical follow-ups after surgery.
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Affiliation(s)
- Mitsuaki Okodo
- Department of Medical Technology, Faculty of Health Sciences, Kyorin University, Mitaka, Tokyo, Japan
| | - Kaori Okayama
- School of Medical Technology, Faculty of Health Science, Gumma Paz University, Gumma, Japan
| | - Koji Teruya
- Department of Health and Welfare, Faculty of Health Sciences, Kyorin University, Tokyo, Japan
| | - Toshiyuki Sasagawa
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Ishikawa, Japan
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43
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Zhang K, Liu Z, Li J, Li J, Yan J, Su Y, Li S, Li J. Analysis of human papilloma virus type 52 integration status in exfoliated cervical cells. Exp Ther Med 2017; 14:5817-5824. [PMID: 29285126 PMCID: PMC5740806 DOI: 10.3892/etm.2017.5279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 08/22/2017] [Indexed: 11/25/2022] Open
Abstract
To explore the significance of human papilloma virus type 52 (HPV52) infection and its integration in cells within cervical lesions, the expression levels of HPV52 were detected using polymerase chain reaction (PCR). The copy numbers of HPV52 E2, HPV52 E6 and the reference gene β-actin were determined by quantitative PCR to analyze the association between HPV52 integration and cervical lesions. HPV52 integration was analyzed by the amplification of papillomavirus oncogene transcripts. A total of 13 samples from 468 cases were positive for HPV52. Among the samples, 1 case with an E2/E6 ratio >1 was purely episomal, 3 cases with an E2/E6 ratio of 0 were purely integrated, and 9 cases with an E2/E6 ratio of between 0 and 1 were a mixture of integrated and episomal. With the progression of cervical disease, the prevalence of the episomal type decreased gradually, and the prevalence of the integrated (episomal and integrated) forms increased. The pure integration of HPV52 occurred in chromosomes 2, 5 and 8. These results indicate that HPV52 integration into the host genome may be a key factor in cervical lesions. Thus, patients at high risk for cervical lesions may potentially be identified by screening for HPV52 infection and integration.
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Affiliation(s)
- Ke Zhang
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Zhanjun Liu
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Ji Li
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Juan Li
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Jianghong Yan
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Yunchuan Su
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Shuying Li
- Hebei Key Laboratory for Chronic Diseases/Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Jintao Li
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124, P.R. China
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44
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A behavioral economics approach to the failed HPV vaccination program in Japan. Vaccine 2017; 35:6931-6933. [PMID: 29150210 DOI: 10.1016/j.vaccine.2017.10.064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/17/2017] [Accepted: 10/20/2017] [Indexed: 11/22/2022]
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45
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Khoo SP, Bhoo-Pathy N, Yap SH, Anwar Shafii MK, Hairizan Nasir N, Belinson J, Subramaniam S, Goh PP, Zeng M, Tan HD, Gravitt P, Woo YL. Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population. Sex Transm Infect 2017; 94:277-283. [DOI: 10.1136/sextrans-2017-053320] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/17/2017] [Accepted: 11/11/2017] [Indexed: 12/29/2022] Open
Abstract
ObjectivesCervical cancer is a largely preventable disease, and the strategic implementation of a cervical cancer prevention programme is partly dependent on the impact of human papillomavirus (HPV) infection interpreted within the context of the country’s sociodemographic attributes. The objective of this study is to determine the prevalence of cervicovaginal HPV infection among a healthy, community-based, multiethnic Malaysian population. The HPV prevalence was subsequently correlated to the individual’s sociodemographics and sexual/reproductive history. Of significance, the observed prevalence captured was in a birth cohort not included in the national school-based HPV vaccination programme.MethodsThis was a cross-sectional study where 1293 healthy women aged between 18 and 60 years were recruited via convenience sampling from five community-based clinics in Selangor, Malaysia. Cervicovaginal self-samples were obtained and DNA was extracted for HPV detection and genotyping. A comprehensive questionnaire was administered to determine the sociodemographics and behavioural patterns of participants.ResultsThe median age at enrolment was 37 years old (IQR: 30–47). In total, 86/1190 (7.2%) of the samples collected were positive for HPV infection, with the highest HPV prevalence (11.9%) detected in the subgroup of 18–24 years old. The top three most prevalent HPV genotypes were HPV 16, 52 and 58. The independent risk factors associated with higher rates of HPV infection included Indian ethnicity, widowed status and women with partners who are away from home for long periods and/or has another sexual partner.ConclusionsThe overall prevalence of HPV infection in this Malaysian multiethnic population was 7.2%, with 6.5% being high-risk genotypes. The top three most common high-risk HPV types were HPV 16, 52 and 58. This information is important for the planning of primary (HPV vaccination) and secondary (screening) cervical cancer prevention programmes in Malaysia.
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Nilyanimit P, Chansaenroj J, Karalak A, Laowahutanont P, Junyangdikul P, Poovorawan Y. Comparison of human papillomavirus (HPV) detection in urine and cervical swab samples using the HPV GenoArray Diagnostic assay. PeerJ 2017; 5:e3910. [PMID: 29038761 PMCID: PMC5637711 DOI: 10.7717/peerj.3910] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/19/2017] [Indexed: 12/02/2022] Open
Abstract
Human papillomavirus (HPV) is the leading cause of cervical cancer. Urine-based HPV testing offers a simple and non-invasive method because of its increasing acceptance. A total of 164 pairs of cervical swab and urine samples from Thai women who underwent cervical cancer screening were used for HPV testing with HPV GenoArray Diagnostic Kits. The overall concordance percentage for HPV detection in the cervical swab and urine samples was 65.2%. The HPV genotypes most commonly detected were HPV16 and HPV18. An analysis of the urine samples and a second analysis of the cervical swab samples showed that the differences in the overall HPV detection rate between women with normal and abnormal cytology were not significant (p > 0.05). Urine samples processed with the GenoArray assay is an alternative for women who decline to undergo Pap smear even though it is not ideal as the first-line screening option.
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Affiliation(s)
- Pornjarim Nilyanimit
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jira Chansaenroj
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Anant Karalak
- Department of Pathology, National Cancer Institute, Bangkok, Thailand
| | | | - Pairoj Junyangdikul
- Department of Pathology, Samitivej Srinakarin Hospital, Bangkok Hospital Group, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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47
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Morisada T, Teramoto K, Takano H, Sakamoto I, Nishio H, Iwata T, Hashi A, Katoh R, Okamoto A, Sasaki H, Nakatani E, Teramukai S, Aoki D. CITRUS, cervical cancer screening trial by randomization of HPV testing intervention for upcoming screening: Design, methods and baseline data of 18,471 women. Cancer Epidemiol 2017; 50:60-67. [DOI: 10.1016/j.canep.2017.07.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/24/2017] [Accepted: 07/30/2017] [Indexed: 10/19/2022]
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48
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Oba S, Toyoshima M, Ogata H. Association of Cervical Cancer Screening with Knowledge of Risk Factors, Access to Health Related Information, Health Profiles, and Health Competence Beliefs among Community-Dwelling Women in Japan. Asian Pac J Cancer Prev 2017; 18:2115-2121. [PMID: 28843231 PMCID: PMC5697469 DOI: 10.22034/apjcp.2017.18.8.2115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: The aim of this study was to evaluate the past attendance for cervical cancer screening with knowledge
of risk factors, access to health-related information, health profiles and health competence beliefs among Japanese
women. Methods: Women ages 25, 30, 35, 40, 45, 50, 55, and 60 were contacted cross-sectionally as part of a project
for the Japanese Ministry of Health, Labour and Welfare in Nikaho, Akita prefecture Japan between June 2010 and
March 2011, and 249 women were analyzed for the current study. The questionnaire asked about past cervical cancer
screening. Knowledge of each cervical cancer risk factor was determined on a four-point scale. A barriers to information
access scale was utilized to assess the degree of difficulty in accessing health-related information. Health profiles were
measured using the EuroQOL EQ-5D. Perceived health competence was measured using a scale (PHCS). The association
was evaluated with odds ratios with 95% confidence interval were calculated from a logistic regression analysis after
adjustment for age and potential confounders. The trend across the level was also assessed. Results: Women who knew
that sexual intercourse at young age was a risk factor were significantly more likely to have participated in cervical
cancer screening sometime in their lives (p for trend =0.02). Women who had pain/discomfort and those who had
anxiety/depression were significantly more likely to have participated in cervical screening within the past two years
(odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04–3.94; OR: 2.32, 95% CI: 1.05–5.16, respectively). Women
with higher PHCS were significantly more likely to have attended for cervical screened at some point in their lives
(p=0.04). Conclusion: This study observed that specific knowledge of cervical cancer risk factors, health profiles and
PHCS were associated with the past attendance for cervical cancer screening among women in a community. Further
researches are warranted.
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Affiliation(s)
- Shino Oba
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, Japan.
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49
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Tenjimbayashi Y, Onuki M, Hirose Y, Mori S, Ishii Y, Takeuchi T, Tasaka N, Satoh T, Morisada T, Iwata T, Miyamoto S, Matsumoto K, Sekizawa A, Kukimoto I. Whole-genome analysis of human papillomavirus genotypes 52 and 58 isolated from Japanese women with cervical intraepithelial neoplasia and invasive cervical cancer. Infect Agent Cancer 2017; 12:44. [PMID: 28785305 PMCID: PMC5545048 DOI: 10.1186/s13027-017-0155-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/27/2017] [Indexed: 11/10/2022] Open
Abstract
Background Human papillomavirus genotypes 52 and 58 (HPV52/58) are frequently detected in patients with cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC) in East Asian countries including Japan. As with other HPV genotypes, HPV52/58 consist of multiple lineages of genetic variants harboring less than 10% differences between complete genome sequences of the same HPV genotype. However, site variations of nucleotide and amino acid sequences across the viral whole-genome have not been fully examined for HPV52/58. The aim of this study was to investigate genetic variations of HPV52/58 prevalent among Japanese women by analyzing the viral whole-genome sequences. Methods The entire genomic region of HPV52/58 was amplified by long-range PCR with total cellular DNA extracted from cervical exfoliated cells isolated from Japanese patients with CIN or ICC. The amplified DNA was subjected to next generation sequencing to determine the complete viral genome sequences. Phylogenetic analyses were performed with the whole-genome sequences to assign variant lineages/sublineages to the HPV52/58 isolates. The variability in amino acid sequences of viral proteins was assessed by calculating the Shannon entropy scores at individual amino acid positions of HPV proteins. Results Among 52 isolates of HPV52 (CIN1, n = 20; CIN2/3, n = 21; ICC, n = 11), 50 isolates belonged to lineage B (sublineage B2) and two isolates belonged to lineage A (sublineage A1). Among 48 isolates of HPV58 (CIN1, n = 21; CIN2/3, n = 19; ICC, n = 8), 47 isolates belonged to lineage A (sublineages A1/A2/A3) and one isolate belonged to lineage C. Single nucleotide polymorphisms specific for individual variant lineages were determined throughout the viral genome based on multiple sequence alignments of the Japanese HPV52/58 isolates and reference HPV52/58 genomes. Entropy analyses revealed that the E1 protein was relatively variable among the HPV52 isolates, whereas the E7, E4, and L2 proteins showed some variations among the HPV58 isolates. Conclusions Among the HPV52/58-positive specimens from Japanese women with CIN/ICC, the variant distributions were strongly biased toward lineage B for HPV52 and lineage A for HPV58 across histological categories. Different patterns of amino acid variations were observed in HPV52 and HPV58 across the viral whole-genome. Electronic supplementary material The online version of this article (doi:10.1186/s13027-017-0155-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuri Tenjimbayashi
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.,Pathogen Genomics Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-murayama, Tokyo, 208-0011 Japan
| | - Mamiko Onuki
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Yusuke Hirose
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.,Pathogen Genomics Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-murayama, Tokyo, 208-0011 Japan
| | - Seiichiro Mori
- Pathogen Genomics Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-murayama, Tokyo, 208-0011 Japan
| | - Yoshiyuki Ishii
- Pathogen Genomics Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-murayama, Tokyo, 208-0011 Japan
| | - Takamasa Takeuchi
- Pathogen Genomics Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-murayama, Tokyo, 208-0011 Japan
| | - Nobutaka Tasaka
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tohru Morisada
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Iwata
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Shingo Miyamoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Iwao Kukimoto
- Pathogen Genomics Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashi-murayama, Tokyo, 208-0011 Japan
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50
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Awua AK, Adanu RMK, Wiredu EK, Afari EA, Severini A. Differences in age-specific HPV prevalence between self-collected and health personnel collected specimen in a cross-sectional study in Ghana. Infect Agent Cancer 2017; 12:26. [PMID: 28529541 PMCID: PMC5437497 DOI: 10.1186/s13027-017-0136-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HPV infections are ubiquitous and particularly common among sexually active young women. However, there are regional and national variations in age-specific HPV prevalence, which have implications for cervical cancer control. Data on age-specific HPV prevalences for Ghana and most sub-Saharan countries are scanty. Therefore, this study primarily sought to determine the age-specific HPV prevalence among women in a Ghanaian community and to determine whether these prevalences determined with health-personnel and self-collected specimens were comparable. METHODS In this cross-sectional study, conducted between March 2012 and March 2013, cervical specimens were collected by self- and health-personnel collection from 251 women who were between the ages of 15 and 65 years. HPV present in these specimens were genotyped by a nested-multiplex PCR and Luminex fluoro-microspheres based method. Information on the demographic, sexual and reproductive characteristics of the women were also obtained. A Chi-square test of association was employed to determine the association of the distribution of age groups with each categorised sexual and reproductive characteristic and HPV risk type's status. RESULTS The age group distribution of the participants was significantly associated with overall (χ2 = 36.1; p = 0.001), high risk (χ2 = 26.09; p = 0.002) and low risk (χ2 = 21.49; p = 0.011) HPV prevalences. The age-specific HPV prevalence pattern for each of the HPV risk types, determined with self-collected specimen, showed three peaks (at 20-24 years; 40-44 years and ≥ 55 years), while those determined with health-personnel collected specimen, showed two peaks (at 20-24 years and ≥ 55 years) for each HPV risk type's prevalence pattern. The high risk HPV prevalences determined with self-collected specimen were often higher than those determined with health-personnel specimen for the age groups between 25 and 45 years, who are mostly targeted for screening by HPV testing. Additionally, there were interesting variations in patterns of age-specific HPV genotype-specific prevalence between the two specimen collection methods. CONCLUSIONS The usefulness of self-collected specimen for high risk HPV burden determination and the existence of a two peaked and three peaked age-specific HPV prevalences in Ghana have been clearly indicated.
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Affiliation(s)
- Adolf K. Awua
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Cellular and Clinical Research Centre, Radiological and Medical Sciences Research Institute, GAEC, Accra, Ghana
| | - Richard M. K. Adanu
- Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Edwin K. Wiredu
- Department of Pathology, School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Edwin A. Afari
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alberto Severini
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB Canada
- University of Manitoba, Winnipeg, MB Canada
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