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Tekkesin N, Goktas S, Alkis V, Tekkesin E, Goktas P. Male Human Papillomavirus Infection and Genotyping in Turkey. Asian Pac J Cancer Prev 2023; 24:4187-4193. [PMID: 38156854 PMCID: PMC10909111 DOI: 10.31557/apjcp.2023.24.12.4187] [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: 07/21/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND High-risk (HR) Human Papillomavirus (HPV) has been shown to play an important role in men in various locations in Turkey. This study aims to screen the male persistent infection with the high-risk human papillomavirus (HPV) genotype status in Turkey to provide a reference basis for formulating prevention strategies for the development of genitourinary tract neoplasia. METHODS The HPV QUANT-21 Quantitative RT-PCR Kit® was used to identify and quantify low-risk HPV (HPV 6, 11, 44) and high-risk (HPV 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82) from male individuals in Turkey. RESULTS Of the total 1304 samples, 473 were positive for at least one HPV genotype, with an overall frequency of 36.2%. Two-hundred fifty-four patients were positive only for one or more LR HPV genotypes (54%), and 219 patients were positive for one or more HR HPV genotypes (46%). The LR HPV genotype frequency was 53.7%, while the HR HPV genotype frequency was 46.3%. Our technology had the positive advantage of being able to calculate concentrations for each genotype. Genotype 51 was second in frequency but had the highest average concentration of 5.38 log (copies/sample). CONCLUSION The presence and genotype of the virus before HPV vaccination are also of increasing importance. The data obtained will serve as a guide for prevention strategies, especially vaccination. Based on our findings there is a need of new estimates of the efficacy of currently available HPV vaccines and to develop a screening program to prevent and reduce the incidence of genitourinary tract neoplasias in Turkey. Further studies are planned to measure and define the high levels of infection that may lead to the development of cervical tumors. Using this technique, it may be possible to make clinical decisions about the extent of cytological alterations.
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Affiliation(s)
- Nilgun Tekkesin
- Department of Clinical Biochemistry, Uskudar University, Istanbul, Turkey.
| | - Safak Goktas
- School of Medicine, Maltepe University, Istanbul, Turkey.
| | - Veysi Alkis
- Gelisim Laboratories Molecular Technician, Istanbul, Turkey.
| | - Efe Tekkesin
- School of Medicine, Istinye University, Istanbul, Turkey.
| | - Pasa Goktas
- Director of Special Gelisim Laboratories, Istanbul, Turkey.
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Kulkarni SP, Paliwal S, Kosta S. Genotypic Diversity of Human Papillomavirus (HPV) Types and Its Prevalence With Cervical Cancer (CC) in Central India. Cureus 2023; 15:e35227. [PMID: 36968914 PMCID: PMC10032616 DOI: 10.7759/cureus.35227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
Background The high-risk human papillomavirus (hr-HPV) is linked with cervical cancer (CC), and the distinct proportional impact of each genotype on the prevalence of the disease depends on the area. Therefore, to find out the prevalence of HPV types in women with cervical lesions from central India, the current study was performed. Methodology Age, prior history of cervical disease, changes in lifestyle characteristics, menopausal status, and HPV vaccination status were all carefully gathered at enrollment for the 736 women (aged 21 to 60) screened in this cross-sectional study who were referred for regular screening of cervical during the study period. Cervix was examined for lesions by visual inspection with acetic acid (VIA) screening and HPV genotypes were identified by real-time polymerase chain reaction (RT-PCR). Result Among 736 women 215 (29.2%) were in the 21-30 age group, 321 (43.6%) in the 31-40 age group, 132 (17.9%) in the 41-50 age group, and 68 (9.3%) cases in >50 age group. According to education, there were 398 (54.1 %) with primary and below education, 115 (15.6%) with secondary education, and 223 (30.3%) with college and above education. HPV-16, 18, 31, and 45 each had a prevalence of 29.6%, 11.1%, 12.9%, and 9.2%, respectively, while the overall prevalence of hr-HP) was present in populations at 7.3% in individuals and 37.0% in combinations. Hr-HPV infection and prevalence were provocatively more (79.6%) in the VIA-positivity rate with CC. Conclusion Individual hr-HPV genotype prevalence was shown to be lower than with combinations (HPV-16, 18, 31, and 45). The HPV-16 genotype was identified to have a higher prevalence than HPV-18, 31, and 45. However, more awareness programs are needed for a better understanding of CC and HPV testing in central India.
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Lan Z, Zhang J, Li H, He R, Zhao Q, Yang F. Prevalence of human papillomavirus genotypes and related cervical morphological results in southern Hunan Province of China, 2018-2020: Baseline measures at a tertiary institution prior to mass human papillomavirus vaccination. Front Microbiol 2023; 13:1094560. [PMID: 36687652 PMCID: PMC9845708 DOI: 10.3389/fmicb.2022.1094560] [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: 11/10/2022] [Accepted: 12/08/2022] [Indexed: 01/06/2023] Open
Abstract
Background Human papillomavirus (HPV) infection is closely correlated with cervical lesions. However, the HPV prevalence varies among different districts. This retrospective study investigated the HPV genotype distribution and its relationship with cervical lesions in southern Hunan Province. Methods The database at our Pathology Department was searched for HPV and morphological results during 2018-2020 were reviewed. A total of 49,955 gynaecological inpatients and outpatients, each of whom underwent HPV testing based on the amplification of L1 sequence and reverse dot blot hybridization, were included in this study. Available cytology and relevant histological examination results were reviewed. Enrolled cases were categorized into seven groups based on their age. Household registry and educational level were evaluated. Results Seven thousand two hundred eighty-six females were positive for HPV and the overall HPV positivity rate was 14.59%. The top five most prevalent HPV genotypes were HPV52, 16, 58, 53 and 51 (22.98%, 17.54%, 14.29%, 7.47%, and 5.70%, respectively). The HPV prevalence curve specific to the seven age groups showed a bimodal distribution. High school education or blow and rural residence served as risk factors for HPV infection. Single infection was the main type of HPV infection, and multiple infections occurred in 21.92% of the infected women. Of 3,148 cases had cytological results, 1,149 (36.50%) had abnormal cytological abnormalities. Among 2,833 participants with histological examination, 2000 (70.60%) had cervical abnormalities. Cytological and pathological abnormalities were mainly associated with infection with HPV16, 52 and 58. Further analysis found that HPV16, 58, 52 and 33 were the main genotypes associated with high-grade squamous lesions (HSIL) and that HPV16, 31, 33 and 58 were independent risk factors for HSIL (odd ratio [OR] = 1.70, 1.99, 2.59, 2.29; 95% CI = 1.41-2.03, 1.17-3.41, 1.88-3.59, 1.85-2.82; all p < 0.05). HPV16, 58, 52, 18 and 33 were the most frequent genotypes detected in squamous cell carcinoma (SCC) patients, and HPV16 and 18 were independent risk factors for cervical carcinomas (OR = 6.72;95% CI = 5.48-8.25; p < 0.001; OR = 1.67, 95% CI = 1.22-2.30; p = 0.001). Conclusion This retrospective study demonstrated the prevalence and the distribution characteristics of HPV infection and its correlation with cervical lesions in southern Hunan Province. The comprehensive results of this survey can guide HPV vaccine research to protect against some common genotypes in China.
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Affiliation(s)
- Zhihua Lan
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Jing Zhang
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Hongtao Li
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Rongfang He
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Qiang Zhao
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Fang Yang
- Department of Anorectal Surgery of Traditional Chinese Medicine, The First Affiliated Hospital, University of South China, Hengyang, China,*Correspondence: Fang Yang, ✉
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Zhang M, Chen G, Dai X, Wu Z, Huang H, Zheng Y. Prevalence of human papillomavirus in Wenzhou, China: a cross-sectional study of 127 938 outpatient women. BMJ Open 2022; 12:e066698. [PMID: 36581425 PMCID: PMC9806085 DOI: 10.1136/bmjopen-2022-066698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Understanding the prevalence and genotype distribution of human papillomavirus (HPV) is critical for managing HPV vaccination programmes. Using a retrospective cross-sectional study, we examined long-term trends of HPV prevalence in Wenzhou, a coastal city in China. SETTING AND PARTICIPANTS Cervical exfoliated cells were collected from 127 938 women who underwent cervical cancer screening at the gynaecology outpatient clinic of Wenzhou People's Hospital from January 2011 to December 2020. HPV infections and genotypes were determined. The HPV genotypes were 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 6, 11, 42, 43, 44 and 81. From 2011 to 2014, we used PCR and inflow hybridisation for typing assays. In 2015-2020, HPV genotyping was performed on the collected specimens using PCR and flow fluorescence hybridisation. RESULTS The overall prevalence of HPV infection was 17.8%. Across age groups, the prevalence fluctuated between 15.9% and 37.4%, with two peaks in the ≤20 and ≥51 year groups. The annual prevalence varied between 12.2% and 28.8%, with a significant decrease in 2011-2018 and a flat trend in 2018-2020. The five most common HPV genotypes were HPV52 (3.6%), 16 (3.0%), 58 (2.5%), 53 (1.9%) and 81 (1.3%). The prevalence of high-risk gene subtypes HPV56, 59 and the low-risk subtype HPV44 increased. Single HPV infection was the most common. CONCLUSION The prevalence of HPV in Wenzhou is low to mid-range; however, the high-risk genetic subtypes HPV56 and 59 have increased in recent years. We need to promote HPV vaccination and increase education regarding safer sex.
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Affiliation(s)
- Mengqi Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Gang Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xuchao Dai
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Zhigang Wu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Huang
- Zhejiang Provincial Key Laboratory of Watershed Sciences and Health, Wenzhou Medical University, Wenzhou, China
| | - Yuanyuan Zheng
- Department of Pathology, Wenzhou People's Hospital, Wenzhou, China
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Li ZF, Jia XH, Ren XY, Wu BK, Chen W, Feng XX, Wang LB, Qiao YL. Comparison of the performance of HPV DNA chip test and HPV PCR test in cervical cancer screening in rural China. Front Microbiol 2022; 13:1040285. [PMID: 36439807 PMCID: PMC9691997 DOI: 10.3389/fmicb.2022.1040285] [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: 09/09/2022] [Accepted: 10/21/2022] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the performance of two different principles of HPV testing in primary cervical cancer screening and ASC-US triage in rural areas. METHODS 3,328 and 3,913 women were enrolled in Shanxi, China in 2017 and 2018, respectively, and screened using liquid-based cytology and different HPV tests with a 4-year follow-up. Different screening methods commonly used in clinical practice were evaluated. RESULTS In the HPV PCR test cohort, the prevalence of HPV infection was 14.90%. A total of 38 cases of CIN2+ were identified at baseline, 2 of which were in the HPV-negative cohort and the rest in the HPV-positive cohort (2 = 186.85, p < 0.001). Fifty-three cases of CIN2+ were accumulated over 4 years. The HPV infection rate in the HPV DNA chip test cohort was 21.10%. A total of 26 CIN2+ cases were identified at baseline, all in the HPV-positive population (2 = 92.96, p < 0.001). 54 CIN2+ cases were cumulative over 4 years. At 4-year follow-up, HPV-negative results were significantly more protective against cervical intraepithelial neoplasia grade 2 or worse (CIN2+) than normal cytologic results at baseline. HPV screening was more sensitive and specific than cytologic screening (using ASC-US as the threshold) and performed better on the HPV DNA microarray test. In addition, compared with HPV 16/18 testing, sensitivity increases and specificity decreases when using HPV testing for cytologic ASC-US triage, regardless of which HPV test is used. CONCLUSION In the rural areas where we implemented the study, HPV tests performed well for screening than LBC and HPV DNA chip testing performed better than HPV PCR testing in the screening cohort. Optimal screening was achieved technically when used in combination with LBC for ASC-US population triage, without thinking the feasibility for resource availability.
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Affiliation(s)
- Zhi-Fang Li
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Xin-Hua Jia
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Xin-Yu Ren
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Bei-Ke Wu
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Wen Chen
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiang-Xian Feng
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Li-Bing Wang
- Department of Pathology, Affiliated Heping Hospital of Changzhi Meidical College, Changzhi, China
| | - You-Lin Qiao
- Center for Global Health, School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yu YQ, Hao JQ, Mendez MJG, Mohamed SB, Fu SL, Zhao FH, Qiao YL. The Prevalence of Cervical HPV Infection and Genotype Distribution in 856,535 Chinese Women with Normal and Abnormal Cervical Lesions: A Systemic Review. J Cytol 2022; 39:137-147. [PMID: 36605868 PMCID: PMC9809425 DOI: 10.4103/joc.joc_42_22] [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: 02/24/2022] [Revised: 04/27/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022] Open
Abstract
Cervical cancer is the commonest cancer affecting women worldwide. During the last decades, the incidence and mortality rates of cervical cancer have increased in China. This research aims to assess the overall and genotype-specific prevalence of the human papillomavirus (HPV) infection among Chinese women with normal cervix, considering age, and geographic location. We selected studies about HPV prevalence in women from Chinese in Mainland China with normal cervix and abnormal cervical lesions, published between January 1995 and December 2020. The HPV prevalence was analyzed using meta-analysis based on the following: cytological and histological diagnoses, regions, and ages. The overall HPV prevalence in 856,535 women was 14.3%, 95% confidence interval (CI) and it increased from 8.2% to 16.5% in studies published from 2006 to 2020. The prevalence of high-risk (HR) and low-risk (LR) HPV types was 11.3% and 2.7%, respectively. The commonest types of HPV in women from Mainland China were HPV 16 (2.6%), 52 (2.4%), 58 (1.7%), 18 (0.9%), and 33 (0.8%). According to the geographical analysis, the prevalence of different HPV genotypes varied by region, Central China had the highest overall HPV prevalence. HPV16 was the commonest type in all the regions except in South China and East China, where HPV52 was found to be common. Regarding diagnosis, the HPV infection led to cervical cancer diagnosis by cytology and histology with 90.1% and 91.5% rates, respectively. HPV16 and HPV18 were common types associated with cervical cancer diagnosed by cytology and histology. HPV 16, 58, 52, 18, and 33 were the commonest types found in women with normal cervixes from Mainland China. The prevalence of different HPV genotypes varied by age group and region.
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Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Jin-Qi Hao
- Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Maria J. G. Mendez
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Dalian Medical University, Dalian City, China
| | - S Bangura Mohamed
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Dalian Medical University, Dalian City, China
| | - Shi-Lan Fu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang-Hui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences and Peking Union Medical College School of Population Medicine and Public Health, Beijing, China
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Yu YQ, Jiang MY, Dang L, Feng RM, Bangura MS, Chen W, Qiao YL. Changes in High-Risk HPV Infection Prevalence and Associated Factors in Selected Rural Areas of China: A Multicenter Population-Based Study. Front Med (Lausanne) 2022; 9:911367. [PMID: 35903319 PMCID: PMC9319042 DOI: 10.3389/fmed.2022.911367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe Chinese government has taken action to prevent cervical cancer by implementing the National Cervical Cancer Screening Programme in Rural Areas (NACCSPRA), which was launched in 2009. Numerous studies have demonstrated that long-term cervical cancer screening alters human papillomavirus (HPV) infection rates and cervical disease detection. Nearly 80 million women have been screened over 10 years, representing <30% of the target population; however, in some rural areas, such as Ordos City of Inner Mongolia Autonomous Region, Xiangyuan County of Shanxi Province, and Jinyun County, and Jingning County of Zhejiang Province, programs for prevention and treatment of cervical cancer have been implemented. Numerous studies have demonstrated that long-term cervical cancer screening alters rates of human papillomavirus (HPV) infection and cervical disease detection. In this study, we aimed to determine the infection rates of high-risk HPV (hrHPV) and the detection rate of cervical lesions; and changes in factors associated with cervical cancer, to provide scientific data to inform efforts to eliminate cervical cancer in rural areas.MethodsThis was a cross-sectional, population-based, and multi-center survey. Populations from three rural areas of China (Ordos City of Inner Mongolia Autonomous Region, Xiangyuan County of Shanxi Province, and Jinyun County and Jingning County of Zhejiang Province) were selected and 9,332 women aged 20–64 years old were invited to participate in cervical cancer screening by both cytology and HPV testing. The outcomes assessed were: infection rates with hrHPV, HPV16, 18, 16/18, and other 12 hrHPV types (HPV 31,33,35,39,45,51,52,56,58,59,66 and 68); detection rates of cytological and histological lesions; and factors associated with HPV infection.ResultsA total of 9,217 women aged 45.62 ± 8.02 years were included in this study. Infection rates with hrHPV, HPV 16, 18, 16/18, and other 12 hrHPV types were 16.3%, 3.0%, 1.5%, 4.3%, and 13.6%, respectively. There were significant differences among the age-specific HPV infection rates (P < 0.05). Infection rates with hrHPV, 16, 18, 16/18, and the other 12 hrHPV types showed a single peak infection mode, with a peak age of 56–65 years old. Age, marital status, number of live births, education level, reproductive disease history, and a history of alcohol consumption were risk factors for hrHPV infection. The detection rate of cytological abnormalities was 12.98% in the study and was higher in women older than 56 years old. The detection rates of cervical intraepithelial neoplasia CIN2+ and CIN3+ in the population were 1.45% and 0.77%, respectively. The highest incidence rates of CIN2+ and CIN3+ were 32.12% and 17.51%, respectively, in the 41–45 years old group.ConclusionInfection rates with hrHPV, HPV16, and cervical lesions among our screening population were lower than the mean level in rural areas of China. Infection rates with hrHPV, HPV16, 18, and 16/18 showed a single-peak infection pattern, with the peak age of infection being 56-65 years old. Risk factors for hrHPV infection were age, history of alcohol consumption, marital status, reproductive diseases, education level, and the number of live births. Based on these data, we recommend that cervical cancer screening be offered to women older than 30 years in rural areas, particularly those aged 41–45 years.
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Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Ming-Yue Jiang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Dang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui-Mei Feng
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Mohamed S. Bangura
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Dalian Medical University, Dalian, China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Wen Chen
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences and Peking Union Medical College School of Population Medicine and Public Health, Beijing, China
- *Correspondence: You-Lin Qiao
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Age-specific prevalence of high-risk human papillomavirus infection among women in rural China, 2016-2018. J Infect 2022; 85:e92-e93. [PMID: 35840010 DOI: 10.1016/j.jinf.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022]
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Yan X, Shen L, Xiao Y, Wang Q, Li F, Qian Y. Prevalence, characteristics, and distribution of HPV genotypes in women from Zhejiang Province, 2016-2020. Virol J 2021; 18:208. [PMID: 34670576 PMCID: PMC8527678 DOI: 10.1186/s12985-021-01676-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/12/2021] [Indexed: 02/02/2023] Open
Abstract
Objective To evaluate and understand the prevalence of HPV genotypes and characteristics of female populations in specific areas and the relationship with cervical lesions, which can effectively guide cervical cancer screening and formulate HPV vaccine prevention strategies. Methods A total of 77,443 women who visited gynecological clinics and underwent health examinations in the Second Affiliated Hospital of Zhejiang University School of Medicine during 2016–2020 were enrolled in this survey. Cervical samples were collected for HPV DNA genotyping and cervical cytology testing. Cervical biopsies were performed for patients with visible cervical abnormality or abnormal cytological results. Results The results showed the 5-year overall positive rate was 22.3%, of which the gynecology clinic group had significantly more positive results compared with the health examination group (P < 0.001). The five most common genotypes in Zhejiang Province were HPV 52, 58, CP8304, 16, and 51 (23.9%, 12.7%, 11.7%, 11.7% and 9.3%). HPV infection was age-specific, with the highest infection rate in the age group ≤ 20 compared to other age groups (P < 0.001). HPV infection was also season-specific, with the highest infection rate in spring or winter. The main HPV infection mode was single infection (P = 0.004), but patients ≤ 20 years old were more likely to develop multiple infections (51.0%). HPV 16, 52 and 58 were the main genotypes that caused cytological abnormalities and HPV16, 18, 56, 58 and 66 were independent risk factors for cervical lesions (OR = 2.352, 1.567, 2.000, 1.694, 1.889; all P < 0.05). Further analysis found HPV 16 and 18 were the main genotypes that cause cervical cancer histological abnormalities and were independent risk factors for cervical cancer (OR = 5.647, P < 0.001; OR = 3.495, P = 0.036). Conclusion This article analyzed the prevalence of distribution characteristics of HPV infection and revealed the corelation between HPV infection and cytological and histological abnormalities. Comprehensive results of this survey will help Zhejiang Province to formulate public health policies and provide evidence for future selection of specific HPV vaccines.
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Affiliation(s)
- Xiaotian Yan
- Department of Clinical Laboratory, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Lingwei Shen
- Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yufei Xiao
- Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Wang
- Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fugang Li
- Shanghai Upper Bio Tech Pharma Company Limited, Shanghai, China
| | - Yun Qian
- Department of Clinical Laboratory, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China.
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Arnold JD, Byrne ME, Monroe AK, Abbott SE. The Risk of Anal Carcinoma After Anogenital Warts in Adults Living With HIV. JAMA Dermatol 2021; 157:283-289. [PMID: 33439220 DOI: 10.1001/jamadermatol.2020.5252] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance In the US, incidence of and mortality due to anal carcinoma are rising faster than for most other cancers. Identifying populations who have a higher risk of developing anal cancers is critical to target preventive interventions. Objective To assess the risk of developing anal carcinoma in adults living with HIV who have a history of anogenital warts. Design, Setting, and Participants This longitudinal cohort study included adults living with HIV from 14 clinics in Washington, DC, and at least 18 months of follow-up. Data were collected from January 1, 2011, to March 31, 2017, and analyzed from June 1, 2019, to October 31, 2020. Exposures Development of warts in the anal or genital region identified by diagnosis codes. Main Outcomes and Measures Individuals with anal carcinoma were identified by diagnosis codes or anal biopsy results. Results A total of 6515 participants were enrolled (4720 male [72.4%] at birth; mean [SD] age, 49.9 [12.7] years), and 383 (5.9%) developed anogenital warts during the study period. Patients who were diagnosed with anogenital warts were more likely to subsequently develop anal carcinoma (17 of 383 [4.4%]) compared with participants without a history of anogenital warts (17 of 6132 [0.3%]) (P < .001). After adjusting for covariates, the odds of developing anal carcinoma were 12.79 (95% CI, 6.19-26.45; P < .001) times higher in individuals with a history of anogenital warts compared with individuals without a history of anogenital warts. Conclusions and Relevance These findings suggest that adults living with HIV who have a history of anogenital warts have a substantially increased risk of developing anal carcinoma. Clinicians should counsel individuals living with HIV who have anogenital warts on this risk.
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Affiliation(s)
- Justin D Arnold
- George Washington University School of Medicine and Health Sciences, Washington, DC.,Now with Transitional Year Residency, Riverside Community Hospital, University of California, Riverside
| | - Morgan E Byrne
- Milken Institute School of Public Health, Department of Epidemiology, George Washington University, Washington, DC
| | - Anne K Monroe
- Milken Institute School of Public Health, Department of Epidemiology, George Washington University, Washington, DC
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11
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Huber J, Mueller A, Sailer M, Regidor PA. Human papillomavirus persistence or clearance after infection in reproductive age. What is the status? Review of the literature and new data of a vaginal gel containing silicate dioxide, citric acid, and selenite. ACTA ACUST UNITED AC 2021; 17:17455065211020702. [PMID: 34096424 PMCID: PMC8785287 DOI: 10.1177/17455065211020702] [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] [Indexed: 11/15/2022]
Abstract
Cervical cancer, the third most common cancer in women, is caused in nearly all cases by a persistent infection with high-risk types of the human papillomavirus. Although human papillomavirus infections are 80%-90% transient and disappear spontaneously within 24 months, human papillomavirus infections that remain are at risk of developing cervical lesions. Different therapeutical approaches have been tested to promote the regression of low-grade lesions or prevent progression. They include the application of 5-fluorouracil, curcumin, imiquimod, interferons, Vitamin D, and others. Also, the effect of probiotics and vaginal therapy with carboxy-methyl-beta glucan was assessed. Review of the literature and presentation of the last study data are presented. Clearance of high-risk human papillomavirus seemed to be promoted by treatment with a new vaginal gel containing a highly disperse SiO2 and an anti-oxidative combination of citric acid and sodium. This gel showed, after 6 months, an improvement of cytological Pap findings (ASC-US, LSIL, ASC-H, or HSIL) in 80.9% of the participants. Similarly, there was a clearing of hr-human papillomavirus in 53% of cases after 3 months of gel administration. The percentage increased slightly in the non-treated control group from 78.3% at baseline to 83% after 3 months. The percentage of patients who were tested positive for p16/Ki67 reduced from 75% at baseline to 5.3% in the treatment group after 6 months, while the percentage decreased only slightly in the non-treated group (baseline: 91.5%; 6 months: 75.2%). The examined vaginal gel may support the healing of conspicuous cytological findings (ASC-US, LSIL, ASC-H, or HSIL) and clearance of hr-human papillomavirus positive results.
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Kudela E, Liskova A, Samec M, Koklesova L, Holubekova V, Rokos T, Kozubik E, Pribulova T, Zhai K, Busselberg D, Kubatka P, Biringer K. The interplay between the vaginal microbiome and innate immunity in the focus of predictive, preventive, and personalized medical approach to combat HPV-induced cervical cancer. EPMA J 2021; 12:199-220. [PMID: 34194585 PMCID: PMC8192654 DOI: 10.1007/s13167-021-00244-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022]
Abstract
HPVs representing the most common sexually transmitted disease are a group of carcinogenic viruses with different oncogenic potential. The immune system and the vaginal microbiome represent the modifiable and important risk factors in HPV-induced carcinogenesis. HPV infection significantly increases vaginal microbiome diversity, leading to gradual increases in the abundance of anaerobic bacteria and consequently the severity of cervical dysplasia. Delineation of the exact composition of the vaginal microbiome and immune environment before HPV acquisition, during persistent/progressive infections and after clearance, provides insights into the complex mechanisms of cervical carcinogenesis. It gives hints regarding the prediction of malignant potential. Relative high HPV prevalence in the general population is a challenge for modern and personalized diagnostics and therapeutic guidelines. Identifying the dominant microbial biomarkers of high-grade and low-grade dysplasia could help us to triage the patients with marked chances of lesion regression or progression. Any unnecessary surgical treatment of cervical dysplasia could negatively affect obstetrical outcomes and sexual life. Therefore, understanding the effect and role of microbiome-based therapies is a breaking point in the conservative management of HPV-associated precanceroses. The detailed evaluation of HPV capabilities to evade immune mechanisms from various biofluids (vaginal swabs, cervicovaginal lavage/secretions, or blood) could promote the identification of new immunological targets for novel individualized diagnostics and therapy. Qualitative and quantitative assessment of local immune and microbial environment and associated risk factors constitutes the critical background for preventive, predictive, and personalized medicine that is essential for improving state-of-the-art medical care in patients with cervical precanceroses and cervical cancer. The review article focuses on the influence and potential diagnostic and therapeutic applications of the local innate immune system and the microbial markers in HPV-related cancers in the context of 3P medicine.
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Affiliation(s)
- Erik Kudela
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Alena Liskova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Marek Samec
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Lenka Koklesova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Veronika Holubekova
- Jessenius Faculty of Medicine, Biomedical Centre Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Tomas Rokos
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Erik Kozubik
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Terezia Pribulova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Kevin Zhai
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, 24144 Doha, Qatar
| | - Dietrich Busselberg
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, 24144 Doha, Qatar
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
- European Association for Predictive, Preventive and Personalised Medicine, EPMA, 1160 Brussels, Belgium
| | - Kamil Biringer
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
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13
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Temesgen MM, Alemu T, Shiferaw B, Legesse S, Zeru T, Haile M, Gelanew T. Prevalence of oncogenic human papillomavirus (HPV 16/18) infection, cervical lesions and its associated factors among women aged 21-49 years in Amhara region, Northern Ethiopia. PLoS One 2021; 16:e0248949. [PMID: 33760866 PMCID: PMC7990306 DOI: 10.1371/journal.pone.0248949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/08/2021] [Indexed: 12/18/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is considered as the major risk factor for the development of cervical cancer, second most frequent cancer in Ethiopia. However, the magnitude of the problem and the associated factors remain unrevealed in the Amhara region. This study aimed to determine the prevalence of HPV infection and factors contributing to the progression of HPV infection to cervical cancer. Methods Facility-based cross-sectional study design was employed among women aged 21 to 49 years of age who came for routine cervical cancer screening to 4 randomly selected hospitals (2 general and 2 referral) of Amhara region from May to October, 2019. The sample size was calculated by using the single population proportion formula, proportionated to hospitals, and women were recruited consecutively. Socio demographic and clinical data were collected using a pretested questionnaire and detection of HPV infection was done using HPV test (OncoE6TM Cervical Test) specific to HPV16/18 in cervical swabs. Visual inspection with acetic acid (VIA) was used to determine cervical lesions (precancerous and cancerous). Descriptive statistics and bivariate and multivariate logistic regression were used to describe HR-HPV and cervical lesions burden and association between HR-HPV, and cervical lesions and potential risk factors. Results Among 337 women 21 to 49 years (median age of 35 years ±SD = 7.1 years) of age enrolled in the study, The overall prevalence of oncogenic HPVs (HPV16/18) and the VIA-positivity rate, possible an indicative of cervical lesions, were 7.1% and 13.1%, respectively. Logistic regression analysis showed a significant association between early age of first sexual intercourse (COR = 2.26; 95% CI: 1.0–5.05) and level of education (COR = 0.31; 95% CI: 0.12–0.78) with cervical lesions. Higher odds of HPV positivity (COR = 1.56; 95% CI: 0.59–4.11, p = 0.36) and VIA positivity (COR = 1.39; 95% CI: 0.64–3.00, p = 0.39) were observed among participants who had a history of sexually transmitted illnesses (STIs). Conclusions There was a relatively low prevalence of oncogenic HPV 16/18 and VIA-positivity in women attending four hospitals in the Amhara Region. Early age sexual contact, high parity, and being uneducated/low level of education were independently associated factors with HR-HPV infection and development of cervical lesions, highlighting the importance of prioritizing the limited HPV testing to those risk groups.
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Affiliation(s)
| | - Tefera Alemu
- Amhara Public Health Institute Dessie Branch, Dessie, Ethiopia
| | | | - Seid Legesse
- Amhara Public Health Institute Dessie Branch, Dessie, Ethiopia
| | - Taye Zeru
- Amhara Public Health Institute, Bahir Dar, Ethiopia
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14
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Yan X, Huang Y, Zhang M, Hu X, Li K, Jing M. Prevalence of human papillomavirus infection and type distribution among Uyghur females in Xinjiang, northwest China. Oncol Lett 2020; 20:25. [PMID: 32774498 PMCID: PMC7406881 DOI: 10.3892/ol.2020.11886] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/27/2020] [Indexed: 11/06/2022] Open
Abstract
Human papillomavirus (HPV) infection has a key role in the development of cervical cancer. The present study aimed to determine the HPV type distribution among females of Uyghur ethnicity in Xinjiang province, northwest China. A total of 12,165 individuals aged 30-79 years from 12 villages in Zepu County, Kashgar Prefecture, Xinjiang province were recruited for screening. Cervical and vaginal swabs from each subject were collected by gynecologists and tested for HPV DNA using Luminex xMAP technology. The results indicated that the overall HPV prevalence was 9.34% (1,136/12,165) in the present cohort; 7.41% (901/12,165) of the individuals were positive for high-risk type HPV (HR-HPV) and 1.64% (200/12,165) were positive for multiple types. Among the individuals who tested positive for HR-HPV types, the three most prevalent types were HPV16 (2.83%), HPV31 (0.99%) and HPV68 (0.88%). Subgroup analysis by age indicated that the highest frequency of HPV infections occurred in subjects aged >60 years. The most common genotype combinations in subjects with multiple types were HPV16 + HPV54, HPV16 + HPV31 and HPV16 + HPV68. The present study provided data on the prevalence and type distribution of HPV infections among Uyghur females in Xinjiang province, northwestern China, which will assist in the assessment of the potential cost-effectiveness of HPV screening and vaccination in this population. The data will also facilitate the determination of HPV68 and 54 strains that should be included in the multi-type vaccine and the establishment of a vaccination program that caters for the different age groups of the Uyghur population.
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Affiliation(s)
- Xiaolong Yan
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Yan Huang
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Mei Zhang
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Xin Hu
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Ke Li
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Mingxia Jing
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
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15
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Diversity of human papillomavirus typing among women population living in rural and remote areas of Brazilian territory. PAPILLOMAVIRUS RESEARCH 2019; 8:100186. [PMID: 31539646 PMCID: PMC6804508 DOI: 10.1016/j.pvr.2019.100186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 07/04/2019] [Accepted: 09/16/2019] [Indexed: 12/09/2022]
Abstract
Objectives Genotyping HPV from samples tested positive to careHPV™ assay in rural and remote areas of Brazilian territory. Methods A total of 5079 women were enrolled in an opportunistic screening from the Barretos Cancer Hospital, through mobile units or ambulatory unit. All careHPV™ hr-HPV positive samples were tested by a Luminex-based protocol in order to evaluate the HPV infecting types. Results Positive hr-HPV results were obtained in 10.6% (536/5068) of women. Among these cases, HPV-56 and HPV-51 were the most common types detected in 32.3% and 31.4%, respectively. HPV-53 (20.5%), HPV-18 (18.5%), HPV-58 (17.6%), HPV-52 (16.0%) and HPV-16.6%) were the other most frequent types detected. These frequencies represent prevalences of 2.35%, 2.12%, 2.02%, 1.84% and 1.80% respectively, within the population studied. Regarding low-risk HPVs, HPV-6 was detected in 12.9% of the samples. The less frequent types (<3%) were: HPV-70, HPV-11 and HPV-26. Conclusions The most frequent types detected were: HPV-56, HPV-51, HPV-53, HPV-18, HPV-58, HPV-52 and HPV-16 according to decreasing rates.
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Mukanyangezi MF, Rugwizangoga B, Manzi O, Rulisa S, Hellstrand K, Tobin G, Martner A, Bienvenu E, Giglio D. Persistence rate of cervical human papillomavirus infections and abnormal cytology in Rwanda. HIV Med 2019; 20:485-495. [PMID: 31318136 DOI: 10.1111/hiv.12782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES In this study, we determined the incidence and persistence of human papillomavirus (HPV) strains and of squamous intraepithelial lesions (SIL) or worse cytology in 237 HIV-positive and HIV-negative Rwandan women and whether the interleukin (IL)-28B single nucleotide polymorphism (SNP) at rs12979860 correlated with susceptibility to and persistence of HPV infection. METHODS Cervical samples were collected at baseline and after 9, 18 and 24 months for a 40-HPV DNA screening test and a ThinPrep Pap test. Genotyping of the IL-28B SNP rs12979860 was performed using real-time polymerase chain reaction (PCR). RESULTS Chronic high-risk (HR) HPV infections occurred in 56% of HIV-positive women, while no HIV-negative women developed HPV chronicity. High-grade SIL (HSIL) or cancer was diagnosed in 38% of HIV-positive women with persistent HR-HPV infections. HIV and HR-HPV positivity at baseline were factors associated with an increased risk of HPV persistence. Additionally, HR-HPV positivity at baseline was associated with an increased risk of developing HSIL or worse cytology. The unfavourable T/x genotype at rs12979860 is common among Africans, and women with this genotype were found to be more commonly infected with HPV. CONCLUSIONS HPV screening in Rwanda may help to identify women at risk of developing cervical cancer and polymorphism in IL-28B may be associated with risk of contracting HPV infection.
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Affiliation(s)
- M F Mukanyangezi
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - B Rugwizangoga
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - O Manzi
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - S Rulisa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - K Hellstrand
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - G Tobin
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - A Martner
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - E Bienvenu
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - D Giglio
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Lee NR, Winer RL, Cherne S, Noonan CJ, Nelson L, Gonzales AA, Umans JG, Buchwald D. Human Papillomavirus Prevalence Among American Indian Women of the Great Plains. J Infect Dis 2019; 219:908-915. [PMID: 30321371 PMCID: PMC6386810 DOI: 10.1093/infdis/jiy600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/08/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND High-risk human papillomavirus (hrHPV) causes cervical cancer. In the United States, approximately 40% of women aged 14-59 years from all racial and ethnic groups are infected with HPV, and prevalence typically declines with age. However, American Indian (AI) women are insufficiently sampled to permit a population-specific estimate of hrHPV prevalence. METHODS Vaginal swabs were self-collected by 698 AI women aged 21-65 years from a tribal community in the Great Plains. We estimated the population prevalence of hrHPV and identified predominant genotypes. RESULTS The combined prevalence of hrHPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 was 34.8%. HPV-51 (7.6%), HPV-58 (5.3%), HPV-52 (4.3%), HPV-18 (4.3%), and HPV-16 (3.9%) were most prevalent. hrHPV prevalence declined with age, from 42.2% in women aged 21-24 years to 27.9% in women aged 50-65 years. CONCLUSIONS HPV-51 was the single most prevalent oncogenic genotype. The combined prevalence of hrHPV among AI women in our sample was high, particularly among women aged 50-65 years, for whom hrHPV prevalence was approximately triple that of other races. Cervical cancer screening efforts should be increased, particularly among women from the community aged 30 years and older.
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Affiliation(s)
- Naomi R Lee
- Department of Molecular Genetics and Microbiology, University of New Mexico, Albuquerque
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle
| | - Stephen Cherne
- Department of Epidemiology, University of Washington, Seattle
| | - Carolyn J Noonan
- Elson S. Floyd College of Medicine, Initiative for Research and Education to Advance Community Health, Washington State University, Seattle
| | - Lonnie Nelson
- Elson S. Floyd College of Medicine, Initiative for Research and Education to Advance Community Health, Washington State University, Seattle
| | - Angela A Gonzales
- Department of Justice and Social Inquiry, School of Social Transformation, Arizona State University, Tempe
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, Maryland
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, District of Columbia
| | - Dedra Buchwald
- Elson S. Floyd College of Medicine, Initiative for Research and Education to Advance Community Health, Washington State University, Seattle
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Thapa N, Maharjan M, Shrestha G, Maharjan N, Petrini MA, Zuo N, He C, Yang J, Xu M, Ge C, Song Z, Cai H. Prevalence and type-specific distribution of human papillomavirus infection among women in mid-western rural, Nepal- A population-based study. BMC Infect Dis 2018; 18:338. [PMID: 30029626 PMCID: PMC6053738 DOI: 10.1186/s12879-018-3175-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/30/2018] [Indexed: 11/19/2022] Open
Abstract
Background Cervical cancer is the most common cancer among women in Nepal. The prevalence of human papillomavirus (HPV) 16 and or HPV 18 among women with cervical pre-cancer and cancer is higher than the incidence of HPV in the world population. The population-based epidemiological data of HPV in the general population in most parts of the country remains unknown. The objective of this study was to assess the prevalence and type distribution of HPV infection and association of abnormal cytology with high risk HPV infection among women in mid-western rural, Nepal. Methods A population-based cross sectional study was conducted in Jumla, one of the most remote districts in Nepal. A total of 1050 cervical samples were collected from married and non- pregnant women aged 20–65 years during mobile Cervical Cancer Screening Clinics conducted from May 2016 to January 2017. The presence of HPV DNA was firstly confirmed by HPV consensus PCR using PGMY09/PGMY11 designed primers, then HPV positive samples were further genotyped by the membrane hybridization method to detect the 21 high-risk HPV (HR-HPV) and low-risk HPV types. The prevalence of HR-HPV among women with normal and abnormal cytology was calculated. Data were analyzed using SPSS software for Windows. P < 0.05 was considered statistically significant. Results A total of 998 women were eligible for this study with the mean age 32.6 ± 8.6 years, and the mean marital age was 16.7 ± 3.8 years. The overall prevalence of HPV infections was 19.7%. HR-HPV and low-risk HPV were 11.7 and 8.7% respectively. The six most common HR-HPV types were HPV16, 39, 58, 33, 51 and 18. HR-HPV infection among the women with abnormal and normal cytology was of 27.3 and 10.8% respectively. Conclusions There was a higher prevalence of HR-HPV infection among women living in Jumla than other parts of Nepal. This study provides preliminary information on overall HPV and type-specific HR-HPV prevalence, HR-HPV 16, 39, 58, 33, 51, and 18 are the most prevalent genotypes in this region. The data contribute to the epidemiological knowledge about HPV and type-specific HR-HPV genotypes prevalence in mid-Western Nepal.
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Affiliation(s)
- Niresh Thapa
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China.,Karnali Academy of Health Sciences, Jumla, Nepal
| | - Muna Maharjan
- Zhongnan Hospital of Wuhan University, HOPE School of Nursing, Wuhan, Hubei, China
| | | | - Narayani Maharjan
- Department of Clinical Laboratory Science, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | | | - Na Zuo
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China
| | - Can He
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China
| | - Jing Yang
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China
| | - Mengfei Xu
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China
| | - Caiyun Ge
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China
| | - Ziye Song
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China
| | - Hongbing Cai
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key laboratory of Tumor Biological Behaviors, Wuhan, 430071, People's Republic of China.
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Zhou HL, Zhang W, Zhang CJ, Wang SM, Duan YC, Wang JX, Yang H, Wang XY. Prevalence and distribution of human papillomavirus genotypes in Chinese women between 1991 and 2016: A systematic review. J Infect 2018; 76:522-528. [PMID: 29477803 DOI: 10.1016/j.jinf.2018.02.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/11/2018] [Accepted: 02/12/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) associated cervical cancer is one of the most common cancers and ranked as the eighth most common killer for Chinese women. A dozen of HPV vaccines are being developed in China without a solid China-specific distribution of carcinogenic HPV types, thus, we performed this systematic review to explore the China-specific spectrum of high-risk types causing cancer. METHODS Studies on HPV infection among Chinese women were searched. All retrieved articles were screened and reviewed by a standardized algorithm. Distribution of carcinogenic HPV types and age-specific prevalence were analyzed using random-effects model. RESULTS A total of 303 articles were included in the final analysis. The top 10 common HPV types detected in ICC patients, in descending order of frequency, were HPV 16 (62.5%), 18 (12.4%), 58 (8.6%), 52 (5.7%), 33 (4.6%), 31 (3.5%), 55 (2.4%), 68 (2.4%), 53 (2.2%) and 45 (2.0%) respectively. Similar spectrum was found in women with precancer. The prevalence of HPV infection peaked between 20 and 24 years with a rate of 24.3%, thereafter declined substantially and stabilized at middle-ages. Compared to women living in the developed provinces, the second peak was observed among women aged 45-55 years in less developed regions. CONCLUSION In general, the spectrum of HPV types in women with precancer/cancer and the pattern of age-specific prevalence were consistent with that of elsewhere worldwide. However, some distinguished characteristics could also be concluded, and these imprinting should be considered and integrated when developing vaccines and strategy for disease control in China.
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Affiliation(s)
- Hong-Lu Zhou
- Key Laboratory Medical Molecular Virology, MoE/MoH, the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Wei Zhang
- Library of Fudan University, Shanghai, 200032, People's Republic of China
| | - Can-Jing Zhang
- Key Laboratory Medical Molecular Virology, MoE/MoH, the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Song-Mei Wang
- Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, People's Republic of China
| | - Ya-Chen Duan
- Department of Gynecological Oncology, Shanghai Cancer Center, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jin-Xia Wang
- Key Laboratory Medical Molecular Virology, MoE/MoH, the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Huan Yang
- Center for Drug Evaluation, China Food and Drug Administration, Beijing, 100038, People's Republic of China.
| | - Xuan-Yi Wang
- Key Laboratory Medical Molecular Virology, MoE/MoH, the Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
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Abulizi G, Li H, Mijiti P, Abulimiti T, Cai J, Gao J, Meng D, Abula R, Abudereyimu T, Aizezi A, Qiao YL. Risk factors for human papillomavirus infection prevalent among Uyghur women from Xinjiang, China. Oncotarget 2017; 8:97955-97964. [PMID: 29228665 PMCID: PMC5716705 DOI: 10.18632/oncotarget.18901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 03/08/2017] [Indexed: 11/25/2022] Open
Abstract
We investigated the incidence of HPV and risk factors for infection among rural Uyghur women in the Xinjiang province of northwestern China, where there is a high incidence of cervical cancer. We used the careHPV kit to test 6000 sexually active Uyghur women aged 21 to 60 years for HPV, and conducted a comprehensive questionnaire survey to identify relevant HPV infection factors. Our data show the HPV infection rate to be 8.42%, which is lower than 11.7% reported worldwide, despite the higher cervical cancer incidence. Multivariate logistic regression revealed that Uyghur women that had (a) poor personal hygiene and care; (b) no previous gynecological examination; (c) a higher education level; (d) unprotected sex and inadequate personal hygiene; (e) used their fingers for vaginal cleaning (f) smoking husbands and (j) used sanitary napkins or toilet paper during menstruation or used clod as the bathroom wipe material were at greater risk for HPV infection. This suggests that proper interventions that improve personal hygiene, including not using ones fingers for vaginal cleaning, use of condoms, regular gynecological exams and a reduction in smoking by spouses could lower the cervical cancer risk by lowering HPV infection rates. In addition, increasing awareness among more educated women regarding HPV and implementation of effective interventions could reduce the risk of HPV infection in Uyghur women.
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Affiliation(s)
- Guzhalinuer Abulizi
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Hua Li
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Patiman Mijiti
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Tangnuer Abulimiti
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Jing Cai
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Jie Gao
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Dandan Meng
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Reyihanguli Abula
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Tunishahan Abudereyimu
- 5th Department of Gynecological Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Autonomous Region, China
| | - Anarguli Aizezi
- Cervical Cancer Screening Office, Maternal and Child Health Care Center of Karakax County, Xinjiang Uyghur Autonomous Region, China
| | - You Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Mane A, Sahasrabuddhe VV, Nirmalkar A, Risbud AR, Sahay S, Bhosale RA, Vermund SH, Mehendale SM. Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India. J Clin Virol 2016; 88:26-32. [PMID: 28152432 DOI: 10.1016/j.jcv.2016.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 09/30/2016] [Accepted: 10/25/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Several studies in recent years have documented the genotype-specific prevalence of HPV infection and wide diversity and multiplicity of HPV genotypes among HIV-seropositive women. Yet, information on changes in HPV genotype-specific incidence and clearance rates over time, and their correlation with clinical or immunologic factors among HIV-seropositive women is scarce. OBJECTIVES We conducted a prospective study to investigate the incidence and clearance rates of cervical HPV genotypes among HIV-seropositive women in India and expand the evidence base in this area of research. STUDY DESIGN Cervical samples were collected from n=215 HIV-seropositive women in Pune, India who underwent two screening visits separated by a median of 11-months (interquartile range: 8-18 months). HPV genotypes were determined by Roche Linear Array HPV assay. Individual genotype-specific and carcinogenicity-grouping-specific HPV incidence and clearance rates were calculated and the associations between incidence/clearance and age and HIV-related metrics were explored. RESULTS Incidence and clearance rates for 'any HPV' and 'carcinogenic HPV' genotypes were 11.1 and 18.3, and 6.7 and 33.8, per 100 person-years, respectively. Incidence and clearance rates for HPV genotypes of alpha-9 species (HPV16, HPV31, HPV33, HPV35, HPV52 and HPV58) and alpha-7 species (HPV18, HPV39, HPV45, HPV59 and HPV68) were 5.8 and 2.04, and 32.1 and 53.5, per 100 person-years, respectively. Clearance of any HPV type was associated with increasing age of participants (odds ratio: 1.08, 95%CI: 1.004-1.17), although the association marginally lost its statistical significance when adjusted for CD4 counts and antiretroviral therapy status. CONCLUSIONS Genotype-specific clearance rates of HPV were higher than corresponding incidence rates. The suggestion of a positive associations of increasing age with HPV clearance points to the need for etiologic studies on age-related hormonal changes on clearance of cervical HPV infection.
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Affiliation(s)
- Arati Mane
- National AIDS Research Institute, Pune, India
| | | | | | | | - Seema Sahay
- National AIDS Research Institute, Pune, India
| | | | - Sten H Vermund
- Vanderbilt University School of Medicine, Nashville, USA
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Huang Z, Zheng Y, Wen W, Wu C, Bao P, Wang C, Zhong W, Gao YT, Jin F, Xiang YB, Shu XO, Beeghly-Fadiel A. Incidence and mortality of gynaecological cancers: Secular trends in urban Shanghai, China over 40 years. Eur J Cancer 2016; 63:1-10. [PMID: 27254837 PMCID: PMC4942399 DOI: 10.1016/j.ejca.2016.04.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 11/30/2022]
Abstract
AIM Appraisal of cancer trends is essential for future cancer control, but relevant studies in China are scarce due to a lack of long-term data. With 40-years of cancer registry data, we sought to evaluate secular time trends in incidence and mortality of gynaecological cancers in an urban Chinese population. MATERIALS AND METHODS Data on incidence and mortality of invasive cervical, uterine and ovarian cancer were collected by the Shanghai Cancer Registry. Age-standardised incidence and mortality rates were calculated for women aged 20-84 in urban Shanghai between 1973 and 2012. Age-period-cohort Poisson regression models were used to evaluate age, period and cohort effects. Overall linear trends, interpreted as the estimated annual percentage change (EAPC), were derived from the net drift in age-drift models. RESULTS Overall, cervical cancer incidence and mortality substantially decreased (EAPC = -4.5% and -5.5%, respectively); however, an upward trend was apparent among younger women (age <60). Uterine cancer incidence increased slightly (EAPC = 1.8%), while mortality decreased over time (EAPC = -2.4%). Ovarian cancer incidence and mortality both increased, although the increase in incidence (EAPC = 1.8%) was larger than mortality (EAPC = 0.6%). While cohort effects were most evident for cervical cancer incidence and mortality, significant age, period, and cohort effects were found for all three gynaecological cancers evaluated. CONCLUSIONS These secular trends in incidence and mortality of gynaecological cancers in Shanghai likely reflect changing risk factor profiles and improved cancer prognosis over time, and suggest new priorities and call for additional efforts for gynaecological cancer prevention and control for women in China.
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Affiliation(s)
- Zhezhou Huang
- Institute of Non-Communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, People's Republic of China
| | - Ying Zheng
- Institute of Non-Communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, People's Republic of China.
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37203-1738, USA
| | - Chunxiao Wu
- Institute of Non-Communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, People's Republic of China
| | - Pingping Bao
- Institute of Non-Communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, People's Republic of China
| | - Chunfang Wang
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, People's Republic of China
| | - Weijian Zhong
- Institute of Non-Communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, People's Republic of China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, People's Republic of China
| | - Fan Jin
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, People's Republic of China
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, People's Republic of China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37203-1738, USA
| | - Alicia Beeghly-Fadiel
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37203-1738, USA
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Wu MF, Li J, Lu HW, Wang LJ, Zhang BZ, Lin ZQ. Impact of the care provided by gynecologic oncologists on outcomes of cervical cancer patients treated with radical hysterectomy. Onco Targets Ther 2016; 9:1361-70. [PMID: 27022291 PMCID: PMC4792213 DOI: 10.2147/ott.s99874] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
For many malignant diseases, specialized care has been reported to be associated with better outcomes. The purpose of this study is to investigate the influence of gynecologic oncologists on treatment outcomes for cervical cancer patients treated by radical hysterectomy. Records of patients who received radical hysterectomy between January 2005 and June 2010 were reviewed. Perioperative morbidity, recurrence-free survival, and cancer-specific survival were assessed. Cox regression model was used to evaluate gynecologic oncologists as an independent predictor of survival. A total of 839 patients were included. Of these patients, 553 were treated by gynecologic oncologists, while 286 were treated by other subspecialties. With regard to operative outcomes, significant differences in favor of operation by gynecologic oncologists were found in number of patients receiving para-aortic node sampling and dissection (P=0.038), compliance with surgical guidelines (P=0.003), operative time (P<0.0001), estimated blood loss (P<0.0001), transfusion rate (P=0.046), number of removed nodes (P=0.033), and incidences of ureteric injury (P=0.027), cystotomy (P=0.038), and fistula formation (P=0.002). Patients who were operated on by gynecologic oncologists had longer recurrence-free survival (P=0.001; hazard ratio [HR] =0.64; 95% confidence interval [CI] [0.48, 0.84]) and cancer-specific survival (P=0.005; HR=0.64; 95% CI [0.47, 0.87]), and this association remained significant in patients with locally advanced disease. Care by gynecologic oncologists was an independent predictor for improved recurrence-free survival (P<0.0001; HR=0.57; 95% CI [0.42, 0.76]) and cancer-specific survival (P=0.001; HR=0.58; 95% CI [0.42, 0.81]), which was still significant among patients with locally advanced cancer. Given the results, we believe for cervical cancer patients receiving radical hysterectomy, operation by gynecologic oncologists results in significantly improved surgical and survival outcomes. The importance of the subspecialty of a gynecologist for cervical cancer patients should be addressed in clinical practice, especially for those in developing countries.
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Affiliation(s)
- Miao-Fang Wu
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jing Li
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Team-based Learning Group of Clinical Study, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Huai-Wu Lu
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Li-Juan Wang
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Bing-Zhong Zhang
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zhong-Qiu Lin
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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Liang H, Griffith CC, Ma L, Ling B, Feng D, Li Z, Zhao C. The sensitivity of Pap cytology and HPV testing to detect incident cervical cancer: prior testing results in 178 patients with invasive cervical cancer at a large general hospital in China. J Am Soc Cytopathol 2016; 5:64-70. [PMID: 31042493 DOI: 10.1016/j.jasc.2015.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Prior screening results in women diagnosed with cervical carcinoma are only reported in the literature in small numbers. We wish to examine a larger number of prior testing results in women with cervical carcinoma from China to better understand the strengths and weaknesses of Pap (Papanicolaou) cytology and human papillomavirus (HPV) testing. MATERIALS AND METHODS In our study, 178 patients with histologically diagnosed cervical carcinoma and Pap cytology and/or HPV testing in the year prior to diagnosis were retrospectively studied. Pap cytology was performed using liquid-based preparations and HPV testing was done with mostly Hybrid Capture 2 but also included other methods. RESULTS In our study, 82.0% of women were symptomatic at presentation with vaginal bleeding or abnormal vaginal discharge. HPV testing was negative in 9.8% of women in the short period before diagnosis of cervical cancer and Pap cytology had a higher rate of false negative results at 16.7%. Adenocarcinoma showed a higher negative testing rate than squamous cell carcinoma did with both cytology and HPV testing. Only 1 of 78 patients (1.3%) having both tests showed a double negative result. Negative high-risk HPV testing was noted in 2 of 9 squamous cell carcinoma patients with routine gynecological examination. CONCLUSIONS Both Pap cytology and HPV testing have higher rates of prior negative results in women with cervical carcinoma. When testing is performed using both methods, the greatest number of cervical carcinomas can be detected. These results should also be considered when making screening recommendations with the understanding that HPV testing alone will miss at least a proportion of women with incident cervical carcinoma.
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Affiliation(s)
- Haiyan Liang
- Department of Gynecology/Obstetrics, China-Japan Friendship Hospital, Hepingli, Beijing People's Republic of China
| | - Christopher C Griffith
- Department of Pathology, Magee Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Li Ma
- Department of Gynecology/Obstetrics, China-Japan Friendship Hospital, Hepingli, Beijing People's Republic of China
| | - Bin Ling
- Department of Gynecology/Obstetrics, China-Japan Friendship Hospital, Hepingli, Beijing People's Republic of China.
| | - Dingqing Feng
- Department of Gynecology/Obstetrics, China-Japan Friendship Hospital, Hepingli, Beijing People's Republic of China
| | - Zaibo Li
- Department of Pathology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Chengquan Zhao
- Department of Pathology, Magee Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Li Z, Liu F, Cheng S, Shi L, Yan Z, Yang J, Shi L, Yao Y, Ma Y. Prevalence of HPV infection among 28,457 Chinese women in Yunnan Province, southwest China. Sci Rep 2016; 6:21039. [PMID: 26868772 PMCID: PMC4751528 DOI: 10.1038/srep21039] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/15/2016] [Indexed: 01/03/2023] Open
Abstract
Human papillomavirus (HPV) infection plays a key role in the development of cervical cancer. The aim of the current study was to investigate the HPV type distribution in Chinese women from Yunnan Province, southwest China. A total of 28,457 individuals ranging in age from 17-84 years were recruited from 13 clinical hospitals located in 10 different regions of Yunnan Province. Cervicovaginal swabs were collected from each participant, and HPV screening was performed using Luminex xMAP technology. Our results showed that the HPV prevalence was 12.9% in Yunnan Province. Overall, 10.6% of the individuals were positive for a single HPV type, and 2.3% were positive for multiple types. Among the individuals who tested positive for a single HPV type and multiple HPV types, the three most prevalent high-risk types were 52, 16, and 58. Age subgroup analysis showed two peaks for the frequencies of single and multiple HPV infections, one for the group of women under 25 years old, and the other for the group over 56 years old. Here, we present data regarding the prevalence and type distribution of HPV infection, which will aid in the estimation of the potential clinical benefit and cost-effectiveness of HPV screening and vaccination in China.
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Affiliation(s)
- Zheng Li
- Department of Laboratory, Yan'an Hospital of Kunming, Kunming 650051, China
| | - Feng Liu
- Department of Laboratory, General Hospital of Yunnan Armed Police Force, Kunming 650111, China
| | - Si Cheng
- Department of Laboratory, Yan'an Hospital of Kunming, Kunming 650051, China
| | - Lei Shi
- Institute of Medical Biology, Chinese Academy of Medical Sciences &Peking Union Medical College, Kunming 650118, China
| | - Zhiling Yan
- Department of Gynaecologic Oncology, The 3rd Affiliated Hospital of Kunming Medical University &Yunnan Tumour Hospital, Kunming 650118, China
| | - Jie Yang
- Wenzhou Medical University, Wenzhou 325035, China
| | - Li Shi
- Institute of Medical Biology, Chinese Academy of Medical Sciences &Peking Union Medical College, Kunming 650118, China
| | - Yufeng Yao
- Institute of Medical Biology, Chinese Academy of Medical Sciences &Peking Union Medical College, Kunming 650118, China
| | - Yanbing Ma
- Institute of Medical Biology, Chinese Academy of Medical Sciences &Peking Union Medical College, Kunming 650118, China
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Kingnate C, Supoken A, Kleebkaow P, Chumworathayi B, Luanratanakorn S, Kietpeerakool C. Is Age an Independent Predictor of High-Grade Histopathology in Women Referred for Colposcopy after Abnormal Cervical Cytology? Asian Pac J Cancer Prev 2015; 16:7231-5. [PMID: 26514516 DOI: 10.7314/apjcp.2015.16.16.7231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study was conducted to determine whether advancing age is an independent predictor of increased risk of high-grade pathologies among women referred for colposcopy after abnormal cervical cytology. Medical records were reviewed for women with abnormal cervical cytology who underwent colposcopy at Khon Kaen University Hospital. Logistic regression was used to determine the independent impact of age on the risk of high-grade pathologies. Mean age of the women was 42.8 years. Of 482 women, 97 (20.1%) were postmenopausal, and 92 (19.1%) were nulliparous. The rate of high-grade pathologies included cervical intraepithelial neoplasia 2-3, 99 (20.5%), adenocarcinoma in situ, 4 (0.8%), cervical cancer, 30 (6.2%), and endometrial cancer, 1 (0.2%). The prevalence of significant lesions was 26.9% (95% CI, 23.1%-31.2%). In total, 31 women had cancers (6.4%; 95% CI, 4.4%-9.0%). When controlling for smear types and parity, age was noted to be a significant independent predictor of high-grade histopathology. Women older than 35-40 years were approximately 2 times as likely to have severe histopathology as the younger women. This study illustrates the substantial risk of underlying significant lesions especially invasive cancer in Thai women with abnormal cervical cytology. Age was a significant independent factor predicting the risk of high-grade pathologies.
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Affiliation(s)
- Chalita Kingnate
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand E-mail :
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Hong H, He TF, Ni HX, Zhang S, Xu GZ. Prevalence and genotype distribution of HPV infection among women in Ningbo, China. Int J Gynaecol Obstet 2015; 131:96-9. [PMID: 26072045 DOI: 10.1016/j.ijgo.2015.04.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/18/2015] [Accepted: 05/19/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate HPV prevalence and genotype distribution among women in Ningbo, China. METHODS A cluster-sampling study of women from four randomly selected villages was undertaken between April 1 and June 30, 2012. Married women who were not menstruating and had not had sexual intercourse, used vaginal medications, or performed vaginal douching within the previous 48hours were enrolled when attending community health centers for family planning appointments. Exfoliated cell specimens were collected for HPV DNA genotyping and cytologic diagnostic tests. RESULTS Among 1373 included women, 185 (13.5%) were found to be HPV positive and 178 (13.0%) had a high-risk HPV (HR-HPV) genotype. Among 56 women with cervical cytologic abnormalities, 35 (62.5%) had an HPV infection. The frequency of HPV or HR-HPV infections rose with increasing severity of cytological abnormalities (P<0.001 for both). HPV52 was the most prevalent genotype, followed by HPV58, HPV16, HPV33, and HPV68. An HPV prevalence peak was observed in women aged 40-49 years (101/564 [17.9%]). CONCLUSION In Ningbo, many women with cervical cytologic abnormalities have HPV infection. Vaccines targeting HPV52 and HPV58 in conjunction with HPV16 and HPV18 are required for the prevention and treatment of cervical lesions in Chinese women.
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Affiliation(s)
- Hang Hong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Tian-feng He
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Hong-xia Ni
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Shu Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Guo-zhang Xu
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China.
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Liu XX, Fan XL, Yu YP, Ji L, Yan J, Sun AH. Human papillomavirus prevalence and type-distribution among women in Zhejiang Province, Southeast China: a cross-sectional study. BMC Infect Dis 2014; 14:708. [PMID: 25523884 PMCID: PMC4278233 DOI: 10.1186/s12879-014-0708-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is the main etiological factor for cervical cancer and premalignant lesions of the cervix. The purposes of the present study were to determine the prevalence of type-specific HPV infections and the association of different HPV types with cervical dysplasia among women in Zhejiang province, Southeast China. Methods A total of 15,267 women presenting to a gynaecological outpatient clinic were enrolled in this study. Women were screened for HPV in addition to routine cervical cytology testing. Microarray hybridization and liquid-based cytology tests were used to detect HPV genotypes and cervical cytology, respectively. Results Based on the population attending a gynaecological outpatient clinic, overall prevalence of any 23 HPV type was 22.8% and multiple HPV infection was found in 4.0% of all the outpatients. HPV prevalence showed bimodal age distribution, with a peak (55.7%) at the ≤20 age group and a second one (35.5%) at >60 age group. In total samples, the five most frequent types were HPV 16 (4.4%), 58 (2.9%), 52 (2.7%), 33 (2.2%) and 11 (1.9%). Overall HPV prevalence increased with the severity of the cytologic result. Analysis through crude odds ratios (ORs) revealed that the cervical lesion risk of HPV-infected women increased to about 26-fold of uninfected women (OR 26.1, 95% CI 22.4 to 30.3). The five most risky HPV types associated with abnormal cytology were HPV 73, 16, 82, 45 and 51. Conclusions This study provided baseline data on HPV prevalence in women attending a gynecological outpatient clinic in Zhejiang province. Our data will supply guidance for the primary screening and vaccination program for cervical cancer in this area. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0708-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiao-Xiang Liu
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Xing-Li Fan
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Yue-Ping Yu
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Lei Ji
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Jie Yan
- Division of Basic Medical Microbiology, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, 310003, P. R. China. .,Department of Medical Microbiology and Parasitology, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, P. R. China.
| | - Ai-Hua Sun
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
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Ding X, Liu Z, Su J, Yan D, Sun W, Zeng Z. Human papillomavirus type-specific prevalence in women referred for colposcopic examination in Beijing. J Med Virol 2014; 86:1937-43. [PMID: 25132373 DOI: 10.1002/jmv.24044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 11/11/2022]
Abstract
Human papillomavirus (HPV) is associated with several disorders of the genital tract, skin, and oropharynx. This study investigated the prevalence of infection by 37 HPV genotypes among women of the Beijing area in China. Cervical specimens from 1,082 patients and 165 healthy controls were tested for HPV genotypes using a chip hybridization assay. Based on the local pathology, patients were divided into cervicitis and cervical lesion groups. Overall HPV infection rates were 30.5% for the cervicitis group and 78.4% for the cervical lesion group; whereas infection rates for high-risk HPV types (i.e., those associated with cervical cancers) were 24.0% and 73.4%, respectively. The most common HPV genotypes were HPV 52, 16, 81, 58, and 18 in healthy controls, HPV 52, 61, 55, 16, and 53 in those with cervicitis, HPV 52, 16, 33, 39, and 58 in cervical intraepithelial neoplasia grade 1, HPV 16, 58, 31, 52, and 33 in cervical intraepithelial neoplasia grade 2 or grade 3, and HPV 16, 33, 18, 52, and 58 in cervical cancer. Established high-risk HPV showed two peaks, in patients aged 30-34 and 55-79 years. In Beijing, HPV 16, 52, 58, and 33 are the most prevalent HPV types in women with cervical lesions, which should affect development of a cervical cancer vaccination for local use.
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Affiliation(s)
- Xiurong Ding
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Munkhdelger J, Choi Y, Lee D, Kim S, Kim G, Park S, Choi E, Jin H, Jeon BY, Lee H, Park KH. Comparison of the performance of the NucliSENS EasyQ HPV E6/E7 mRNA assay and HPV DNA chip for testing squamous cell lesions of the uterine cervix. Diagn Microbiol Infect Dis 2014; 79:422-7. [PMID: 24856365 DOI: 10.1016/j.diagmicrobio.2014.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/02/2014] [Accepted: 04/18/2014] [Indexed: 11/30/2022]
Abstract
This study aims to evaluate the clinical performance of the NucliSENS EasyQ assay and compare it with HPV DNA genotyping for the detection of high-grade squamous intraepithelial lesions (HSIL) and cancer in a Korean population. In 188 total thin prep samples, the remaining fluid after cytology slide preparation was tested with Goodgene HPV DNA chips and the NucliSENS EasyQ HPV E6/E7 messenger RNA (mRNA) assay. The sensitivity and specificity of each test were calculated with HSIL and squamous cell carcinoma (SCC) as the disease endpoint. Out of the 188 samples, 139 (74%) were positive for DNA of 14 HPV types, while 57 (30%) cases were positive for E6/E7 mRNA. The DNA test was positive in cytology cases of SCC, HSIL, and atypical squamous cell. The mRNA test yielded results of 75%, 74%, 60%, 56%, and 29% positivity in abnormal cytology cases of SCC, HSIL, atypical squamous cells - cannot exclude HSIL, atypical squamous cells of undetermined significance, and low-grade squamous intraepithelial lesion, respectively. In normal cytology cases, the positivity rates were 9% and 53% for the mRNA and DNA tests, respectively. For detection of HSIL and SCC, the sensitivity of the mRNA test was 74.36% and that of the DNA test was 100%, while the specificities of the tests were 85% and 40.83%, respectively. These findings suggest that the HPV E6/E7 mRNA assay can overcome the shortcoming of low specificity of DNA assays for clinical detection of high-grade cervical lesions and malignancies.
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Affiliation(s)
- Jijgee Munkhdelger
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Yeonim Choi
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Republic of Korea; Department of Biomedical Laboratory Science, Songho College, Hoengseoung, Republic of Korea
| | - Dongsup Lee
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea; Department of Clinical Laboratory Science, Hyejeon College, Hongseong, Republic of Korea
| | - Sunghyun Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Republic of Korea; Institute for Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Geehyuk Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Republic of Korea
| | - Sangjung Park
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Republic of Korea; Department of Clinical Laboratory Science, College of Medical Science, Daegu Haany University, Daegu, Republic of Korea
| | - Eunhee Choi
- Institute for Lifestyle Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Hyunwoo Jin
- Department of Clinical Laboratory Sciences, College of Health Science, Catholic University of Pusan, Pusan, Republic of Korea
| | - Bo-Young Jeon
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Republic of Korea
| | - Hyeyoung Lee
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Republic of Korea.
| | - Kwang Hwa Park
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
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