Bayesian analysis of baseline risk of CIN2 and ≥CIN3 by HPV genotype in a European referral cohort: International Journal of Cancer

J. Bonde, F. Bottari, V. Parvu, H. Pedersen, K. Yanson, A.D. Iacobone, S. Kodsi, F. Landoni, L. Vaughan, D.M. Ejegod, M.T. Sandri

Research output: Contribution to journalArticlepeer-review

Abstract

Whereas HPV16 and HPV18 have been the focus in current risk-based cervical cancer screening algorithms using HPV genotype information, mounting evidence suggests that oncogenic HPV types such as HPV31, 33, 52 and 58 pose a ≥CIN3 risk equivalent to or greater than that of HPV18, and the combined risk of HPV31 and HPV33 rivals even HPV16 in women above 30 years of age. Here, we evaluate the baseline risk of CIN2 and CIN3 by genotype in a colposcopy referral population from Denmark and Italy. In total, 655 women were enrolled upon a referral to colposcopy after a positive screening sample. All samples were HPV analyzed using Onclarity HPV assay with extended genotyping and combined with the histology outcomes, a Bayesian probability modeling was used to determine the risk per genotype assessed. The combined data for this referral population showed that the ≥CIN2 risk of HPV16 was 69.1%, HPV31 at 63.3%, HPV33/58 at 52.7%, HPV18 at 46.6% and HPV52 at 40.8%. For ≥CIN3, the risks were 44.3%, 38.5%, 36.8%, 30.9% and 16.8% for HPV16, HPV31, HPV18, HPV33/58 and HPV52, respectively, indicating that the baseline risk of disease arising from HPV16 is, not surprisingly, the highest among the oncogenic HPV genotypes. We find that the HPV genotype-specific ≥CIN2 and ≥CIN3 risk-patterns are so distinct that, for example, 35/39/68 and 56/59/66 should be considered only for low intensive follow-up, thereby proposing active use of this information in triage strategies for screening HPV-positive women. © 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC
Original languageEnglish
Pages (from-to)1033-1041
Number of pages9
JournalInt. J. Cancer
Volume145
Issue number4
DOIs
Publication statusPublished - 2019

Keywords

  • adult
  • aged
  • Article
  • Bayes theorem
  • cancer risk
  • cancer screening
  • clinical outcome
  • cohort analysis
  • colposcopy
  • controlled study
  • Denmark
  • female
  • follow up
  • genotype
  • histopathology
  • human
  • human cell
  • Human papillomavirus type 16
  • Human papillomavirus type 18
  • Human papillomavirus type 31
  • Human papillomavirus type 33
  • Human papillomavirus type 52
  • Human papillomavirus type 58
  • human tissue
  • Italy
  • major clinical study
  • middle aged
  • nonhuman
  • patient referral
  • priority journal
  • probability
  • retrospective study
  • risk assessment
  • uterine cervix carcinoma in situ
  • Wart virus
  • young adult
  • adolescent
  • complication
  • early cancer diagnosis
  • Europe
  • genetics
  • mass screening
  • Papillomaviridae
  • papillomavirus infection
  • procedures
  • risk
  • uterine cervix tumor
  • virology
  • Adolescent
  • Adult
  • Aged
  • Bayes Theorem
  • Cohort Studies
  • Early Detection of Cancer
  • Female
  • Genotype
  • Humans
  • Mass Screening
  • Middle Aged
  • Papillomavirus Infections
  • Risk
  • Uterine Cervical Neoplasms
  • Young Adult

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