TY - JOUR
T1 - Human papillomavirus genotypes in cervical and other HPV-related anogenital cancer in Rwanda, according to HIV status
AU - Mpunga, Tharcisse
AU - Chantal Umulisa, Marie
AU - Tenet, Vanessa
AU - Rugwizangoga, Belson
AU - Milner, Danny A.
AU - Munyanshongore, Cyprien
AU - Heideman, Daniëlle A.M.
AU - Bleeker, Maaike C.G.
AU - Tommasino, Massimo
AU - Franceschi, Silvia
AU - Baussano, Iacopo
AU - Gheit, Tarik
AU - Sayinzoga, Felix
AU - Clifford, Gary M.
N1 - Funding Information:
The work reported in this article was undertaken by Tharcisse Mpunga during the tenure of PhD studentship granted by the International Agency for Research on Cancer, under joint supervision with the University of Rwanda, School of Public Health. The authors thank the histotechnicians in the histopathology departments of Kigali Teaching Hospital, CHUB and BCCOE, as well as D. Buma for technical assistance in Amsterdam, and S. Bwogi of the Department of Pathology, University Teaching Hospital of Butare, Rwanda.
Publisher Copyright:
© 2019 International Agency for Research on Cancer (IARC/WHO); licensed by UICC
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/3/15
Y1 - 2020/3/15
N2 - The study aim was to describe human papillomavirus (HPV)-attributable cancer burden in Rwanda, according to anogenital cancer site, HPV type, age and HIV status. Tissue specimens of cervical, vulvar, vaginal, penile and anal cancer diagnosed in 2012–2018 were retrieved from three cancer referral hospitals and tested for high-risk (HR) HPV DNA. Cervical cancer represented the majority of cases (598 of 738), of which 96.0% were HR-HPV positive. HPV-attributable fractions in other cancer sites varied from 53.1% in 81 penile, through 76.7% in 30 vulvar, 83.3% in 24 vaginal, up to 100% in 5 anal cases. HPV16 was the predominant HR-HPV type in cervical cancer (55.0%), followed by HPV18 (16.6%) and HPV45 (13.4%). HPV16 also predominated in other cancer sites (60–80% of HR-HPV-attributable fraction). For cervical cancer, type-specific prevalence varied significantly by histology (higher alpha-9 type prevalence in 509 squamous cell carcinoma vs. higher alpha-7 type prevalence in 80 adenocarcinoma), but not between 501 HIV-negative and 97 HIV-positive cases. With respect to types targeted, and/or cross-protected, by HPV vaccines, HPV16/18 accounted for 73%, HPV31/33/45/52/58 for an additional 22% and other HR-HPV types for 5%, of HPV-attributable cancer burden, with no significant difference by HIV status nor age. These data highlight the preventive potential of the ongoing national HPV vaccination program in Rwanda, and in sub-Saharan Africa as a whole. Importantly for this region, the impact of HIV on the distribution of causal HPV types was relatively minor, confirming type-specific relevance of HPV vaccines, irrespective of HIV status.
AB - The study aim was to describe human papillomavirus (HPV)-attributable cancer burden in Rwanda, according to anogenital cancer site, HPV type, age and HIV status. Tissue specimens of cervical, vulvar, vaginal, penile and anal cancer diagnosed in 2012–2018 were retrieved from three cancer referral hospitals and tested for high-risk (HR) HPV DNA. Cervical cancer represented the majority of cases (598 of 738), of which 96.0% were HR-HPV positive. HPV-attributable fractions in other cancer sites varied from 53.1% in 81 penile, through 76.7% in 30 vulvar, 83.3% in 24 vaginal, up to 100% in 5 anal cases. HPV16 was the predominant HR-HPV type in cervical cancer (55.0%), followed by HPV18 (16.6%) and HPV45 (13.4%). HPV16 also predominated in other cancer sites (60–80% of HR-HPV-attributable fraction). For cervical cancer, type-specific prevalence varied significantly by histology (higher alpha-9 type prevalence in 509 squamous cell carcinoma vs. higher alpha-7 type prevalence in 80 adenocarcinoma), but not between 501 HIV-negative and 97 HIV-positive cases. With respect to types targeted, and/or cross-protected, by HPV vaccines, HPV16/18 accounted for 73%, HPV31/33/45/52/58 for an additional 22% and other HR-HPV types for 5%, of HPV-attributable cancer burden, with no significant difference by HIV status nor age. These data highlight the preventive potential of the ongoing national HPV vaccination program in Rwanda, and in sub-Saharan Africa as a whole. Importantly for this region, the impact of HIV on the distribution of causal HPV types was relatively minor, confirming type-specific relevance of HPV vaccines, irrespective of HIV status.
KW - attributable fraction
KW - cancer
KW - epidemiology
KW - HIV
KW - human papillomavirus
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U2 - 10.1002/ijc.32491
DO - 10.1002/ijc.32491
M3 - Article
C2 - 31173641
AN - SCOPUS:85068344740
VL - 146
SP - 1514
EP - 1522
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 6
ER -