Prevalence of human papillomavirus types in high-grade cervical intraepithelial neoplasia and cancer in Italy

Francesca M. Carozzi, Maria L. Tornesello, Elena Burroni, Giovanna Loquercio, Giuseppe Carillo, Claudio Angeloni, Aurora Scalisi, Rosalba Macis, Francesco Chini, Franco M. Buonaguro, Paolo Giorgi Rossi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this multicentric study was to identify human papillomavirus (HPV) type distribution in invasive cervical cancer and high-grade cervical intraepithelial neoplasia 2/3 (CIN2/3) in Italy. Methods: Cases were sampled through the electronic databases at the pathology units of eight centers in six regions from central and southern Italy. HPV types were detected from paraffin-embedded tissue samples and cervical specimens through amplification of HPV DNA with GP5+/GP6+ primers, followed by genotyping with reverse line blot (RLB). Untyped HPV-positive samples were sequenced. HPV-negative samples underwent nested PCR, followed by either RLB or sequencing. Finally, the remaining HPV-negative samples were amplified with primers targeting the virus E6 to E7 regions. Results: From 1,162 cases initially selected, 722 samples were further analyzed: 144 CIN2, 385 CIN3, 157 invasive squamous carcinomas, and 36 adenocarcinomas. Samples (6.9%) were HPV negative. The proportion of HPV16/18 was 60.8%, 76.6%, and 78.8% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.004). There was a significant decreasing trend of HPV16/18 with age in invasive cancers, going from 92% in women 55 years (P = 0.036). The proportion of coinfections was 16.8%, 15.5%, and 10.0% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.07). Conclusions: The proportion of invasive cancers caused by HPV16/18 decreases with age at diagnosis. Impact: The absolute risk of an invasive cancer due to non-HPV16/18 in women under 35 is extremely low. This finding might prompt us to rise the age at which public HPV screening for vaccinated women should start.

Original languageEnglish
Pages (from-to)2389-2400
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume19
Issue number9
DOIs
Publication statusPublished - Sep 2010

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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