Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease

Elmar A. Joura, Kevin A. Ault, F. Xavier Bosch, Darron Brown, Jack Cuzick, Daron Ferris, Suzanne M. Garland, Anna R. Giuliano, Mauricio Hernandez-Avila, Warner Huh, Ole Erik Iversen, Susanne K. Kjaer, Joaquin Luna, Dianne Miller, Joseph Monsonego, Nubia Munoz, Evan Myers, Jorma Paavonen, Punnee Pitisuttithum, Marc StebenCosette M. Wheeler, Gonzalo Perez, Alfred Saah, Alain Luxembourg, Heather L. Sings, Christine Velicer

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Background: We estimated the prevalence and incidence of 14 human papillomavirus (HPV) types (6/11/ 16/18/31/33/35/39/45/51/52/56/58/59) in cervicovaginal swabs, and the attribution of these HPV types in cervical intraepithelial neoplasia (CIN), and adenocarcinoma in situ (AIS), using predefined algorithms that adjusted for multiple-type infected lesions. Methods: A total of 10,656 women ages 15 to 26 years and 1,858 women ages 24 to 45 years were enrolled in the placebo arms of one of three clinical trials of a quadrivalent HPV vaccine. We estimated the cumulative incidence of persistent infection and the proportion of CIN/AIS attributable to individual carcinogenic HPV genotypes, as well as the proportion of CIN/AIS lesions potentially preventable by a prophylactic 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine. Results: The cumulative incidence of persistent infection with≥1 of the seven high-risk types included in the 9-valent vaccine was 29%, 12%, and6%forwomen ages 15 to 26, 24 to 34, and 35 to 45 years, respectively.Atotal of 2,507 lesions were diagnosed as CIN or AIS by an expert pathology panel. After adjusting for multiple-type infected lesions, amongwomen ages 15 to 45 years, these seven high-risk types were attributed to 43% to 55% of CIN1, 70% to 78% of CIN2, 85% to 91% of CIN3, and 95% to 100% of AIS lesions, respectively. The other tested types (HPV35/39/51/56/59) were attributed to 23% to 30% of CIN1, 7% to 14% of CIN2, 3% to 4% of CIN3, and 0% of AIS lesions, respectively. Conclusions: Approximately 85% or more of CIN3/AIS, >70% CIN2, and approximately 50% of CIN1 lesions worldwide are attributed to HPV6/11/16/18/31/33/45/52/58. Impact: If 9-valent HPV vaccination programs are effectively implemented, the majority of CIN2 and CIN3 lesions worldwide could be prevented, in addition to approximately one-half of CIN1.

Original languageEnglish (US)
Pages (from-to)1997-2008
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2014

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Genotype
Infection
Cervical Intraepithelial Neoplasia
Incidence
Vaccines
Adenocarcinoma in Situ
Human papillomavirus 11
Human papillomavirus 6
Papillomavirus Vaccines
Vaccination
Placebos
Clinical Trials
Pathology

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease. / Joura, Elmar A.; Ault, Kevin A.; Bosch, F. Xavier; Brown, Darron; Cuzick, Jack; Ferris, Daron; Garland, Suzanne M.; Giuliano, Anna R.; Hernandez-Avila, Mauricio; Huh, Warner; Iversen, Ole Erik; Kjaer, Susanne K.; Luna, Joaquin; Miller, Dianne; Monsonego, Joseph; Munoz, Nubia; Myers, Evan; Paavonen, Jorma; Pitisuttithum, Punnee; Steben, Marc; Wheeler, Cosette M.; Perez, Gonzalo; Saah, Alfred; Luxembourg, Alain; Sings, Heather L.; Velicer, Christine.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 23, No. 10, 01.10.2014, p. 1997-2008.

Research output: Contribution to journalArticle

Joura, EA, Ault, KA, Bosch, FX, Brown, D, Cuzick, J, Ferris, D, Garland, SM, Giuliano, AR, Hernandez-Avila, M, Huh, W, Iversen, OE, Kjaer, SK, Luna, J, Miller, D, Monsonego, J, Munoz, N, Myers, E, Paavonen, J, Pitisuttithum, P, Steben, M, Wheeler, CM, Perez, G, Saah, A, Luxembourg, A, Sings, HL & Velicer, C 2014, 'Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease', Cancer Epidemiology Biomarkers and Prevention, vol. 23, no. 10, pp. 1997-2008. https://doi.org/10.1158/1055-9965.EPI-14-0410
Joura, Elmar A. ; Ault, Kevin A. ; Bosch, F. Xavier ; Brown, Darron ; Cuzick, Jack ; Ferris, Daron ; Garland, Suzanne M. ; Giuliano, Anna R. ; Hernandez-Avila, Mauricio ; Huh, Warner ; Iversen, Ole Erik ; Kjaer, Susanne K. ; Luna, Joaquin ; Miller, Dianne ; Monsonego, Joseph ; Munoz, Nubia ; Myers, Evan ; Paavonen, Jorma ; Pitisuttithum, Punnee ; Steben, Marc ; Wheeler, Cosette M. ; Perez, Gonzalo ; Saah, Alfred ; Luxembourg, Alain ; Sings, Heather L. ; Velicer, Christine. / Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease. In: Cancer Epidemiology Biomarkers and Prevention. 2014 ; Vol. 23, No. 10. pp. 1997-2008.
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abstract = "Background: We estimated the prevalence and incidence of 14 human papillomavirus (HPV) types (6/11/ 16/18/31/33/35/39/45/51/52/56/58/59) in cervicovaginal swabs, and the attribution of these HPV types in cervical intraepithelial neoplasia (CIN), and adenocarcinoma in situ (AIS), using predefined algorithms that adjusted for multiple-type infected lesions. Methods: A total of 10,656 women ages 15 to 26 years and 1,858 women ages 24 to 45 years were enrolled in the placebo arms of one of three clinical trials of a quadrivalent HPV vaccine. We estimated the cumulative incidence of persistent infection and the proportion of CIN/AIS attributable to individual carcinogenic HPV genotypes, as well as the proportion of CIN/AIS lesions potentially preventable by a prophylactic 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine. Results: The cumulative incidence of persistent infection with≥1 of the seven high-risk types included in the 9-valent vaccine was 29{\%}, 12{\%}, and6{\%}forwomen ages 15 to 26, 24 to 34, and 35 to 45 years, respectively.Atotal of 2,507 lesions were diagnosed as CIN or AIS by an expert pathology panel. After adjusting for multiple-type infected lesions, amongwomen ages 15 to 45 years, these seven high-risk types were attributed to 43{\%} to 55{\%} of CIN1, 70{\%} to 78{\%} of CIN2, 85{\%} to 91{\%} of CIN3, and 95{\%} to 100{\%} of AIS lesions, respectively. The other tested types (HPV35/39/51/56/59) were attributed to 23{\%} to 30{\%} of CIN1, 7{\%} to 14{\%} of CIN2, 3{\%} to 4{\%} of CIN3, and 0{\%} of AIS lesions, respectively. Conclusions: Approximately 85{\%} or more of CIN3/AIS, >70{\%} CIN2, and approximately 50{\%} of CIN1 lesions worldwide are attributed to HPV6/11/16/18/31/33/45/52/58. Impact: If 9-valent HPV vaccination programs are effectively implemented, the majority of CIN2 and CIN3 lesions worldwide could be prevented, in addition to approximately one-half of CIN1.",
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T1 - Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease

AU - Joura, Elmar A.

AU - Ault, Kevin A.

AU - Bosch, F. Xavier

AU - Brown, Darron

AU - Cuzick, Jack

AU - Ferris, Daron

AU - Garland, Suzanne M.

AU - Giuliano, Anna R.

AU - Hernandez-Avila, Mauricio

AU - Huh, Warner

AU - Iversen, Ole Erik

AU - Kjaer, Susanne K.

AU - Luna, Joaquin

AU - Miller, Dianne

AU - Monsonego, Joseph

AU - Munoz, Nubia

AU - Myers, Evan

AU - Paavonen, Jorma

AU - Pitisuttithum, Punnee

AU - Steben, Marc

AU - Wheeler, Cosette M.

AU - Perez, Gonzalo

AU - Saah, Alfred

AU - Luxembourg, Alain

AU - Sings, Heather L.

AU - Velicer, Christine

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background: We estimated the prevalence and incidence of 14 human papillomavirus (HPV) types (6/11/ 16/18/31/33/35/39/45/51/52/56/58/59) in cervicovaginal swabs, and the attribution of these HPV types in cervical intraepithelial neoplasia (CIN), and adenocarcinoma in situ (AIS), using predefined algorithms that adjusted for multiple-type infected lesions. Methods: A total of 10,656 women ages 15 to 26 years and 1,858 women ages 24 to 45 years were enrolled in the placebo arms of one of three clinical trials of a quadrivalent HPV vaccine. We estimated the cumulative incidence of persistent infection and the proportion of CIN/AIS attributable to individual carcinogenic HPV genotypes, as well as the proportion of CIN/AIS lesions potentially preventable by a prophylactic 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine. Results: The cumulative incidence of persistent infection with≥1 of the seven high-risk types included in the 9-valent vaccine was 29%, 12%, and6%forwomen ages 15 to 26, 24 to 34, and 35 to 45 years, respectively.Atotal of 2,507 lesions were diagnosed as CIN or AIS by an expert pathology panel. After adjusting for multiple-type infected lesions, amongwomen ages 15 to 45 years, these seven high-risk types were attributed to 43% to 55% of CIN1, 70% to 78% of CIN2, 85% to 91% of CIN3, and 95% to 100% of AIS lesions, respectively. The other tested types (HPV35/39/51/56/59) were attributed to 23% to 30% of CIN1, 7% to 14% of CIN2, 3% to 4% of CIN3, and 0% of AIS lesions, respectively. Conclusions: Approximately 85% or more of CIN3/AIS, >70% CIN2, and approximately 50% of CIN1 lesions worldwide are attributed to HPV6/11/16/18/31/33/45/52/58. Impact: If 9-valent HPV vaccination programs are effectively implemented, the majority of CIN2 and CIN3 lesions worldwide could be prevented, in addition to approximately one-half of CIN1.

AB - Background: We estimated the prevalence and incidence of 14 human papillomavirus (HPV) types (6/11/ 16/18/31/33/35/39/45/51/52/56/58/59) in cervicovaginal swabs, and the attribution of these HPV types in cervical intraepithelial neoplasia (CIN), and adenocarcinoma in situ (AIS), using predefined algorithms that adjusted for multiple-type infected lesions. Methods: A total of 10,656 women ages 15 to 26 years and 1,858 women ages 24 to 45 years were enrolled in the placebo arms of one of three clinical trials of a quadrivalent HPV vaccine. We estimated the cumulative incidence of persistent infection and the proportion of CIN/AIS attributable to individual carcinogenic HPV genotypes, as well as the proportion of CIN/AIS lesions potentially preventable by a prophylactic 9-valent HPV6/11/16/18/31/33/45/52/58 vaccine. Results: The cumulative incidence of persistent infection with≥1 of the seven high-risk types included in the 9-valent vaccine was 29%, 12%, and6%forwomen ages 15 to 26, 24 to 34, and 35 to 45 years, respectively.Atotal of 2,507 lesions were diagnosed as CIN or AIS by an expert pathology panel. After adjusting for multiple-type infected lesions, amongwomen ages 15 to 45 years, these seven high-risk types were attributed to 43% to 55% of CIN1, 70% to 78% of CIN2, 85% to 91% of CIN3, and 95% to 100% of AIS lesions, respectively. The other tested types (HPV35/39/51/56/59) were attributed to 23% to 30% of CIN1, 7% to 14% of CIN2, 3% to 4% of CIN3, and 0% of AIS lesions, respectively. Conclusions: Approximately 85% or more of CIN3/AIS, >70% CIN2, and approximately 50% of CIN1 lesions worldwide are attributed to HPV6/11/16/18/31/33/45/52/58. Impact: If 9-valent HPV vaccination programs are effectively implemented, the majority of CIN2 and CIN3 lesions worldwide could be prevented, in addition to approximately one-half of CIN1.

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