Incident cervical HPV infections in young women: Transition probabilities for CIN and infection clearance

Ralph P. Insinga, Gonzalo Perez, Cosette M. Wheeler, Laura A. Koutsky, Suzanne M. Garland, Sepp Leodolter, Elmar A. Joura, Daron Gale Ferris, Marc Steben, Mauricio Hernandez-Avila, Darron R. Brown, Elamin Elbasha, Nubia Muñoz, Jorma Paavonen, Richard M. Haupt

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Background: We describe transition probabilities for incident human papillomavirus (HPV) 16/18/31/33/35/45/52/58/59 infections and cervical intraepithelial neoplasia (CIN) 1 lesions. Methods: Women ages 16 to 23 years underwent cytology and cervical swab PCR testing for HPV at approximately 6-month intervals for up to 4 years in the placebo arm of an HPV vaccine trial. The cumulative proportion of incident HPV infections with diagnosed CIN, clearing (infection undetectable), or persisting without CIN, were estimated. Results: Most incident infections cleared, without detection of CIN, ranging at 36 months from 66.9% for HPV31 to 91.1% for HPV59. There was little variation in the 36-month proportion of incident HPV16, 18, and 31 infections followed by a CIN1 lesion positive for the relevant HPV type (range 16.7%-18.6%), with lower risks for HPV59 (6.4%) and HPV33 (2.9%). Thirty-six-month transition probabilities for CIN2 ranged across types from 2.2% to 9.1%; however, the number of events was generally too small for statistically significant differences to be seen across types for this endpoint, or CIN3. Conclusions: Some incident HPV types appear more likely to result in diagnosed CIN1 than others. The relative predominance of HPV16, vis-à-vis some other high-risk HPV types (e.g., HPV33) in prevalent CIN2/3, appears more directly associated with relatively greater frequency of incident HPV16 infections within the population, than a higher risk of infection progression to CIN2/3. Impact: Nearly all incident HPV infections either manifest as detectable CIN or become undetectable within 36 months. Some HPV types (e.g., 16 and 33) appear to have similar risk of CIN2/3 despite widely varied incidence.

Original languageEnglish (US)
Pages (from-to)287-296
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2011

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Cervical Intraepithelial Neoplasia
Papillomavirus Infections
Infection
Human papillomavirus 16
Papillomavirus Vaccines
Human papillomavirus 18
Cell Biology
Placebos
Polymerase Chain Reaction
Incidence
Population

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Insinga, R. P., Perez, G., Wheeler, C. M., Koutsky, L. A., Garland, S. M., Leodolter, S., ... Haupt, R. M. (2011). Incident cervical HPV infections in young women: Transition probabilities for CIN and infection clearance. Cancer Epidemiology Biomarkers and Prevention, 20(2), 287-296. https://doi.org/10.1158/1055-9965.EPI-10-0791

Incident cervical HPV infections in young women : Transition probabilities for CIN and infection clearance. / Insinga, Ralph P.; Perez, Gonzalo; Wheeler, Cosette M.; Koutsky, Laura A.; Garland, Suzanne M.; Leodolter, Sepp; Joura, Elmar A.; Ferris, Daron Gale; Steben, Marc; Hernandez-Avila, Mauricio; Brown, Darron R.; Elbasha, Elamin; Muñoz, Nubia; Paavonen, Jorma; Haupt, Richard M.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 20, No. 2, 01.02.2011, p. 287-296.

Research output: Contribution to journalArticle

Insinga, RP, Perez, G, Wheeler, CM, Koutsky, LA, Garland, SM, Leodolter, S, Joura, EA, Ferris, DG, Steben, M, Hernandez-Avila, M, Brown, DR, Elbasha, E, Muñoz, N, Paavonen, J & Haupt, RM 2011, 'Incident cervical HPV infections in young women: Transition probabilities for CIN and infection clearance', Cancer Epidemiology Biomarkers and Prevention, vol. 20, no. 2, pp. 287-296. https://doi.org/10.1158/1055-9965.EPI-10-0791
Insinga, Ralph P. ; Perez, Gonzalo ; Wheeler, Cosette M. ; Koutsky, Laura A. ; Garland, Suzanne M. ; Leodolter, Sepp ; Joura, Elmar A. ; Ferris, Daron Gale ; Steben, Marc ; Hernandez-Avila, Mauricio ; Brown, Darron R. ; Elbasha, Elamin ; Muñoz, Nubia ; Paavonen, Jorma ; Haupt, Richard M. / Incident cervical HPV infections in young women : Transition probabilities for CIN and infection clearance. In: Cancer Epidemiology Biomarkers and Prevention. 2011 ; Vol. 20, No. 2. pp. 287-296.
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abstract = "Background: We describe transition probabilities for incident human papillomavirus (HPV) 16/18/31/33/35/45/52/58/59 infections and cervical intraepithelial neoplasia (CIN) 1 lesions. Methods: Women ages 16 to 23 years underwent cytology and cervical swab PCR testing for HPV at approximately 6-month intervals for up to 4 years in the placebo arm of an HPV vaccine trial. The cumulative proportion of incident HPV infections with diagnosed CIN, clearing (infection undetectable), or persisting without CIN, were estimated. Results: Most incident infections cleared, without detection of CIN, ranging at 36 months from 66.9{\%} for HPV31 to 91.1{\%} for HPV59. There was little variation in the 36-month proportion of incident HPV16, 18, and 31 infections followed by a CIN1 lesion positive for the relevant HPV type (range 16.7{\%}-18.6{\%}), with lower risks for HPV59 (6.4{\%}) and HPV33 (2.9{\%}). Thirty-six-month transition probabilities for CIN2 ranged across types from 2.2{\%} to 9.1{\%}; however, the number of events was generally too small for statistically significant differences to be seen across types for this endpoint, or CIN3. Conclusions: Some incident HPV types appear more likely to result in diagnosed CIN1 than others. The relative predominance of HPV16, vis-{\`a}-vis some other high-risk HPV types (e.g., HPV33) in prevalent CIN2/3, appears more directly associated with relatively greater frequency of incident HPV16 infections within the population, than a higher risk of infection progression to CIN2/3. Impact: Nearly all incident HPV infections either manifest as detectable CIN or become undetectable within 36 months. Some HPV types (e.g., 16 and 33) appear to have similar risk of CIN2/3 despite widely varied incidence.",
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T2 - Transition probabilities for CIN and infection clearance

AU - Insinga, Ralph P.

AU - Perez, Gonzalo

AU - Wheeler, Cosette M.

AU - Koutsky, Laura A.

AU - Garland, Suzanne M.

AU - Leodolter, Sepp

AU - Joura, Elmar A.

AU - Ferris, Daron Gale

AU - Steben, Marc

AU - Hernandez-Avila, Mauricio

AU - Brown, Darron R.

AU - Elbasha, Elamin

AU - Muñoz, Nubia

AU - Paavonen, Jorma

AU - Haupt, Richard M.

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N2 - Background: We describe transition probabilities for incident human papillomavirus (HPV) 16/18/31/33/35/45/52/58/59 infections and cervical intraepithelial neoplasia (CIN) 1 lesions. Methods: Women ages 16 to 23 years underwent cytology and cervical swab PCR testing for HPV at approximately 6-month intervals for up to 4 years in the placebo arm of an HPV vaccine trial. The cumulative proportion of incident HPV infections with diagnosed CIN, clearing (infection undetectable), or persisting without CIN, were estimated. Results: Most incident infections cleared, without detection of CIN, ranging at 36 months from 66.9% for HPV31 to 91.1% for HPV59. There was little variation in the 36-month proportion of incident HPV16, 18, and 31 infections followed by a CIN1 lesion positive for the relevant HPV type (range 16.7%-18.6%), with lower risks for HPV59 (6.4%) and HPV33 (2.9%). Thirty-six-month transition probabilities for CIN2 ranged across types from 2.2% to 9.1%; however, the number of events was generally too small for statistically significant differences to be seen across types for this endpoint, or CIN3. Conclusions: Some incident HPV types appear more likely to result in diagnosed CIN1 than others. The relative predominance of HPV16, vis-à-vis some other high-risk HPV types (e.g., HPV33) in prevalent CIN2/3, appears more directly associated with relatively greater frequency of incident HPV16 infections within the population, than a higher risk of infection progression to CIN2/3. Impact: Nearly all incident HPV infections either manifest as detectable CIN or become undetectable within 36 months. Some HPV types (e.g., 16 and 33) appear to have similar risk of CIN2/3 despite widely varied incidence.

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