Targeting the human papillomavirus for prevention of cervical cancer

Different types of human papillomavirus (HPV) vary in the extent they cause precursor lesions (CIN) and cancer. There are limited long-term efficacy data on HPV testing in primary screening Among 72 cervical cancers in Mozambique, HPV 16 and 18 were the most frequent HPV types (69% of cases). Comparing 108 cervical cancers cases and 517 matched controls nested within a population-based cohort in Taiwan, HPV 16 seropositivity implied a 6-fold increased cancer risk. In a cohort of 5696 women in Sweden, HPV types 16, 31 and 33 conveyed the highest risks for future high-grade CIN (CIN 2+), attributing to 33.1%, 18.3% and 7.7% of CIN 2+ cases, respectively. In a pooled analysis of seven European longitudinal studies of HPV-based cervical screening, the cumulative incidence rate of CIN grade 3 or worse (CIN 3+) was higher after 3 years among women with normal cytology than among women with a negative HPV test after 6 years. Finally, in a randomized cervical cancer screening trial in Sweden, adding testing for HPV persistence resulted in a 51% (95% CI: 13-102) increase of CIN 2+ at prevalent screening, which was followed by a reduction of 42% (95% CI: 4-76) of CIN 2+ at incident screening. In conclusion, HPV-based cervical cancer screening protects against future CIN 2+, and the long-term protective effect should enable extended screening intervals to 6 years. Albeit HPV 16 is the most important carcinogenic HPV type all over the world, different ?high-risk? HPV types convey distinctly different risks for CIN 2+, which should be considered in design of screening tests and vaccines.

Grantor dc:publisher

Medical Microbiology, Lund University

Year dc:date

2007

Author dc:creator

• Naucler, Pontus

• Microbiology in the Medical Area
• bakteriologi
• virologi
• Mikrobiologi
• mycology
• virology
• bacteriology
• prevention
• Microbiology
• CIN
• vaccine
• cervical intraepithelial neoplasia
• screening
• cervical cancer
• Human Papillomavirus
• HPV
• mykologi
• Public health
• epidemiology
• Folkhälsa
• epidemiologi

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

eng

Identifier

urn:isbn:978-91-85559-75-6

OAI identifier oai:identifier

oai:lup.lub.lu.se:848bf8ca-5c98-4298-a186-0f4b9bce68f8