Limits...
Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study.

Hibbitts S, Jones J, Powell N, Dallimore N, McRea J, Beer H, Tristram A, Fielder H, Fiander AN - Br. J. Cancer (2008)

Bottom Line: Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status.Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18).The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. hibbittssj@cf.ac.uk

ABSTRACT
In this cross-sectional population-based study we determine human papillomavirus (HPV) prevalence in South Wales to provide comprehensive baseline data for future assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. Liquid-based cytology samples from women attending routine cervical screening were collected (n=10 000: mean age 38 years, 93% cytology negative, and 64.8% from the 50% least deprived LSOA according to social deprivation score (SDS)). High-Risk (HR) and Low-Risk HPV screening was performed using HPV PCR-EIA with genotyping of HR positives and data correlated with age, SDS and cytology. Overall HPV prevalence was 13.5% (9.3% age standardised) and the most frequent HR types were HPV 16, 31, 18 and 58. In HR HPV-positive cases 42.4% had a single HR type and they were predominant in women with severe cytological abnormalities. Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status. HPV prevalence increased significantly with degree of dyskaryosis from 7% in cytology negative samples to 80% in samples with severe cytological abnormalities (P-value <0.0001). Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18). The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

Show MeSH

Related in: MedlinePlus

Cross-sectional overview of HR HPV type distribution in South Wales. The total number of HR HPV cases with single HR and multiple HR types in each genotype calculated as a percentage of the total number of positive cases (n=1015). The HR HPV prevalence of each type in order of predominance was as follows: HPV 16 (n=319 31.4%), HPV 31 (n=230 22.6%), HPV 18 (n=221 21.7%), HPV 58 (n=201 19.8%), HPV 33 (n=151 14.9%), HPV 45 (n=138 13.6%), HPV 39 (n=126 12.4%), HPV 56 (n=110 10.8%), HPV 59 (n=109 10.7%), HPV 35 (n=108 10.6%), HPV 51 (n=100 9.8%), HPV 66 (n=89 8.8%), HPV 52 (n=80 7.9%) and HPV 68 (n=25 2.5%). Single HR HPV type distribution (in order of predominance): HPV 16 (n=143 14.1%), HPV 66 (n=40 3.9%), HPV 51 (n=38 3.7%), HPV 31 (n=31 3.1%), HPV 45 (n=30 3.0%), HPV 39 (n=30 3.0%), HPV 58 (n=28 2.8%), HPV 59 (n=26 2.6%), HPV 52 (n=24 2.4%), HPV 18 (n=20 2.0%), HPV 56 (n=10 1.0%), HPV 68 (n=5 0.5%), HPV 35 (n=3 0.3%), and HPV 33 (n=2 0.2%). Multiple HR HPV type distribution: HPV 18 (n=201 19.8%), HPV 31 (n=199 19.6%), HPV 16 (n=176 17.3%), HPV 58 (n=173 17.0%), HPV 33 (n=149 14.7%), HPV 45 (n=108 10.6%), HPV 35 (n=105 10.3%), HPV 56 (n=100 5.5%), HPV 39 (n=96 9.5%), HPV 59 (n=83 8.2%), HPV 51 (n=62 6.1%), HPV 52 (n=56 5.5%), HPV 66 (n=49 4.8%), and HPV 68 (n=20 2.0%).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2600697&req=5

fig1: Cross-sectional overview of HR HPV type distribution in South Wales. The total number of HR HPV cases with single HR and multiple HR types in each genotype calculated as a percentage of the total number of positive cases (n=1015). The HR HPV prevalence of each type in order of predominance was as follows: HPV 16 (n=319 31.4%), HPV 31 (n=230 22.6%), HPV 18 (n=221 21.7%), HPV 58 (n=201 19.8%), HPV 33 (n=151 14.9%), HPV 45 (n=138 13.6%), HPV 39 (n=126 12.4%), HPV 56 (n=110 10.8%), HPV 59 (n=109 10.7%), HPV 35 (n=108 10.6%), HPV 51 (n=100 9.8%), HPV 66 (n=89 8.8%), HPV 52 (n=80 7.9%) and HPV 68 (n=25 2.5%). Single HR HPV type distribution (in order of predominance): HPV 16 (n=143 14.1%), HPV 66 (n=40 3.9%), HPV 51 (n=38 3.7%), HPV 31 (n=31 3.1%), HPV 45 (n=30 3.0%), HPV 39 (n=30 3.0%), HPV 58 (n=28 2.8%), HPV 59 (n=26 2.6%), HPV 52 (n=24 2.4%), HPV 18 (n=20 2.0%), HPV 56 (n=10 1.0%), HPV 68 (n=5 0.5%), HPV 35 (n=3 0.3%), and HPV 33 (n=2 0.2%). Multiple HR HPV type distribution: HPV 18 (n=201 19.8%), HPV 31 (n=199 19.6%), HPV 16 (n=176 17.3%), HPV 58 (n=173 17.0%), HPV 33 (n=149 14.7%), HPV 45 (n=108 10.6%), HPV 35 (n=105 10.3%), HPV 56 (n=100 5.5%), HPV 39 (n=96 9.5%), HPV 59 (n=83 8.2%), HPV 51 (n=62 6.1%), HPV 52 (n=56 5.5%), HPV 66 (n=49 4.8%), and HPV 68 (n=20 2.0%).

Mentions: In HR HPV-positive cases (n=1015) the most prevalent HR genotypes detected were 16 (31.4%), 31 (22.6%), 18 (21.7%) and 58 (19.8%). The proportion of HR HPV cases attributable to types included in currently licensed prophylactic HPV vaccines (HPV 16 and HPV 18) was 46% overall (n=471 out of 1015) and 70% (n=28 out of 40) for cases with severe cytological abnormalities. Here, 42% (n=430 out of 1015; 95% CI 39.4–45.5%) of HR HPV-positive cases had an infection with a single HR type and in these women HPV 16 was the predominant genotype (n=143 out of 430). The remaining 58% (n=585 out of 1015; 95% CI 54.5–60.6%) had multiple HR types and HPV 18 was the most predominant type detected (n=201 out of 585). The prevalence of each HPV genotype in cases with a single HR infection was compared with cases containing multiple HR types and no statistically significant differences were found for HPV 16, 51 or 66 (χ2 test; P=0.2594, P=0.3461 and P=0.6142 respectively). All other genotypes were statistically significantly more common in cases with multiple HR types compared with those with a single HR type (Figure 1). In cases with a single HR type the genotype distribution in each cytology grade (negative, borderline and dyskaryotic) was assessed. HPV 16 was the only genotype significantly more prevalent in cases with dyskaryosis (mild, moderate or severe) compared with borderline and negative cases (Figure 2; χ2 test; P=0.0395 and P>0.0001 respectively).


Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study.

Hibbitts S, Jones J, Powell N, Dallimore N, McRea J, Beer H, Tristram A, Fielder H, Fiander AN - Br. J. Cancer (2008)

Cross-sectional overview of HR HPV type distribution in South Wales. The total number of HR HPV cases with single HR and multiple HR types in each genotype calculated as a percentage of the total number of positive cases (n=1015). The HR HPV prevalence of each type in order of predominance was as follows: HPV 16 (n=319 31.4%), HPV 31 (n=230 22.6%), HPV 18 (n=221 21.7%), HPV 58 (n=201 19.8%), HPV 33 (n=151 14.9%), HPV 45 (n=138 13.6%), HPV 39 (n=126 12.4%), HPV 56 (n=110 10.8%), HPV 59 (n=109 10.7%), HPV 35 (n=108 10.6%), HPV 51 (n=100 9.8%), HPV 66 (n=89 8.8%), HPV 52 (n=80 7.9%) and HPV 68 (n=25 2.5%). Single HR HPV type distribution (in order of predominance): HPV 16 (n=143 14.1%), HPV 66 (n=40 3.9%), HPV 51 (n=38 3.7%), HPV 31 (n=31 3.1%), HPV 45 (n=30 3.0%), HPV 39 (n=30 3.0%), HPV 58 (n=28 2.8%), HPV 59 (n=26 2.6%), HPV 52 (n=24 2.4%), HPV 18 (n=20 2.0%), HPV 56 (n=10 1.0%), HPV 68 (n=5 0.5%), HPV 35 (n=3 0.3%), and HPV 33 (n=2 0.2%). Multiple HR HPV type distribution: HPV 18 (n=201 19.8%), HPV 31 (n=199 19.6%), HPV 16 (n=176 17.3%), HPV 58 (n=173 17.0%), HPV 33 (n=149 14.7%), HPV 45 (n=108 10.6%), HPV 35 (n=105 10.3%), HPV 56 (n=100 5.5%), HPV 39 (n=96 9.5%), HPV 59 (n=83 8.2%), HPV 51 (n=62 6.1%), HPV 52 (n=56 5.5%), HPV 66 (n=49 4.8%), and HPV 68 (n=20 2.0%).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600697&req=5

fig1: Cross-sectional overview of HR HPV type distribution in South Wales. The total number of HR HPV cases with single HR and multiple HR types in each genotype calculated as a percentage of the total number of positive cases (n=1015). The HR HPV prevalence of each type in order of predominance was as follows: HPV 16 (n=319 31.4%), HPV 31 (n=230 22.6%), HPV 18 (n=221 21.7%), HPV 58 (n=201 19.8%), HPV 33 (n=151 14.9%), HPV 45 (n=138 13.6%), HPV 39 (n=126 12.4%), HPV 56 (n=110 10.8%), HPV 59 (n=109 10.7%), HPV 35 (n=108 10.6%), HPV 51 (n=100 9.8%), HPV 66 (n=89 8.8%), HPV 52 (n=80 7.9%) and HPV 68 (n=25 2.5%). Single HR HPV type distribution (in order of predominance): HPV 16 (n=143 14.1%), HPV 66 (n=40 3.9%), HPV 51 (n=38 3.7%), HPV 31 (n=31 3.1%), HPV 45 (n=30 3.0%), HPV 39 (n=30 3.0%), HPV 58 (n=28 2.8%), HPV 59 (n=26 2.6%), HPV 52 (n=24 2.4%), HPV 18 (n=20 2.0%), HPV 56 (n=10 1.0%), HPV 68 (n=5 0.5%), HPV 35 (n=3 0.3%), and HPV 33 (n=2 0.2%). Multiple HR HPV type distribution: HPV 18 (n=201 19.8%), HPV 31 (n=199 19.6%), HPV 16 (n=176 17.3%), HPV 58 (n=173 17.0%), HPV 33 (n=149 14.7%), HPV 45 (n=108 10.6%), HPV 35 (n=105 10.3%), HPV 56 (n=100 5.5%), HPV 39 (n=96 9.5%), HPV 59 (n=83 8.2%), HPV 51 (n=62 6.1%), HPV 52 (n=56 5.5%), HPV 66 (n=49 4.8%), and HPV 68 (n=20 2.0%).
Mentions: In HR HPV-positive cases (n=1015) the most prevalent HR genotypes detected were 16 (31.4%), 31 (22.6%), 18 (21.7%) and 58 (19.8%). The proportion of HR HPV cases attributable to types included in currently licensed prophylactic HPV vaccines (HPV 16 and HPV 18) was 46% overall (n=471 out of 1015) and 70% (n=28 out of 40) for cases with severe cytological abnormalities. Here, 42% (n=430 out of 1015; 95% CI 39.4–45.5%) of HR HPV-positive cases had an infection with a single HR type and in these women HPV 16 was the predominant genotype (n=143 out of 430). The remaining 58% (n=585 out of 1015; 95% CI 54.5–60.6%) had multiple HR types and HPV 18 was the most predominant type detected (n=201 out of 585). The prevalence of each HPV genotype in cases with a single HR infection was compared with cases containing multiple HR types and no statistically significant differences were found for HPV 16, 51 or 66 (χ2 test; P=0.2594, P=0.3461 and P=0.6142 respectively). All other genotypes were statistically significantly more common in cases with multiple HR types compared with those with a single HR type (Figure 1). In cases with a single HR type the genotype distribution in each cytology grade (negative, borderline and dyskaryotic) was assessed. HPV 16 was the only genotype significantly more prevalent in cases with dyskaryosis (mild, moderate or severe) compared with borderline and negative cases (Figure 2; χ2 test; P=0.0395 and P>0.0001 respectively).

Bottom Line: Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status.Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18).The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. hibbittssj@cf.ac.uk

ABSTRACT
In this cross-sectional population-based study we determine human papillomavirus (HPV) prevalence in South Wales to provide comprehensive baseline data for future assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. Liquid-based cytology samples from women attending routine cervical screening were collected (n=10 000: mean age 38 years, 93% cytology negative, and 64.8% from the 50% least deprived LSOA according to social deprivation score (SDS)). High-Risk (HR) and Low-Risk HPV screening was performed using HPV PCR-EIA with genotyping of HR positives and data correlated with age, SDS and cytology. Overall HPV prevalence was 13.5% (9.3% age standardised) and the most frequent HR types were HPV 16, 31, 18 and 58. In HR HPV-positive cases 42.4% had a single HR type and they were predominant in women with severe cytological abnormalities. Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status. HPV prevalence increased significantly with degree of dyskaryosis from 7% in cytology negative samples to 80% in samples with severe cytological abnormalities (P-value <0.0001). Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18). The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

Show MeSH
Related in: MedlinePlus