Human papillomavirus genotype-specific risks for cervical intraepithelial lesions

Prevalence of different HPV genotypes is changing after HPV vaccination. The associated risks are needed for optimizing cervical cancer screening. To estimate HPV type-specific prevalence, odds ratio (OR), and positive predictive value (PPV) for cervical cytological abnormalities, we determined 41 d...

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Bibliographic Details
Published in:Human Vaccines & Immunotherapeutics
Main Authors: Mari Nygård, Bo T. Hansen, Susanne K. Kjaer, Maria Hortlund, Laufey Tryggvadóttir, Christian Munk, Camilla Lagheden, Lara G. Sigurdardottir, Suzanne Campbell, Kai-Li Liaw, Joakim Dillner
Format: Article in Journal/Newspaper
Language:English
Published: Taylor & Francis Group 2021
Subjects:
denmark
high-risk hpv
iceland
liquid-based cytology
low-risk hpv
norway
population-based prevalence
sweden
Immunologic diseases. Allergy
RC581-607
Therapeutics. Pharmacology
RM1-950
Norway
Iceland
Online Access:https://doi.org/10.1080/21645515.2020.1814097
https://doaj.org/article/1a3132436787418e979345f5da26171f
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Summary:Prevalence of different HPV genotypes is changing after HPV vaccination. The associated risks are needed for optimizing cervical cancer screening. To estimate HPV type-specific prevalence, odds ratio (OR), and positive predictive value (PPV) for cervical cytological abnormalities, we determined 41 different HPV genotypes in cervical samples from a population-based sample of 8351 women aged 18–51 years before HPV vaccination era (V501-033; NCT01077856). Prevalence of HPV16 was 4.9% (95% CI: 4.4–5.5) with the PPV for high-grade cytology 11.2%, and OR 11.9 (95% CI: 8.5–16.5). Carcinogenic HPVs included in the nonavalent vaccine (HPV16,18,31,33,45,52,58) had a population prevalence of 14.4% (95% CI: 13.5–15.4), with PPV of 8.0% (95% CI: 6.8–9.3) and OR 23.7 (95% CI: 16.0–63.5) for high-grade cytology. HPV types currently included in most screening tests, but not vaccinated against (HPV35,39,51,56,59,66,68) had a joint prevalence of 8.5% (95% CI: 7.8–9.2) with PPV of 4.4% (95% CI: 3.3–5.7) and OR of 2.9 (95% CI: 2.0–4.0) for high-grade cytology. The other 27 non-carcinogenic genotypes had a prevalence of 11.8%, PPV of 2.9% (95% CI:2.1–3.9), and OR 1.5 (95% CI: 1.1–2.2.) for high-grade cytology. These results suggest that HPV screening tests in the post-vaccination era might perform better if restricted to the HPV types in the nonavalent vaccine and screening for all 14 HPV types might result in suboptimal balance of harms and benefits.

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