Journal
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
Volume 20, Issue 2, Pages 287-296Publisher
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-10-0791
Keywords
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Funding
- Merck and Co., Inc.
- Sanofi Pasteur MSD
- institution for reagents and equipment for Roche Molecular Systems
- institution to conduct HPV studies for GlaxoSmithKline
- Commonwealth Serum Laboratories and GlaxoSmithKline
- institution to conduct HPV vaccine studies for GlaxoSmithKline
- Merck
- institution to conduct epidemiological HPV studies for GlaxoSmithKline
- GlaxoSmithKline
- institutions to conduct HPV vaccine studies for Merck
- Merck Research Laboratories
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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. Cancer Epidemiol Biomarkers Prev; 20(2); 287-96. (C)2011 AACR.
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