TY - JOUR
T1 - Human papillomavirus genotype contribution to cervical cancer and precancer
T2 - Implications for screening and vaccination in Japan
AU - Onuki, Mamiko
AU - Matsumoto, Koji
AU - Iwata, Takashi
AU - Yamamoto, Kasumi
AU - Aoki, Yoichi
AU - Maenohara, Shoji
AU - Tsuda, Naotake
AU - Kamiura, Shoji
AU - Takehara, Kazuhiro
AU - Horie, Koji
AU - Tasaka, Nobutaka
AU - Yahata, Hideaki
AU - Takei, Yuji
AU - Aoki, Yoichi
AU - Kato, Hisamori
AU - Motohara, Takeshi
AU - Nakamura, Keiichiro
AU - Ishikawa, Mitsuya
AU - Kato, Tatsuya
AU - Yoshida, Hiroyuki
AU - Matsumura, Noriomi
AU - Nakai, Hidekatsu
AU - Shigeta, Shogo
AU - Takahashi, Fumiaki
AU - Noda, Kiichiro
AU - Yaegashi, Nobuo
AU - Yoshikawa, Hiroyuki
N1 - Funding Information:
This work was supported by grants obtained from the Foundation for Advancement of International Science (FAIS), the Japan Agency of Medical Research and Development (AMED) (grant number: 20fk0108098) and MEXT KAKENHI (grant number: 17K11297). The supporting organizations played no role in the design or conduct of the study, collection, management, analysis, or interpretation of the data, nor preparation, review, or approval of the manuscript. We thank Edanz Group for editing a draft of this manuscript.
Publisher Copyright:
© 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - To obtain baseline data for cervical cancer prevention in Japan, we analyzed human papillomavirus (HPV) data from 5045 Japanese women aged less than 40 years and diagnosed with cervical abnormalities at 21 hospitals during 2012-2017. These included cervical intraepithelial neoplasia grade 1 (CIN1, n = 573), CIN2-3 (n = 3219), adenocarcinoma in situ (AIS, n = 123), and invasive cervical cancer (ICC, n = 1130). The Roche Linear Array was used for HPV genotyping. The HPV type-specific relative contributions (RCs) were estimated by adding multiple infections to single types in accordance with proportional weighting attributions. Based on the comparison of type-specific RCs between CIN1 and CIN2-3/AIS/ICC (CIN2+), RC ratios were calculated to estimate type-specific risks for progression to CIN2+. Human papillomavirus DNA was detected in 85.5% of CIN1, 95.7% of CIN2-3/AIS, and 91.2% of ICC. Multiple infections decreased with disease severity: 42.9% in CIN1, 40.4% in CIN2-3/AIS, and 23.7% in ICC (P <.0001). The relative risk for progression to CIN2+ was highest for HPV16 (RC ratio 3.78, 95% confidence interval [CI] 3.01-4.98), followed by HPV31 (2.51, 1.54-5.24), HPV18 (2.43, 1.59-4.32), HPV35 (1.56, 0.43-8.36), HPV33 (1.01, 0.49-3.31), HPV52 (0.99, 0.76-1.33), and HPV58 (0.97, 0.75-1.32). The relative risk of disease progression was 1.87 (95% CI, 1.71-2.05) for HPV16/18/31/33/35/45/52/58, but only 0.17 (95% CI, 0.14-0.22) for HPV39/51/56/59/66/68. Human papillomavirus 16/18/31/33/45/52/58/6/11 included in a 9-valent vaccine contributed to 89.7% (95% CI, 88.7-90.7) of CIN2-3/AIS and 93.8% (95% CI, 92.4-95.3) of ICC. In conclusion, our data support the Japanese guidelines that recommend discriminating HPV16/18/31/33/35/45/52/58 genotypes for CIN management. The 9-valent vaccine is estimated to provide over 90% protection against ICC in young Japanese women.
AB - To obtain baseline data for cervical cancer prevention in Japan, we analyzed human papillomavirus (HPV) data from 5045 Japanese women aged less than 40 years and diagnosed with cervical abnormalities at 21 hospitals during 2012-2017. These included cervical intraepithelial neoplasia grade 1 (CIN1, n = 573), CIN2-3 (n = 3219), adenocarcinoma in situ (AIS, n = 123), and invasive cervical cancer (ICC, n = 1130). The Roche Linear Array was used for HPV genotyping. The HPV type-specific relative contributions (RCs) were estimated by adding multiple infections to single types in accordance with proportional weighting attributions. Based on the comparison of type-specific RCs between CIN1 and CIN2-3/AIS/ICC (CIN2+), RC ratios were calculated to estimate type-specific risks for progression to CIN2+. Human papillomavirus DNA was detected in 85.5% of CIN1, 95.7% of CIN2-3/AIS, and 91.2% of ICC. Multiple infections decreased with disease severity: 42.9% in CIN1, 40.4% in CIN2-3/AIS, and 23.7% in ICC (P <.0001). The relative risk for progression to CIN2+ was highest for HPV16 (RC ratio 3.78, 95% confidence interval [CI] 3.01-4.98), followed by HPV31 (2.51, 1.54-5.24), HPV18 (2.43, 1.59-4.32), HPV35 (1.56, 0.43-8.36), HPV33 (1.01, 0.49-3.31), HPV52 (0.99, 0.76-1.33), and HPV58 (0.97, 0.75-1.32). The relative risk of disease progression was 1.87 (95% CI, 1.71-2.05) for HPV16/18/31/33/35/45/52/58, but only 0.17 (95% CI, 0.14-0.22) for HPV39/51/56/59/66/68. Human papillomavirus 16/18/31/33/45/52/58/6/11 included in a 9-valent vaccine contributed to 89.7% (95% CI, 88.7-90.7) of CIN2-3/AIS and 93.8% (95% CI, 92.4-95.3) of ICC. In conclusion, our data support the Japanese guidelines that recommend discriminating HPV16/18/31/33/35/45/52/58 genotypes for CIN management. The 9-valent vaccine is estimated to provide over 90% protection against ICC in young Japanese women.
KW - adenocarcinoma in situ
KW - cervical intraepithelial neoplasia
KW - human papillomavirus
KW - invasive cervical cancer
KW - vaccine
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U2 - 10.1111/cas.14445
DO - 10.1111/cas.14445
M3 - Article
C2 - 32372453
AN - SCOPUS:85085054053
SN - 1347-9032
VL - 111
SP - 2546
EP - 2557
JO - Cancer Science
JF - Cancer Science
IS - 7
ER -
