Obstetrics & Gynecology

Skip Navigation LinksHome > April 2014 - Volume 123 - Issue 4 > Human Papillomavirus Genotype Prevalence in Invasive Vaginal...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000171
Contents: Original Research

Human Papillomavirus Genotype Prevalence in Invasive Vaginal Cancer From a Registry-Based Population

Sinno, Abdulrahman K. MD; Saraiya, Mona MD, MPH; Thompson, Trevor D. BS; Hernandez, Brenda Y. PhD, MPH; Goodman, Marc T. PhD, MPH; Steinau, Martin PhD; Lynch, Charles F. PhD, MD; Cozen, Wendy DO, MPH; Saber, Maria Sibug MD; Peters, Edward S. ScD, DMD; Wilkinson, Edward J. MD; Copeland, Glenn MBA; Hopenhayn, Claudia PhD, MPH; Watson, Meg MPH; Lyu, Christopher MPA; Unger, Elizabeth R. PhD, MD

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Abstract

OBJECTIVE: To describe the human papillomavirus (HPV) genotype distribution in invasive vaginal cancers diagnosed before the introduction of the HPV vaccine and evaluate if survival differed by HPV status.

METHODS: Four population-based registries and three residual tissue repositories provided formalin-fixed, paraffin-embedded tissue from microscopically confirmed primary vaginal cancer cases diagnosed between 1994 and 2005 that were tested by L1 consensus polymerase chain reaction with type-specific hybridization in a central laboratory. Clinical, demographic, and all-cause survival data were assessed by HPV status.

RESULTS: Sixty cases of invasive vaginal cancer were included. Human papillomavirus was detected in 75% (45) and 25% (15) were HPV-negative. HPV 16 was most frequently detected (55% [33/60]) followed by HPV 33 (18.3% [11/60]). Only one case was positive for HPV 18 (1.7%) Multiple types were detected in 15% of the cases. Vaginal cancers in women younger than 60 years were more likely to be HPV 16– or HPV 18–positive (HPV 16 and 18) than older women, 77.3% compared with 44.7% (P=.038). The median age at diagnosis was younger in the HPV 16 and 18 (59 years) group compared with other HPV-positive (68 years) and no HPV (77 years) (P=.003). The HPV distribution did not significantly vary by race or ethnicity or place of residence. The 5-year unadjusted all-cause survival was 57.4% for women with HPV-positive vaginal cancers compared with 35.7% among those with HPV-negative tumors (P=.243).

CONCLUSION: Three fourths of all vaginal cancers in the United States had HPV detected, much higher than previously found, and 57% could be prevented by current HPV vaccines.

LEVEL OF EVIDENCE: III

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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