Skip Navigation LinksHome > October 2013 - Volume 17 - Issue 4 > Human Papillomavirus Prevalence in Invasive Anal Cancers in...
Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e31827ed372
Original Articles

Human Papillomavirus Prevalence in Invasive Anal Cancers in the United States Before Vaccine Introduction

Steinau, Martin PhD1; Unger, Elizabeth R. MD, PhD1; Hernandez, Brenda Y. PhD2; Goodman, Marc T. PhD3; Copeland, Glenn MBA4; Hopenhayn, Claudia PhD5; Cozen, Wendy DO6; Saber, Maria S. MD6; Huang, Youjie DrPh, MD7; Peters, Edward S. ScD, DMD8; Lynch, Charles F. MD, PhD9; Wilkinson, Edward J. MD10; Rajeevan, Mangalathu S. PhD1; Lyu, Christopher MPA11; Saraiya, Mona MD12

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Abstract

Objective: This study aimed to conduct a representative survey of human papillomavirus (HPV) prevalence and its genotype distribution in invasive anal cancer specimens in the United States.

Materials and Methods: Population-based archival anal cancer specimens were identified from Florida, Kentucky, Louisiana, and Michigan cancer registries and Surveillance, Epidemiology, and End Results (SEER) tissue repositories in Hawaii, Iowa, and Los Angeles. Sections from 1 representative block per case were used for DNA extraction. All extracts were assayed first by linear array and retested with INNO-LiPA if inadequate or HPV negative.

Results: Among 146 unique invasive anal cancer cases, 93 (63.7%) were from women, and 53 (36.3%) were from men. Human papillomavirus (any type) was detected in 133 cases (91.1%) and 129 (88.4%) contained at least 1 high risk-type, most (80.1%) as a single genotype. Human papillomavirus type 16 had the highest prevalence (113 cases, 77.4%); HPV types 6, 11, 18, and 33 were also found multiple times. Among HPV-16–positive cases, 37% were identified as prototype variant Ep, and 63% were nonprototypes: 33% Em, 12% E-G131G, 5% Af1, 4% AA/NA-1, 3% E-C109G, 3% E-G131T, 2% As, and 1% Af2. No significant differences in the distributions of HPV (any), high-risk types, or HPV-16/18 were seen between sex, race, or age group.

Conclusions: The establishment of prevaccine HPV prevalence in the United States is critical to the surveillance of vaccine efficacy. Almost 80% of anal cancers were positive for the vaccine types HPV-16 or HPV-18, and in 70%, these were the only types detected, suggesting that a high proportion might be preventable by current vaccines.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology

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