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Prevalence of Human Papillomavirus Types in Invasive Cervical Cancers From 7 US Cancer Registries Before Vaccine Introduction

Hopenhayn, Claudia PhD, MPH1; Christian, Amy MSPH1; Christian, Warren Jay PhD, MPH1; Watson, Meg MPH2; Unger, Elizabeth R. PhD, MD3; Lynch, Charles F. PhD, MD4; Peters, Edward S. ScD, DMD5; Wilkinson, Edward J. MD6; Huang, Youjie DrPh, MD7; Copeland, Glenn MBA8; Cozen, Wendy DO, MPH9; Saber, Maria Sibug MD9; Goodman, Marc T. PhD, MPH10; Hernandez, Brenda Y. PhD10; Steinau, Martin PhD3; Lyu, Christopher MPA11; Tucker, Thomas T. PhD1,12; Saraiya, Mona MD, MPH2

Journal of Lower Genital Tract Disease: April 2014 - Volume 18 - Issue 2 - p 182–189
doi: 10.1097/LGT.0b013e3182a577c7
Original Articles

Objective We conducted a baseline study of human papillomavirus (HPV) type prevalence in invasive cervical cancers (ICCs) using data from 7 cancer registries (CRs) in the United States. Cases were diagnosed between 1994 and 2005 before the implementation of the HPV vaccines.

Materials and Methods Cancer registries from Florida, Kentucky, Louisiana, Michigan, Hawaii, Iowa, and Los Angeles, California identified eligible ICC cases and obtained sections from representative blocks of archived tumor specimens for DNA extraction. All extracts were assayed by linear array and, if inadequate or HPV negative, retested with INNO-LiPA Genotype test. Clinical and demographic factors were obtained from the CRs and merged with the HPV typing data to analyze factors associated with different types and with HPV negativity.

Results A total of 777 ICCs were included in this analysis, with broad geographic, age, and race distribution. Overall, HPV was detected in 91% of cases, including 51% HPV-16, 16% HPV-18 (HPV-16–negative), and 24% other oncogenic and rare types. After HPV-16 and -18, the most common types were 45, 33, 31, 35, and 52. Older age and nonsquamous histology were associated with HPV-negative typing.

Conclusions This study provides baseline prevaccine HPV types for postvaccine ICC surveillance in the future. HPV-16 and/or -18 were found in 67% of ICCs, indicating the potential for vaccines to prevent a significant number of cervical cancers.

Data from 7 US cancer registries shows that type-specific HPV prevalence in invasive cervical cancers mirrors that shown in several international meta-analyses.

1Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY; 2Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, and 3Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA; 4Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA; 5Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA; 6Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL; 7Florida Department of Health, Tallahassee, FL; 8Michigan Department of Community Health, Lansing, MI; 9Norris Comprehensive Cancer Center and Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA; 10University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI; 11Battelle Memorial Institute, Durham, NC; and 12Markey Cancer Control Program, University of Kentucky, Lexington, KY

Reprint requests to: Claudia Hopenhayn, PhD, MPH, University of Kentucky, 111 Washington Ave, Lexington, KY 40536. E-mail:

This project was supported in part by the Centers for Disease Control and Prevention (CDC) grant nos. 5U58DP000810-5 (Kentucky), 5U58DP000844-5 (Florida), 5U58DP000812-5 (Michigan), and 5U58DP000769-5 (Louisiana) and from the SEER Program, National Institutes of Health, Department of Health and Human Services, under Contracts N01-PC-35139 (Los Angeles), N01-PC-35143 (Iowa), and N01-PC-35137 (Hawaii). Support for collection of specimens from Kentucky, Florida, Michigan, and Louisiana; coordination of genotyping data from both SEER registry and National Program of Cancer Registries; and genotyping was largely supported by CDC intramural funds and Vaccine for Children Funds.

Data collection from California was largely supported by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; by the National Cancer Institute, National Institutes of Health, Department of Health and Human Services under Contract N01-PC-2010-00035; and grant number 1U58DP000807-3 from the CDC.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

The authors declare that they have no conflicts of interest.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology