Cervical adenocarcinoma in situ: Human papillomavirus types and incidence trends in five states, 2008–2015

Details

• Alternative Title:
  Int J Cancer
• Personal Author:
  Cleveland, Angela A. ; Gargano, Julia W. ; Park, Ina U. ; Griffin, Marie R. ; Niccolai, Linda M. ; Powell, Melissa ; Bennett, Nancy M. ; Saadeh, Kayla ; Pemmaraju, Manideepthi ; Higgins, Kyle ; Ehlers, Sara ; Scahill, Mary ; Jones, Michelle L. Johnson ; Querec, Troy ; Markowitz, Lauri E. ; Unger, Elizabeth R.
• Corporate Authors:
  HPV-IMPACT Working Group
• Description:
  Primary prevention through the use of human papillomavirus (HPV) vaccination is expected to impact both cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS). While CIN is well described, less is known about the epidemiology of AIS, a rare cervical precancer. We identified AIS and CIN grade 3 (CIN3) cases through population-based surveillance, and analyzed data on HPV types and incidence trends overall, and among women screened for cervical cancer. From 2008 to 2015, 470 AIS and 6,587 CIN3 cases were identified. The median age of women with AIS was older than those with CIN3 (35 vs. 31 years; p < 0.01). HPV16 was the most frequently detected type in both AIS and CIN3 (57% in AIS; 58% in CIN3), whereas HPV18 was the second most common type in AIS and less common in CIN3 (38% vs. 5%; p < 0.01). AIS lesions were more likely than CIN3 lesions to be positive for high-risk types targeted by the bivalent and quadrivalent vaccines (HPV16/18, 92% vs. 63%; p < 0.01), and 9-valent vaccine (HPV16/18/31/33/45/52/58, 95% vs. 87%; p < 0.01). AIS incidence rates decreased significantly in the 21-24 year age group (annual percent change [APC] overall: -22.1%, 95% CI: -33.9 to -8.2; APC among screened: -16.1%, 95% CI: -28.8 to -1.2), but did not decrease significantly in any older age group. This report on the largest number of genotyped AIS cases to date suggests an important opportunity for vaccine prevention of AIS, and is the first to document a decline in AIS incidence rates among young women during the vaccine era.
• Subjects:
  Adenocarcinoma In Situ Adolescent Adult Age Factors DNA, Viral Female Human Papillomavirus 16 Human Papillomavirus 18 Humans Incidence Mass Screening Papillomavirus Infections Papillomavirus Vaccines Precancerous Conditions Uterine Cervical Dysplasia Uterine Cervical Neoplasms Young Adult

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• Keywords:
  Adenocarcinoma In Situ AIS Cervical Cancer Cervical Intraepithelial Lesions HPV
• Source:
  Int J Cancer. 146(3):810-818
• Pubmed ID:
  30980692
• Pubmed Central ID:
  PMC9112013
• Document Type:
  Journal Article
• Funding:
  U50CK000486 [New York]/CC/CDC HHSUnited States/ ; U50CK000484 [Oregon]/CC/CDC HHSUnited States/ ; U54CK000482/ACL/ACL HHSUnited States/ ; U50CK000491 [Tennessee]/CC/CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U54 CK000482/CK/NCEZID CDC HHSUnited States/ ; U50CK000488 [Connecticut]/CC/CDC HHSUnited States/ ; U54CK000484/ACL/ACL HHSUnited States/ ; U50CK000482 [California]/CC/CDC HHSUnited States/ ; U54 CK000484/CK/NCEZID CDC HHSUnited States/
• Volume:
  146
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3d496e6b46663ccef81ec9f84f70fa4b7f6fed0603d4ba96f92fb46d23e3156d
• Download URL:
  https://stacks.cdc.gov/view/cdc/117627/cdc_117627_DS1.pdf
• File Type:
  [PDF - 510.20 KB ]