Human Papillomavirus Prevalence in Invasive Anal Cancers in the United States prior to Vaccine Introduction
Published Date:Oct 2013
Source:J Low Genit Tract Dis. 17(4):397-403.
Funding:1U58DP000807-3/DP/NCCDPHP CDC HHS/United States
5U58DP000769-5/DP/NCCDPHP CDC HHS/United States
5U58DP000810-5/DP/NCCDPHP CDC HHS/United States
5U58DP000812-5/DP/NCCDPHP CDC HHS/United States
5U58DP000844-5/DP/NCCDPHP CDC HHS/United States
N01-PC 2010-00035/PC/NCI NIH HHS/United States
N01-PC-35137/PC/NCI NIH HHS/United States
N01-PC-35139/PC/NCI NIH HHS/United States
N01-PC-35143/PC/NCI NIH HHS/United States
N01PC35143/CA/NCI NIH HHS/United States
Conduct a representative survey of Human papillomavirus (HPV) prevalence and its genotype distribution in invasive anal cancer specimens in the U.S.
Population-based archival anal cancer specimens were identified from Florida, Kentucky, Louisiana and Michigan cancer registries and SEER tissue repositories in Hawaii, Iowa and Los Angeles. Sections from one representative block per case were used for DNA extraction. All extracts were assayed first by Linear Array and re-tested with INNO-LiPA if inadequate or HPV negative.
Among 146 unique invasive anal cancer cases, 93 (63.7%) were from women and 53 (36.3%) from men. HPV (any type) was detected in 133 (91.1%) cases and 129 (88.4%) contained at least one high risk type, most (80.1%) as a single genotype. HPV16 had the highest prevalence (113 cases, 77.4%); HPV6, 11, 18 and 33 were also found multiple times. Among HPV16 positive cases, 37% were identified as prototype variant Ep and 63% were non-prototypes: 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 HPV16/18 were seen between gender, race or age group.
The establishment of pre-vaccine HPV prevalence in the U.S. is critical to the surveillance of vaccine efficacy. Almost 80% of anal cancers were positive for the vaccine types HPV16 or HPV18 and in 70% these were the only types detected suggesting that a high proportion might be preventable by current vaccines.
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