Abstract
Epidemiologic studies have reported the underrepresentation of cervical precancerous lesions caused by human papillomavirus (HPV) types 18 and 45 (HPV18/45) compared with the proportion of cervical cancers attributed to these HPV types. We investigated the timing of diagnosis of histologic cervical intraepithelial neoplasia grade 3 or worse (CIN3+) using data from the atypical squamous cells of undetermined significance-low-grade squamous intraepithelial lesion triage study (ALTS). Of the 2,725 women who underwent enrollment colposcopy, 412 of 472 (87.3%) diagnosed with histologic CIN3+ over the 2-year duration of ALTS could be assigned to a HPV type or group of types and were included in this analysis. Eighty-four percent of HPV16-positive CIN3+ were diagnosed at enrollment, compared with 57% of HPV18/45-positive C1N3+, and 58% of C1N3 positive for other carcinogenic HPV types at enrollment. In contrast, only 8% of HPV16-positive CIN3+ were diagnosed at exit, whereas 31% were HPV18/45 positive and 22% were positive for other carcinogenic types at study exit (P<0.001). These results indicate the underrepresentation of HPV18/45 in precancers, whereas HPV16- associated C1N3+ is diagnosed much earlier. Whether the underrepresentation of 18/45 may be due to occult pathology needs further investigation.
Original language | English (US) |
---|---|
Pages (from-to) | 3262-3266 |
Number of pages | 5 |
Journal | Cancer research |
Volume | 69 |
Issue number | 8 |
DOIs | |
State | Published - Apr 15 2009 |
Externally published | Yes |
ASJC Scopus subject areas
- Oncology
- Cancer Research