Prevalence of human papillomavirus in cervical cancer: A worldwide perspective

F. Xavier Bosch, M. Michele Manos, Nubia Muñoz, Mark E. Sherman, Angela M. Jansen, Julian Peto, Mark H. Schiffman, Victor Moreno, Robert Kurman, Keerti V. Shan

Research output: Contribution to journalArticle

2814 Citations (Scopus)

Abstract

Background: Epidemiologic studies have shown that the association of genital human papillomavirus (HPV) with cervical cancer is strong, independent of other risk factors, and consistent in several countries. There are more than 20 different cancer-associated HPV types, but little is known about their geographic variation. Purpose: Our aim was to determine whether the association between HPV infection and cervical cancer is consistent worldwide and to investigate geographic variation in the distribution of HPV types. Methods: More than 1000 specimens from sequential patients with invasive cervical cancer were collected and stored frozen at 32 hospitals in 22 countries. Slides from all patients were submitted for central histologic review to confirm the diagnosis and to assess histologic characteristics. We used polymerase chain reaction-based assays capable of detecting more than 25 different HPV types. A generalized linear Poisson model was fitted to the data on viral type and geographic region to assess geographic heterogeneity. Results: HPV DNA was detected in 93% of the tumors, with no significant variation in HPV positivity among countries. HPV 16 was present in 50% of the specimens, HPV 18 in 14%, HPV 45 in 8%, and HPV 31 in 5%. HPV 16 was the predominant type in all countries except Indonesia, where HPV 18 was more common. There was significant geographic variation in the prevalence of some less common virus types. A clustering of HPV 45 was apparent in western Africa, while HPV 39 and HPV 59 were almost entirely confined to Central and South America. In squamous cell tumors, HPV 16 predominated (51% of such specimens), but HPV 18 predominated in adenocarcinomas (56% of such tumors) and adenosquamous tumors (39% of such tumors). Conclusions: Our results confirm the role of genital HPVs, which are transmitted sexually, as the central etiologic factor in cervical cancer worldwide. They also suggest that most genital HPVs are associated with cancer, at least occasionally. Implication: The demonstration that more than 20 different genital HPV types are associated with cervical cancer has important implications for cervical cancer-prevention strategies that include the development of vaccines targeted to genital HPVs. [J Natl Cancer Inst 87:796-802, 1995].

Original languageEnglish (US)
Pages (from-to)796-802
Number of pages7
JournalJournal of the National Cancer Institute
Volume87
Issue number11
DOIs
StatePublished - Jun 7 1995

Fingerprint

Uterine Cervical Neoplasms
Human papillomavirus 18
Human papillomavirus 16
Neoplasms
Human papillomavirus 31
Central America
Western Africa
Papillomavirus Infections
Indonesia
South America
Cluster Analysis
Epidemiologic Studies
Linear Models
Adenocarcinoma
Vaccines
Epithelial Cells
Viruses
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Prevalence of human papillomavirus in cervical cancer : A worldwide perspective. / Bosch, F. Xavier; Manos, M. Michele; Muñoz, Nubia; Sherman, Mark E.; Jansen, Angela M.; Peto, Julian; Schiffman, Mark H.; Moreno, Victor; Kurman, Robert; Shan, Keerti V.

In: Journal of the National Cancer Institute, Vol. 87, No. 11, 07.06.1995, p. 796-802.

Research output: Contribution to journalArticle

Bosch, FX, Manos, MM, Muñoz, N, Sherman, ME, Jansen, AM, Peto, J, Schiffman, MH, Moreno, V, Kurman, R & Shan, KV 1995, 'Prevalence of human papillomavirus in cervical cancer: A worldwide perspective', Journal of the National Cancer Institute, vol. 87, no. 11, pp. 796-802. https://doi.org/10.1093/jnci/87.11.796
Bosch, F. Xavier ; Manos, M. Michele ; Muñoz, Nubia ; Sherman, Mark E. ; Jansen, Angela M. ; Peto, Julian ; Schiffman, Mark H. ; Moreno, Victor ; Kurman, Robert ; Shan, Keerti V. / Prevalence of human papillomavirus in cervical cancer : A worldwide perspective. In: Journal of the National Cancer Institute. 1995 ; Vol. 87, No. 11. pp. 796-802.
@article{04684153010f4aaa9f390e39a720fd6e,
title = "Prevalence of human papillomavirus in cervical cancer: A worldwide perspective",
abstract = "Background: Epidemiologic studies have shown that the association of genital human papillomavirus (HPV) with cervical cancer is strong, independent of other risk factors, and consistent in several countries. There are more than 20 different cancer-associated HPV types, but little is known about their geographic variation. Purpose: Our aim was to determine whether the association between HPV infection and cervical cancer is consistent worldwide and to investigate geographic variation in the distribution of HPV types. Methods: More than 1000 specimens from sequential patients with invasive cervical cancer were collected and stored frozen at 32 hospitals in 22 countries. Slides from all patients were submitted for central histologic review to confirm the diagnosis and to assess histologic characteristics. We used polymerase chain reaction-based assays capable of detecting more than 25 different HPV types. A generalized linear Poisson model was fitted to the data on viral type and geographic region to assess geographic heterogeneity. Results: HPV DNA was detected in 93{\%} of the tumors, with no significant variation in HPV positivity among countries. HPV 16 was present in 50{\%} of the specimens, HPV 18 in 14{\%}, HPV 45 in 8{\%}, and HPV 31 in 5{\%}. HPV 16 was the predominant type in all countries except Indonesia, where HPV 18 was more common. There was significant geographic variation in the prevalence of some less common virus types. A clustering of HPV 45 was apparent in western Africa, while HPV 39 and HPV 59 were almost entirely confined to Central and South America. In squamous cell tumors, HPV 16 predominated (51{\%} of such specimens), but HPV 18 predominated in adenocarcinomas (56{\%} of such tumors) and adenosquamous tumors (39{\%} of such tumors). Conclusions: Our results confirm the role of genital HPVs, which are transmitted sexually, as the central etiologic factor in cervical cancer worldwide. They also suggest that most genital HPVs are associated with cancer, at least occasionally. Implication: The demonstration that more than 20 different genital HPV types are associated with cervical cancer has important implications for cervical cancer-prevention strategies that include the development of vaccines targeted to genital HPVs. [J Natl Cancer Inst 87:796-802, 1995].",
author = "Bosch, {F. Xavier} and Manos, {M. Michele} and Nubia Mu{\~n}oz and Sherman, {Mark E.} and Jansen, {Angela M.} and Julian Peto and Schiffman, {Mark H.} and Victor Moreno and Robert Kurman and Shan, {Keerti V.}",
year = "1995",
month = "6",
day = "7",
doi = "10.1093/jnci/87.11.796",
language = "English (US)",
volume = "87",
pages = "796--802",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - Prevalence of human papillomavirus in cervical cancer

T2 - A worldwide perspective

AU - Bosch, F. Xavier

AU - Manos, M. Michele

AU - Muñoz, Nubia

AU - Sherman, Mark E.

AU - Jansen, Angela M.

AU - Peto, Julian

AU - Schiffman, Mark H.

AU - Moreno, Victor

AU - Kurman, Robert

AU - Shan, Keerti V.

PY - 1995/6/7

Y1 - 1995/6/7

N2 - Background: Epidemiologic studies have shown that the association of genital human papillomavirus (HPV) with cervical cancer is strong, independent of other risk factors, and consistent in several countries. There are more than 20 different cancer-associated HPV types, but little is known about their geographic variation. Purpose: Our aim was to determine whether the association between HPV infection and cervical cancer is consistent worldwide and to investigate geographic variation in the distribution of HPV types. Methods: More than 1000 specimens from sequential patients with invasive cervical cancer were collected and stored frozen at 32 hospitals in 22 countries. Slides from all patients were submitted for central histologic review to confirm the diagnosis and to assess histologic characteristics. We used polymerase chain reaction-based assays capable of detecting more than 25 different HPV types. A generalized linear Poisson model was fitted to the data on viral type and geographic region to assess geographic heterogeneity. Results: HPV DNA was detected in 93% of the tumors, with no significant variation in HPV positivity among countries. HPV 16 was present in 50% of the specimens, HPV 18 in 14%, HPV 45 in 8%, and HPV 31 in 5%. HPV 16 was the predominant type in all countries except Indonesia, where HPV 18 was more common. There was significant geographic variation in the prevalence of some less common virus types. A clustering of HPV 45 was apparent in western Africa, while HPV 39 and HPV 59 were almost entirely confined to Central and South America. In squamous cell tumors, HPV 16 predominated (51% of such specimens), but HPV 18 predominated in adenocarcinomas (56% of such tumors) and adenosquamous tumors (39% of such tumors). Conclusions: Our results confirm the role of genital HPVs, which are transmitted sexually, as the central etiologic factor in cervical cancer worldwide. They also suggest that most genital HPVs are associated with cancer, at least occasionally. Implication: The demonstration that more than 20 different genital HPV types are associated with cervical cancer has important implications for cervical cancer-prevention strategies that include the development of vaccines targeted to genital HPVs. [J Natl Cancer Inst 87:796-802, 1995].

AB - Background: Epidemiologic studies have shown that the association of genital human papillomavirus (HPV) with cervical cancer is strong, independent of other risk factors, and consistent in several countries. There are more than 20 different cancer-associated HPV types, but little is known about their geographic variation. Purpose: Our aim was to determine whether the association between HPV infection and cervical cancer is consistent worldwide and to investigate geographic variation in the distribution of HPV types. Methods: More than 1000 specimens from sequential patients with invasive cervical cancer were collected and stored frozen at 32 hospitals in 22 countries. Slides from all patients were submitted for central histologic review to confirm the diagnosis and to assess histologic characteristics. We used polymerase chain reaction-based assays capable of detecting more than 25 different HPV types. A generalized linear Poisson model was fitted to the data on viral type and geographic region to assess geographic heterogeneity. Results: HPV DNA was detected in 93% of the tumors, with no significant variation in HPV positivity among countries. HPV 16 was present in 50% of the specimens, HPV 18 in 14%, HPV 45 in 8%, and HPV 31 in 5%. HPV 16 was the predominant type in all countries except Indonesia, where HPV 18 was more common. There was significant geographic variation in the prevalence of some less common virus types. A clustering of HPV 45 was apparent in western Africa, while HPV 39 and HPV 59 were almost entirely confined to Central and South America. In squamous cell tumors, HPV 16 predominated (51% of such specimens), but HPV 18 predominated in adenocarcinomas (56% of such tumors) and adenosquamous tumors (39% of such tumors). Conclusions: Our results confirm the role of genital HPVs, which are transmitted sexually, as the central etiologic factor in cervical cancer worldwide. They also suggest that most genital HPVs are associated with cancer, at least occasionally. Implication: The demonstration that more than 20 different genital HPV types are associated with cervical cancer has important implications for cervical cancer-prevention strategies that include the development of vaccines targeted to genital HPVs. [J Natl Cancer Inst 87:796-802, 1995].

UR - http://www.scopus.com/inward/record.url?scp=0029041842&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029041842&partnerID=8YFLogxK

U2 - 10.1093/jnci/87.11.796

DO - 10.1093/jnci/87.11.796

M3 - Article

C2 - 7791229

AN - SCOPUS:0029041842

VL - 87

SP - 796

EP - 802

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 11

ER -