HPV genotypes and cervical intraepithelial neoplasia in a multiethnic cohort in the southeastern USA

Adriana C Vidal,Rex Bentley,Maggie Gradison,Jennifer S Smith,Fidel Valea,Anne Ford,Susan K Murphy,Kathy Grant,Kimberly S H Yarnall,Cathrine Hoyo,Francine Overcash

doi:10.1007/s10552-014-0406-2

Abstract

PurposeFor poorly understood reasons, invasive cervical cancer (ICC) incidence and mortality rates are higher in women of African descent. Oncogenic human papillomavirus (HPV) genotypes distribution may vary between European American (EA) and African-American (AA) women and may contribute to differences in ICC incidence. The current study aimed at disentangling differences in HPV distribution among AA and EA women.MethodsFive-hundred and seventy-two women were enrolled at the time of colposcopic evaluation following an abnormal liquid-based cytology screen. HPV infections were detected using HPV linear array, and chi-squared tests and linear regression models were used to compare HPV genotypes across racial/ethnic groups by CIN status.ResultsOf the 572 participants, 494 (86 %) had detectable HPV; 245 (43 %) had no CIN lesion, 239 (42 %) had CIN1, and 88 (15 %) had CIN2/3. Seventy-three percent of all women were infected with multiple HPV genotypes. After adjusting for race, age, parity, income, oral contraception use, and current smoking, AAs were two times less likely to harbor HPV 16/18 (OR 0.48, 95 % CI 0.21–0.94, p = 0.03) when all women were considered. This association remained unchanged when only women with CIN2/3 lesions were examined (OR 0.22, 95 % CI 0.05–0.95, p = 0.04). The most frequent high-risk HPV genotypes detected among EAs were 16, 18, 56, 39, and 66, while HPV genotypes 33, 35, 45, 58, and 68 were the most frequent ones detected in AAs.ConclusionsOur data suggest that while HPV 16/18 are the most common genotypes among EA women with CIN, AAs may harbor different genotypes.

Highlights

In 2009, there were an estimated 34,788 new cases of human papillomavirus (HPV)-associated cancers in the USA overall, of which 61 % were among women (21,342) and 39 % among men (13,446) [1]
Oncogenic human papillomavirus (HPV) genotypes distribution may vary between European American (EA) and African-American (AA) women and may contribute to differences in invasive cervical cancer (ICC) incidence
The incidence of ICC is not evenly distributed among racial/ethnic groups with African-American (AA) and Hispanics affected disproportionally higher than European American (EA) women [2]

Summary

Introduction

In 2009, there were an estimated 34,788 new cases of human papillomavirus (HPV)-associated cancers in the USA overall, of which 61 % were among women (21,342) and 39 % among men (13,446) [1]. Liquid-based cytology screening rates, whether selfreported or estimated from insurance claims data, are comparable among AAs and Hispanics compared with EAs and fail to explain the racial/ethnic disparity [3–5]. AAs and Hispanics have lower incidence rates for the more common cancer sites, they have the highest incidence of ICC of any ethnic group in the USA. Lesions in ethnically diverse populations [7, 10]; neither study described the HPV distribution in the spectrum of all women with abnormal cytology-based findings, reporting for colposcopy. We describe HPV genotypes associated with CIN1–3 in a multiethnic cohort of women visiting colposcopy clinics following a cervical abnormality

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Results

Discussion

Conclusion