Single type infection of human papillomavirus as a cause for high-grade cervical intraepithelial neoplasia and invasive cancer in Japan

Jinichi Sakamoto,Shoji Kamiura,Kaori Okayama,Mitsuaki Okodo,Takeo Shibata,Yasuhiro Osaka,Satoko Fujita,Emi Takata,Hiroaki Takagi,Masahiro Takakura,Toshiyuki Sasagawa

doi:10.1016/j.pvr.2018.10.001

Abstract

To elucidate oncogenic human papilloma virus (HPV) types in Japan, HPV genotyping was performed in 1526 cervical intraepithelial neoplasia (CIN) and 371 invasive cervical cancer (ICC) patients with the novel Genosearch-31+5 HPV test. The HPV-positive rates were 89.3% and 90.8% in CIN and ICC. Regarding single-type infections, 13 internationally recognized high-risk (13HR) types excluding HPV 35, and probably HR HPV 53, 67, 69, and 70 were identified in ICC, suggesting that all these types may be oncogenic. HPV16 and 18 were identified in both SCC and adenocarcinoma (ADC). HPV HPV52, 31 and 58 (alpha-9) were predominantly detected in SCC, whereas HPV 18, 45, 39 and 59 (alpha-7) were in ADC. The prevalence of HPV 18 in SCC significantly decreased with increasing age of patients, whereas the opposite trend was observed in the other HR types. HPV18 is likely to induce SCC rapidly. All ICC cases aged 20–29 were positive for HPV 16 or 18, suggesting that present HPV 16, 18 vaccines may be quite effective to prevent ICC in young women.

Highlights

Cervical cancer is the third most common gynecologic cancer in developed countries [1,2]
In cervical intraepithelial neoplasia (CIN), 1363 of 1526 (89.3%) cases were positive for human papillomavirus (HPV), and single- and multiple-type infections were detected in 43.8% (N = 668) and 44.8% (N = 684) of cases, respectively (Table 1)
Single-type infection was observed in 54.8% and 66.7% of CIN3 and adenocarcinoma in situ [AIS] cases, respectively, whereas it was observed in 36.3% of CIN1 cases

Summary

Introduction

Cervical cancer is the third most common gynecologic cancer in developed countries [1,2]. Cervical cancer screening was implemented in Japan in 1980. The incidence and mortality rates have decreased in older women, whereas they have increased in young women in recent years. The number of deaths by cervical cancer in Japan is estimated at 3500 women annually [3]. Half of cervical cancer patients in Japan are women of reproductive age (younger than 50 years) [3]. More than 200 women aged 20–39 years die every year. Cervical cancer is a preventable disease through immunization with prophylactic HPV 16 and 18 vaccines and routine cervical cancer screening. Increased mortality in Japan due to this cancer may be a social problem. Exact reason is not known, low coverage of the screening might be responsible for it

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Discussion

Conclusion