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. 2013 Jul;22(7):1313-1318.
doi: 10.1158/1055-9965.EPI-13-0053. Epub 2013 Apr 30.

Age-specific occurrence of HPV16- and HPV18-related cervical cancer

Silvia de Sanjose #  1   2 , Cosette M Wheeler #  3 , Wim G V Quint  4 , William C Hunt  3 , Nancy E Joste  3 , Laia Alemany  1   2 , F Xavier Bosch  1   2 ; Retrospective International Survey and HPV Time Trends Study Group; Evan R Myers  5 , Philip E Castle  6
Affiliations

Age-specific occurrence of HPV16- and HPV18-related cervical cancer

Silvia de Sanjose et al. Cancer Epidemiol Biomarkers Prev. 2013 Jul.

Abstract

The age-specific occurrence of cervical cancer related to human papillomavirus (HPV) genotypes HPV16 and HPV18, the two targeted by current HPV vaccines, is not well described. We therefore used data from two large, tissue-based HPV genotyping studies of cervical cancer, one conducted in New Mexico (n = 744) and an International study restricted to cancers (n = 1,729) from Europe, North America, and Australia to represent those regions with widely available cervical cancer screening facilities. HPV results were categorized as HPV16- or HPV18-positive (HPV16/18) versus other HPV genotype. We observed a decreasing proportion of HPV16/18-positive cancers with increasing age in the International study (Ptrend < 0.001) and New Mexico study (Ptrend < 0.001). There was no heterogeneity in the relationship between age of diagnosis and the proportion of HPV16/18-positive cancers between studies (P = 0.8). Combining results from the two studies (n = 2,473), the percentages of HPV16/18-positive cases were 77.0% [95% confidence interval (CI): 75.1%-78.9%] for women less than 65 years old and 62.7% [95% confidence interval (CI): 58.4%-66.9%] for women aged 65 and older (P < 0.001). In women who are under the age of 25 and have been vaccinated before becoming sexually active, the cervical cancer incidence is expected to be approximately 3.5 per million by 2020. HPV vaccination against HPV16/18 may have a greater impact on cervical cancers in women under 65 than in women aged 65 and older. These data will inform the age-specific impact of HPV vaccination and its integration with cervical cancer screening activities.

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Figures

Figure 1
Figure 1
The proportions of HPV16/18-positive cancers by age (<65 years vs. 65 and older) and histology type, using data from two previous studies of HPV genotyping of cervical cancers (1,12).
Figure 2
Figure 2
An estimation of the impact of human papillomavirus (HPV) vaccination on the annual incidence of cervical cancer (per 100,000) in U.S., women under the age of 40 years, assuming vaccination before exposure to HPV16 and 18 (HPV16/18) and protective immunity until age 40. The incidence rates were derived based on recently published rates of cervical cancer in the U.S. (15) and the age group-specific fraction of HPV16 /18 cervical cancers (1,12). The rates of HPV16 /18 –negative cancers in women less than 20 years and 20-24 were based on the fraction of non-HPV16/18 cervical cancers in women under the age of 25. * indicates the estimated fraction for HPV16/18-negative cancers assuming no impact of HPV16/18 vaccination on cervical cancers with an unknown histology.
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