Cervical HPV type-specific pre-vaccination prevalence and age distribution in Croatia

PLoS One. 2017 Jul 10;12(7):e0180480. doi: 10.1371/journal.pone.0180480. eCollection 2017.

Abstract

The main etiological factor of precancerous lesion and invasive cervical cancer are oncogenic human papillomaviruses types (HPVs). The objective of this study was to establish the distribution of the most common HPVs in different cervical lesions and cancer prior to the implementation of organized population-based cervical screening and HPV vaccination in Croatia. In this study, 4,432 cervical specimens, collected through a 16-year period, were tested for the presence of HPV-DNA by polymerase chain reaction (PCR) with three sets of broad-spectrum primers and type-specific primers for most common low-risk (LR) types (HPV-6, 11) and the most common high-risk (HR) types (HPV-16, 18, 31, 33, 45, 52, 58). Additional 35 archival formalin-fixed, paraffin embedded tissue of cervical cancer specimens were analyzed using LiPA25 assay. The highest age-specific HPV-prevalence was in the group 18-24 years, which decreased continuously with age (P<0.0001) regardless of the cytological diagnosis. The prevalence of HR-HPV types significantly increased (P<0.0001) with the severity of cervical lesions. HPV-16 was the most common type found with a prevalence (with or without another HPV-type) of 6.9% in normal cytology, 15.5% in atypical squamous cells of undetermined significance, 14.4% in low-grade squamous intraepithelial lesions, 33.3% in high-grade squamous intraepithelial lesions, and 60.9% in cervical cancer specimens (P<0.0001). This study provides comprehensive and extensive data on the distribution of the most common HPV types among Croatian women, which will enable to predict and to monitor the impact of HPV-vaccination and to design effective screening strategies in Croatia.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Croatia / epidemiology
  • Female
  • Humans
  • Incidence
  • Middle Aged
  • Papillomaviridae / classification*
  • Papillomaviridae / immunology*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / immunology*
  • Papillomavirus Infections / virology
  • Prevalence
  • Uterine Cervical Neoplasms / immunology*
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / virology*
  • Vaccination*
  • Young Adult

Grants and funding

This research has been partially supported by the Croatian Ministry of Science, Education and Sports (grant no. 098-0982464-2510, URL: zprojekti.mzos.hr), and partially by the international project ”Retrospective International Survey and HPV Time Trends Study Group” (URL: ico.gencat.cat). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.