A population-based study of human papillomavirus genotype prevalence in the United States: Baseline measures prior to mass human papillomavirus vaccination

Authors

  • Cosette M. Wheeler,

    Corresponding author
    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
    • University of New Mexico Health Sciences Center, Department of Pathology, House of Prevention Epidemiology (HOPE), 1816 Sigma Chi Rd NE, MSC02—1670 Albuquerque, NM 87131, USA
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    • Tel.: [505-272-5785], Fax: +[505-277-0265]

  • William C. Hunt,

    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
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  • Jack Cuzick,

    1. Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
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  • Erika Langsfeld,

    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
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  • Amanda Pearse,

    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
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  • George D. Montoya,

    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
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    • Deceased

  • Michael Robertson,

    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
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  • Catherine A. Shearman,

    1. Department of Pathology and Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, House of Prevention Epidemiology (HOPE), Albuquerque, NM
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  • Philip E. Castle,

    1. American Society for Clinical Pathology Institute, Washington, DC
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  • For The New Mexico HPV Pap Registry Steering Committee

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    • Current members of the NMHPVPR Steering Committee are as follows: Nancy E. Joste, MD, Walter Kinney, MD, Cosette M. Wheeler, PhD., William C. Hunt, MS, Deborah Thompson, MD MSPH, Susan Baum, MD MPH, Linda Gorgos, MD MSc, Alan Waxman, MD MPH, David Espey MD, Jane McGrath MD, Steven Jenison, MD, Mark Schiffman, MD MPH, Philip Castle, PhD MPH, Vicki Benard, PhD, Debbie Saslow, PhD, Jane J.. Kim PhD, Mark H. Stoler MD and Jack Cuzick, PhD. This work was funded by a grant to C.M.W from the US National Cancer Institute (NCI) R01CA134779. Dr. Castle was previously supported by the Intramural Research Program of the NIH, NCI. HPV Linear Array reagents and equipment to automate HPV genotyping assays were provided by Roche Molecular Systems, Inc. C.M.W. has received funds through the University of New Mexico from GlaxoSmith Kline and Merck and Co., Inc., for HPV vaccine studies and equipment and reagents for HPV genotyping from Roche Molecular Systems. P.E.C. has received HPV tests and testing for research at a reduced or no cost from Roche and Qiagen, has a nondisclosure agreement with Roche, and serves on a Merck Data Safety and monitoring board.


Abstract

Currently, two prophylactic human papillomavirus (HPV) vaccines targeting HPV 16 and 18 have been shown to be highly efficacious for preventing precursor lesions although the effectiveness of these vaccines in real-world clinical settings must still be determined. Toward this end, an ongoing statewide surveillance program was established in New Mexico to assess all aspects of cervical cancer preventive care. Given that the reduction in cervical cancer incidence is expected to take several decades to manifest, a systematic population-based measurement of HPV type-specific prevalence employing an age- and cytology-stratified sample of 47,617 women attending for cervical screening was conducted prior to widespread HPV vaccination. A well-validated polymerase chain reaction (PCR) method for 37 HPV genotypes was used to test liquid-based cytology specimens. The prevalence for any of the 37 HPV types was 27.3% overall with a maximum of 52% at age of 20 years followed by a rapid decline at older ages. The HPV 16 prevalences in women aged ≤20 years, 21–29 years or ≥30 years were 9.6, 6.5 and 1.8%, respectively. The combined prevalences of HPV 16 and 18 in these age groups were 12.0, 8.3 and 2.4%, respectively. HPV 16 and/or HPV 18 were detected in 54.5% of high-grade squamous intraepithelial (cytologic) lesions (HSIL) and in 25.0% of those with low-grade SIL (LSIL). These baseline data enable estimates of maximum HPV vaccine impact across time and provide critical reference measurements important to assessing clinical benefits and potential harms of HPV vaccination including increases in nonvaccine HPV types (i.e., type replacement).

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