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Human papillomavirus type-distribution in cervical cancer in China: the importance of HPV 16 and 18

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Abstract

Prophylactic vaccination against HPV 16 and 18 has the potential for effective prevention of high-grade precancer (cervical intraepithelial neoplasia [CIN)] 2/3) and ICC caused by these viruses (globally 50 and 70%, respectively) when employed in women prior to starting sexual activity. To provide data for decisions on HPV vaccination in China, we determined HPV type-distribution in ICC and CIN 2/3 from women of different regions within China. A multicenter study was conducted by randomized sampling of paraffin blocks of 664 ICC (630 squamous cell carcinoma [SCC]; 34 adenocarcinoma [ADC]), 569 CIN 2/3 cases from seven regions of China. Histological diagnosis was confirmed in 1,233 cases by consensus review. HPV DNA was detected using the SPF10 LiPA25 version 1 assay. HPV prevalence was 97.6% in SCC, 85.3% in adenocarcinoma, and 98.9% in CIN 2/3. HPV 16 (76.7%) and HPV 18 (7.8%) were the most common, together accounting for 84.5% of SCC, followed by HPV 31 (3.2%), HPV 52 (2.2%), and HPV 58 (2.2%). HPV positivity in SCC did not differ notably by region. However, SCC cases from women ≤34 years had higher HPV 16 positivity than women over 50 years, among whom HPV 52, 58, and 39 were more common. HPV 16 and 18 were under-represented, whereas HPV 31, 52, and 58 were over-represented in CIN2/3 compared to SCC. The potential impact of vaccines against oncogenic HPV types 16 and 18 is estimated to be high (84.5%) against total SCC. These data are critical for China’s future evaluation of the cost-effectiveness of current cervical cancer vaccines and of HPV-based screening guidelines.

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Abbreviations

HSIL:

High-grade squamous intraepithelial lesions

CIN:

Cervical intraepithelial neoplasia

SCC:

Squamous carcinoma

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Acknowledgments

This work was partly supported by a grant from GlaxoSmithKline Biologicals and Cancer Foundation of China. We thank all the staffs of CICAMS, Pathology review group members, Dr. M van de Sandt and Dr. K. Pirog from DDL, as well as other colleagues who assisted in conducting this work.

Conflict of interest statements

Johannes E. Schmidt is employee of GlaxoSmithKline Biologicals. David Jenkins is a former employee of GlaxoSmithKline Biologicals and is a consultant to GlaxoSmithKline Biologicals. Anco Molijn and Wim Quint are employees of DDL Diagnostic Laboratory. Jennifer S. Smith has received research grants or contracts, honoraria or consulting fees during the last 3 years from GlaxoSmithKline and Merck. You-Lin Qiao is a regional advisory board member of GSK. All other authors have no competing interests to declare.

Author information

Authors and Affiliations

  1. Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China

    Wen Chen

  2. Cancer Institute, Chinese Academy Medical Sciences, Beijing, China

    Wen Chen, Xun Zhang, Ju-Fang Shi & You-Lin Qiao

  3. DDL Diagnostic Laboratory, Voorburg, Netherlands

    Anco Molijn & Wim Quint

  4. University of Nottingham, Nottingham, UK

    David Jenkins

  5. GlaxoSmithKline Biologicals, Rixensart, Belgium

    Johannes E. Schmidt

  6. Shaanxi Cancer Hospital, Xian, China

    Ping Wang

  7. Zhengzhou University Second Affiliated Hospital, Zhengzhou, China

    Yu-Ling Liu

  8. Liaoning Cancer Hospital, Shenyang, China

    Lian-Kun Li

  9. Dalian Medical University First Affiliated Hospital, Dalian, China

    Hong Shi

  10. Sun Yat-sen Univiversity Cancer Hospital, Guangzhou, China

    Ji-Hong Liu

  11. Zhejiang Medical University Women’s Hospital, Hangzhou, China

    Xing Xie

  12. Xinjiang People’s Hospital, Urumchi, China

    Mayinuer Niyazi

  13. Sichuan University Second Affiliated Hospital, Chengdu, China

    Pei Yang

  14. Beijing University People’s Hospital, Beijing, China

    Li-Hui Wei

  15. Jiangxi Women and Children’s Hospital, Nanchang, China

    Long-Yu Li

  16. Hunan People’s Hospital, Changsha, China

    Jie Li

  17. Gansu Women and Children’s Hospital, Lanzhou, China

    Jin-Feng Liu

  18. Chongqing Cancer Hospital, Chongqing, China

    Qi Zhou

  19. Gulou Hospital, Nanjing, China

    Ying Hong

  20. Guangxi Cancer Hospital, Nanning, China

    Li Li

  21. Shenzhen Women and Children’s Hospital, Shenzhen, China

    Qing Li

  22. Kunming Medical College Second Affiliated Hospital, Kunming, China

    Hong-Lin Zhou

  23. China-Japan Friendship Hospital, Beijing, China

    Mei-Lu Bian

  24. GlaxoSmithKline Biologicals, Singapore, Singapore

    Jing Chen

  25. University of North Carolina, Chapel Hill, USA

    Jennifer S. Smith

Authors
  1. Wen Chen
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  2. Xun Zhang
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  3. Anco Molijn
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  4. David Jenkins
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  5. Ju-Fang Shi
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  6. Wim Quint
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  7. Johannes E. Schmidt
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  8. Ping Wang
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  9. Yu-Ling Liu
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  10. Lian-Kun Li
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  11. Hong Shi
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  14. Mayinuer Niyazi
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  15. Pei Yang
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  16. Li-Hui Wei
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  17. Long-Yu Li
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  18. Jie Li
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  19. Jin-Feng Liu
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  20. Qi Zhou
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  21. Ying Hong
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  22. Li Li
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  23. Qing Li
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  24. Hong-Lin Zhou
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  25. Mei-Lu Bian
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  26. Jing Chen
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  27. You-Lin Qiao
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  28. Jennifer S. Smith
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Corresponding authors

Correspondence to You-Lin Qiao or Jennifer S. Smith.

Additional information

Wen Chen and Xun Zhang equally contributed to this study.

The novelty and impact of the manuscript

About 10% of all cases of invasive cervical cancer (ICC) globally occur in China. One important approach to preventing this cancer is to introduce HPV 16/18 prophylactic vaccination. Assessing the current contribution of HPV 16/18 and other types in ICC and precancer is important for decisions about vaccination, as is evidence of possible demographic change. These data on type-specific HPV prevalence of over 1,000 invasive and high-grade cervical biopsy specimens from women in China represents the largest study conducted to date, with data from seven geographical areas throughout Mainland China. These data are critical for China’s future evaluation of the cost-effectiveness of prophylactic cervical cancer vaccines and of HPV-based screening guidelines.

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Chen, W., Zhang, X., Molijn, A. et al. Human papillomavirus type-distribution in cervical cancer in China: the importance of HPV 16 and 18. Cancer Causes Control 20, 1705–1713 (2009). https://doi.org/10.1007/s10552-009-9422-z

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  • DOI: https://doi.org/10.1007/s10552-009-9422-z

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