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Human Papillomavirus Genotype Distribution in Low-Grade Cervical Lesions



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Cancer Epidemiology Biomarkers Prevention 1157 Human Papillomavirus Genotype Distribution in Low Grade Cervical Lesions Comparison by Geographic Region and with Cervical Cancer Gary M Clifford 1 Rashida K Rana 2 Silvia Franceschi 1 Jennifer S Smith 3 Gerald Gough 2 and Jeanne M Pimenta2 1 International Agency for Research on Cancer Lyon France 2 GlaxoSmithKline R D Middlesex United Kingdom and 3 University of North Carolina Chapel Hill North Carolina Abstract Low grade squamous intraepithelial lesions LSIL associated with certain human papillomavirus HPV genotypes may preferentially progress to cervical cancer HPV genotyping may thus have the potential to improve the effectiveness of screening programs and to reduce overtreatment LSIL cases n 8 308 from 55 published studies were included in a meta analysis HPV genotype distribution was assessed by geographic region and in comparison with published data on cervical squamous cell carcinoma SCC HPV detection in LSIL was 80 in North America but less than 70 in other regions most likely reflecting regional differences in LSIL diagnosis Among 5 910 HPVpositive LSILs HPV16 was the most common genotype 26 3 followed by HPV31 11 5 HPV51 10 6 and HPV53 10 2 HPV positive LSILs from Africa were 2 fold less likely to be infected with HPV16 than those in Europe and HPV positive LSILs from North America were more likely to be infected with HPV18 than those from Europe or South Central America Interpretation for rarer genotypes was hampered by variation in HPV testing methodology SCC LSIL prevalence ratios indicated that HPV16 was 2 fold and HPV18 was 1 5 fold more common in SCC than in HPV positive LSIL thus appearing more likely to progress than other high risk genotypes SCC LSIL prevalence ratios between 0 05 and 0 85 HPV53 and HPV66 showed SCC LSIL ratios of 0 02 and 0 01 respectively HPV genotype distribution in LSIL differs from that in cervical cancer highlighting the importance of HPV genotype in the risk of progression



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