Abstract
The aim of this study was to describe the distribution of human papillomavirus (HPV) genotypes among cervical cancers and pre-cancers in Shaanxi province of western China. A total of 17,341 women who were screened for cervical cancer from January 2014 to December 2016, using HPV genotyping and ThinPrep cytologic test were included. The prevalence and attribution of HPV genotypes were stratified by cervical lesion and age group. Of the subjects, 26.3% were infected with HPV, 28.0% of whom had multiple infections. The crude HPV prevalence increased from atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL, 64.3%) to high-grade squamous intraepithelial lesions (HSIL, 79.8%) and to invasive cervical cancer (ICC, 89.7%, P < 0.001). The three most prevalent genotypes were HPV 16 (8.0%), 58 (4.2%), and 52 (4.0%), and HPV 16, 31 and 33 were positively correlated with increased severity of cervical lesions. Additionally, the divalent vaccine genotypes HPV 16 and 18 accounted for 68.2% of ICC cases. Although 78.5% of ICC and 60.3% of HSIL cases were attributed to 9-valent vaccine genotypes, the other genotypes not covered by any vaccine still resulted in increases in coverage, with 1.5% for ICC, 5.3% for HSIL, and 13.5% for ASCUS/LSIL. HPV prevalence in western China was consistent with other regions of China. Early vaccination with 9-valent HPV vaccine is recommended in this locality for females younger than 26 years with no prior infection, while divalent the vaccine is more appropriate for women between 26 and 45 years, considering the efficacy, safety and cost-effectiveness of vaccines.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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The code used in this study will be made available by the authors, without undue reservation, to any qualified researcher.
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Funding
This study was supported by the Clinical Research Award of First Affiliated Hospital of Xi’an Jiaotong University, China [XJTU1AF-CRF-2015-009, XJTU1AF-CRF-2016-011].
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Jiao Li: conceptualization, methodology, investigation, data curation, writing – reviewing and editing, project administration, funding acquisition. Juan-Juan Gao: conceptualization, methodology, formal analysis, data curation, writing – original draft, writing – reviewing and editing. Na Li: methodology, investigation, data curation. Ya-Wen Wang: conceptualization, methodology, writing – reviewing and editing, supervision, funding acquisition
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2016LSL-043).
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Li, J., Gao, JJ., Li, N. et al. Distribution of human papillomavirus genotypes in western China and their association with cervical cancer and precancerous lesions. Arch Virol 166, 853–862 (2021). https://doi.org/10.1007/s00705-021-04960-z
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DOI: https://doi.org/10.1007/s00705-021-04960-z