Human Papillomavirus Genotype Prevalence in Invasive Vaginal Cancer From a Registry-Based Population

• Authors: Abdulrahman K. Sinno, Johns Hopkins University; Mona Saraiya, Emory University; Trevor D. Thompson, Centers for Disease Control and Prevention; Brenda Y. Hernandez, University of Hawaii; Marc T. Goodman, University of Hawaii; Martin Steinau, Centers for Disease Control and Prevention; Charles F. Lynch, University of Iowa; Wendy Cozen, University of Southern California; Maria Sibug Saber, University of Southern California; Edward S. Peters, Louisiana State University; Edward J. Wilkinson, University of Florida; Glenn Copeland, Michigan Department of Community Health; Claudia Hopenhayn, University of Kentucky; Meg Watson, Centers for Disease Control and Prevention; Christopher Lyu, Battelle Memorial Institute; Elizabeth Unger, Emory University
• Journal Title: OBSTETRICS AND GYNECOLOGY
• Volume: Volume 123, Number 4
• Publisher: LIPPINCOTT WILLIAMS & WILKINS | 2014-04-01, Pages 817-821
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/AOG.0000000000000171
• Subjects: Health Sciences, Oncology; Health Sciences, Immunology; Health Sciences, Obstetrics and Gynecology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Obstetrics & Gynecology; UNITED-STATES; PARTICLE VACCINE; CARCINOMA; DNA; HPV; WOMEN; INFECTION

Abstract

OBJECTIVE: To describe the human papillomavirus (HPV) genotype distribution in invasive vaginal cancers diagnosed before the introduction of the HPV vaccine and evaluate if survival differed by HPV status. METHODS: Four population-based registries and three residual tissue repositories provided formalin-fixed, paraffin embedded tissue from microscopically confirmed primary vaginal cancer cases diagnosed between 1994 and 2005 that were tested by L1 consensus polymerase chain reaction with type-specific hybridization in a central laboratory. Clinical, demographic, and all-cause survival data were assessed by HPV status. RESULTS: Sixty cases of invasive vaginal cancer were included. Human papillomavirus was detected in 75% (45) and 25% (15) were HPV-negative. HPV 16 was most frequently detected (55% [33/60]) followed by HPV 33 (18.3% [11/60]). Only one case was positive for HPV 18 (1.7%) Multiple types were detected in 15% of the cases. Vaginal cancers in women younger than 60 years were more likely to be HPV 16- or HPV 18-positive (HPV 16 and 18) than older women, 77.3% compared with 44.7% (P5.038). The median age at diagnosis was younger in the HPV 16 and 18 (59 years) group compared with other HPV-positive (68 years) and no HPV (77 years) (P5.003). The HPV distribution did not significantly vary by race or ethnicity or place of residence. The 5-year unadjusted all-cause survival was 57.4% for women with HPV-positive vaginal cancers compared with 35.7% among those with HPV-negative tumors (P5.243). CONCLUSION: Three fourths of all vaginal cancers in the United States had HPV detected, much higher than previously found, and 57% could be prevented by current HPV vaccines.