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The ATHENA HPV study underrepresents “other” high‐risk HPV genotypes when compared with a diverse New York City population
Author(s) -
Ramos Rivera G.,
Khader S. N.,
Lajara S.,
Schlesinger K.,
Goldstein D. Y.,
Naeem R. C.,
Suhrland M. J.,
Fox A. S.
Publication year - 2017
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12440
Subject(s) - medicine , genotyping , genotype , squamous intraepithelial lesion , cytology , population , cervical cancer , gynecology , oncology , human papillomavirus , cancer , obstetrics , cervical intraepithelial neoplasia , pathology , biology , genetics , gene , environmental health
Objective Persistent infection with oncogenic high risk HPV (hr HPV ) types causes virtually all cases of cervical cancer. HPV 16 and 18 have been targeted for individual genotyping and vaccination because of their presence in 71% of invasive cervical cancers worldwide. Montefiore Medical Center, Bronx, New York serves a population known for ethnic and racial diversity. Given this diversity it is possible that HPV genotypes not individually detected by current testing are causing significant disease. Methods We conducted a retrospective analysis of liquid based cervicovaginal cytology and Cobas HPV results reported between October 5, 2015 and March 30, 2016. This included 20 483 samples from patients aged 16‐95 (average age 42), with racial distribution including: African‐American 32.4%, Other (includes denied, unknown, mixed, Hispanic) 52.1%, Caucasian 14.5%, Asian 0.7%, American Indian/Alaskan Native 0.3%. In all, 14 938 samples (72.9%) were submitted for clinically requested COBAS 4800 HPV testing, which separately reports HPV 16, 18 and a pool of 12 other hr HPV . Results A total of 3180 (21.5%) tested hr HPV positive. The percentage of patients with cytologic diagnosis of HSIL (high‐grade squamous intraepithelial lesion) that were positive only for HPV 16 was 19.4% vs 1.8% for all cytologic diagnoses. However, only one of the HSIL cases was HPV 18 positive along with other hr HPV ( OHR ). Surprisingly, a majority (64.5%) was positive for only OHR . Conclusions Further evaluation is needed to determine if this pool of other hr HPV includes individual genotypes that in our population carry a higher risk of persistence and progression to cancer.