@article {4391,
	title = {HPV type attribution in high grade cervical lesions: assessing the potential benefits of vaccines in a population-based evaluation in the United States.},
	journal = {Cancer epidemiology, biomarkers \& prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology},
	year = {2014},
	month = {2014 Nov 21},
	abstract = {Background:Two currently available vaccines targeting human papillomavirus (HPV) types 16 and 18 could prevent 70\% of cervical cancers and 50\% of high-grade cervical lesions. Next generation vaccines against additional types, such as an investigational 9-valent vaccine against HPV6/11/16/18/31/33/45/52/58, could further reduce HPV-associated disease burden. Methods:HPV was typed in archived tissues from women aged 21-39 years residing in 5 catchment areas in the United States with cervical intraepithelial neoplasia 2/3 and adenocarcinoma in situ (CIN2+) using L1 consensus PCR and type-specific hybridization. Type attribution was estimated using weights to account for lesions with multiple types detected. Results:From 2008-2011, 5,498/6,306 (87.2\%) of specimens obtained from 8,469 women with CIN2+ had valid typing results; HPV DNA was detected in 97.3\%. Overall, 50.1\% of lesions were attributable to HPV16/18, ranging from 50.3\%-52.4\% among those aged 21-34 years, and significantly declined in 35-39 year-olds (43.5\%). HPV16/18 attribution was higher in non-Hispanic whites (56.4\%) versus racial/ethnic minorities (range: 41.8\%-45.9\%) (p<0.001). HPV31/33/45/52/58 attribution was 25.0\% overall and increased with age (p<0.001). A higher proportion of CIN2+ were attributable to HPV31/33/45/52/58 in non-Hispanic black (29.9\%), Hispanic (29.2\%), and Asian (33.1\%) women compared to non-Hispanic whites (22.8\%) (p<0.001). Conclusions:Overall, 75\% of lesions were attributable to 7 oncogenic HPV types: 50\% to HPV16/18 and 25\% to HPV31/33/45/52/58. HPV16/18 had the largest attributable fraction in CIN2+ across all subpopulations, although to a lesser extent in older women and racial/ethnic minorities. Impact:Vaccines targeting additional oncogenic HPV types could reduce racial/ethnic differences in high-grade cervical lesions.},
	issn = {1538-7755},
	author = {Hariri, Susan and Unger, Elizabeth R and Schafer, Sean and Niccolai, Linda M and Park, Ina and Bloch, Karen C and Bennett, Nancy M and Steinau, Martin and Johnson, Michelle L and Markowitz, Lauri E}
}
