Population-Based Assessment of HPV Genotype-Specific Cervical Cancer Survival: CDC Cancer Registry Sentinel Surveillance System

JNCI Cancer Spectrum

Goodman, Marc T¹  Thompson, Trevor D²  Hallowell, Benjamin D²  Saraiya, Mona²  Unger, Elizabeth R²  Wilkinson, Edward³  Peters, Edward S⁴  Copeland, Glenn⁵  Hernandez, Brenda Y⁶  Lynch, Charles F⁷  Tucker, Tom⁸ 

[1] Cedars Sinai Medical Center, Los Angeles, CA;Centers for Disease Control and Prevention, Atlanta, GA;Department of Pathology, University of Florida College of Medicine, Gainesville, FL;Health Science Center School of Public Health, Lousiania State University, New Orleans, LA;Michigan Department of Community Health, Lansing, MI;University of Hawaii, Honolulu, HI;University of Iowa, Iowa City, IA;University of Kentucky College of Public Health, Lexington, KY

关键词: human papillomavirus;    centers for disease control and prevention (u.s.);    genotype;    neoplasms;    cancer;    cervical cancer;    human papillomavirus 16;    human papillomavirus 18;    cervix carcinoma;   

DOI  :  10.1093/jncics/pky036

学科分类：肿瘤学

来源: Oxford University Press

【 摘 要 】

BackgroundHuman papillomavirus (HPV) genotype influences the development of invasive cervical cancer (ICC); however, there is uncertainty regarding the association of HPV genotype with survival among ICC patients.MethodsFollow-up data were collected from 693 previously selected and HPV-typed ICC cases that were part of the Centers for Disease Control and Prevention Cancer Registry Surveillance System. Cases were diagnosed between 1994 and 2005. The Kaplan-Meier method was used to estimate five-year all-cause survival. A multivariable Cox proportional hazards model was used to estimate the effect of HPV genotype on survival after adjusting for demographic, tumor, and treatment characteristics.ResultsFive-year all-cause survival rates varied by HPV status (HPV 16: 66.9%, HPV 18: 65.7%, HPV 31/33/45/52/58: 70.8%, other oncogenic HPV genotypes: 79.0%, nononcogenic HPV: 69.3%, HPV-negative: 54.0%). Following multivariable adjustment, no statistically significant survival differences were found for ICC patients with HPV 16–positive tumors compared with women with tumors positive for HPV 18, other oncogenic HPV types, or HPV-negative tumors. Women with detectable HPV 31/33/33/45/52/58 had a statistically significant 40% reduced hazard of death at five years (95% confidence interval [CI] = 0.38 to 0.95), and women who tested positive for nononcogenic HPV genotypes had a statistically significant 57% reduced hazard of death at five years (95% CI = 0.19 to 0.96) compared with women with HPV 16 tumors. Few statistically significant differences in HPV positivity, tumor characteristics, treatment, or survival were found by race/ethnicity.ConclusionsHPV genotype statistically significantly influenced five-year survival rates among women with ICC; however, screening and HPV vaccination remain the most important factors to improve patient prognosis and prevent future cases.

【 授权许可】

CC BY-NC-ND