Carcinogenic risk of human papillomavirus (HPV) genotypes and potential effects of HPV vaccines in Korea

Abstract

This study investigated the distribution of HPV types in Korean women and evaluated the carcinogenic risk of individual HPV types and the potential effects of HPV vaccines. A total of 4,081 HPV-positive samples between 2014 and 2017 were included. The most prevalent genotypes were HPV 16, 58, 68, and 56. Among them, HPV 16 was significantly higher in high-grade squamous intraepithelial neoplasia or worse (HSIL+ ) group. In cytologically evaluating the risk for HSIL+ by individual HPV types, HPV 16 was associated with the highest risk of HSIL+ (OR = 10.82; 95% CI: 7.93-14.77), followed by HPV 33, 31, 52, 18, 58, 51, and 35, in descending order (OR = 3.50 [type 33] to 2.62 [type 35]). Among those types, HPV 16, 18, 31, 33, and 58 were also significantly associated with HSIL+ on histologic evaluation. The analysis of the HPV subgroups covered by the different vaccines revealed that the HPV types covered by the 9-valent vaccine had a high association with HSIL+ (OR = 4.09; 95% CI: 3.02-5.54). Our findings highlight the different carcinogenic risks posed by the high risk HPV genotypes and the positive potential effects of the 9-valent HPV vaccine in reducing HPV-associated cervical cancer in Korea.

Figure 1

Flow diagram of patient selection. ADC = adenocarcinoma, ASC-H = atypical squamous cells-cannot exclude high-grade squamous intraepithelial neoplasia, ASCUS = atypical squamous cells of undetermined significance, HSIL = high-grade squamous intraepithelial neoplasia, LSIL = low-grade squamous intraepithelial neoplasia, NILM = negative for intraepithelial lesions or malignancy, Pn = number of patients, SCC = squamous cell carcinoma.

Figure 2

Logistic regression analyses of HPV genotypes based on cytologic results.