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oai:lup.lub.lu.se:848bf8ca-5c98-4298-a186-0f4b9bce68f8 2025-07-28T19:30:29Z allFtxt allFtxt thesis thesis:ftxt thesis:doccomp thesis:doccomp:ftxt

Targeting the human papillomavirus for prevention of cervical cancer https://lup.lub.lu.se/record/548843 urn:isbn:978-91-85559-75-6 https://portal.research.lu.se/files/4621169/548844.pdf Naucler, Pontus Different types of human papillomavirus (HPV) vary in the extent they cause precursor lesions (CIN) and cancer. There are limited long-term efficacy data on HPV testing in primary screening Among 72 cervical cancers in Mozambique, HPV 16 and 18 were the most frequent HPV types (69% of cases). Comparing 108 cervical cancers cases and 517 matched controls nested within a population-based cohort in Taiwan, HPV 16 seropositivity implied a 6-fold increased cancer risk. In a cohort of 5696 women in Sweden, HPV types 16, 31 and 33 conveyed the highest risks for future high-grade CIN (CIN 2+), attributing to 33.1%, 18.3% and 7.7% of CIN 2+ cases, respectively. In a pooled analysis of seven European longitudinal studies of HPV-based cervical screening, the cumulative incidence rate of CIN grade 3 or worse (CIN 3+) was higher after 3 years among women with normal cytology than among women with a negative HPV test after 6 years. Finally, in a randomized cervical cancer screening trial in Sweden, adding testing for HPV persistence resulted in a 51% (95% CI: 13-102) increase of CIN 2+ at prevalent screening, which was followed by a reduction of 42% (95% CI: 4-76) of CIN 2+ at incident screening. In conclusion, HPV-based cervical cancer screening protects against future CIN 2+, and the long-term protective effect should enable extended screening intervals to 6 years. Albeit HPV 16 is the most important carcinogenic HPV type all over the world, different ?high-risk? HPV types convey distinctly different risks for CIN 2+, which should be considered in design of screening tests and vaccines. Microbiology in the Medical Area bakteriologi virologi Mikrobiologi mycology virology bacteriology prevention Microbiology CIN vaccine cervical intraepithelial neoplasia screening cervical cancer Human Papillomavirus HPV mykologi Public health epidemiology Folkhälsa epidemiologi eng Medical Microbiology, Lund University 2007 info:eu-repo/semantics/openAccess thesis/doccomp info:eu-repo/semantics/doctoralThesis text application/pdf