The role of human papillomaviruses in anogenital cancers

doi:10.1006/scbi.1998.0081

Seminars in Cancer Biology

Volume 8, Issue 4, 1998, Pages 307-313

https://doi.org/10.1006/scbi.1998.0081 Get rights and content

Abstract

There is substantial evidence to suggest that common risk factors exist for cancer of the cervix and other anogenital cancers. Cervical cancer has been etiologically linked with venereal types of human papillomavirus (HPV) and the same types of HPV are being found in other anogenital tissues. The question is to what extent these HPV types may also contribute to carcinogenesis in anogenital cancer other than cervical cancer. In this review some general aspects of the natural history of HPV are presented followed by a description of the incidence and risk factors for anal, vulvar, and penile cancer. Main focus is given to the evidence for an association between these cancers and HPV.

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Cited by (67)

Epidemiology of Anal Canal Cancer
2017, Surgical Oncology Clinics of North America
Citation Excerpt :
The prevalence of HPV in the United States is variable, ranging from 10% in low-risk groups to nearly 90% in individuals infected with HIV.14–16 It is thought that HPV is associated with 65% to 89% of all SCCA of the anal canal, making this the leading risk factor for this malignancy.17,18 A recent series of 72 metastatic anal cancer cases at MD Anderson revealed that 94% had detectable HPV.19
Oral human papillomavirus type-specific infection in HIV-infected men: A prospective cohort study among men who have sex with men and heterosexual men
2014, Clinical Microbiology and Infection
The natural history of type-specific oral infection of human papillomavirus (HPV) was assessed in a cohort of HIV-infected men (538 men who have sex with men (MSM); 195 heterosexuals). Risk factors associated with oral HPV infections were examined. The overall prevalence of HPV was 16%: HPV-16 was the most prevalent type (3.7% MSM; 7.8% heterosexuals). The prevalence of HPV-16 in heterosexuals was associated with CD4 nadir counts <200 cells/μL (OR_adjusted = 3.0, 95% CI, 1.4–6.3). The overall incidence of HPV was similar between groups (11%), but the incidence of HPV-16 was higher in heterosexuals (OR_adjusted = 3.2, 95% CI, 1.1–9.5). Not only MSM but also HIV-infected heterosexual men are at risk of HPV infection. Regular and careful oral inspection is needed.
Condylomata acuminatum around the ileostomy
2010, Piel
Economic burden of anal cancer management in France
2010, Revue d'Epidemiologie et de Sante Publique
Citation Excerpt :
Like cancer of the cervix, anal cancer is associated with human papillomavirus infection (HPV). HPV has been detected in 88% of anal cancers (“high-risk” types HPV16 and/or 18 have been detected in 80% of cases) and in 93% of high-grade AIN [3–6], as well as being associated with benign anal condylomata, “genital warts” (“low-risk” HPV types 6 and 11) [3]. Other contributing factors influencing development of the disease include immunosuppression, cigarette smoking, receptive anal intercourse, lifetime number of sexual partners and certain venereal diseases [1,4].
The incidence of anal cancer has increased over the last 25 years. No organized screening exists for the precursors of anal cancer (anal intraepithelial neoplasia and carcinoma in situ) and diagnosis is often delayed. Treatment for precursor lesions is of limited success, while cancer management is traumatic for the patient. Like cancers of the cervix, most cases of anal cancer are associated with infection with human papillomavirus (HPV). With increases in the incidence of anal cancer, and in light of the availability of prevention strategies such as screening and HPV vaccination, it is important, from a public health perspective, to assess the economic burden of anal cancer in France.
We performed a retrospective analysis based on data extracted from a French hospital database – the Programme de médicalisation des systèmes d’information (PMSI) – to assess the number and management of patients hospitalized for anal cancer in 2006. Data on radiotherapy sessions performed in private hospitals were obtained from the Statistiques annuelles des établissements de santé (SAE) database. Costs of hospitalization, from the healthcare-payer perspective, were obtained from official diagnosis-related group tariffs for public and private hospitals. Ambulatory and indirect costs were estimated using information obtained from the literature.
In 2006, 3,711 patients with anal cancer were treated in hospitals in France. Of these, the majority were women (69%). The annual cost of hospital treatment for anal cancer was estimated at €20,326,868. The overall estimated cost (including hospitalization, outpatient and daily allowances costs) to the healthcare payer was €38,249,981.
This study, the first to investigate the economic burden of anal cancer in France, shows that the management costs of anal cancer are high and comparable to cervical cancer management costs (€44 million). Further research is required to determine the cost of management of precursor lesions, which is mostly performed in an outpatient setting. Prophylactic HPV vaccination could significantly reduce the burden of this disease.
L’incidence du cancer anal a augmenté depuis ces 25 dernières années. Il n’existe pas de dépistage organisé pour les problèmes précurseurs du cancer anal, la néoplasie intraépithéliale anale, et le diagnostic est souvent prononcé tardivement. Le succès de la prise en charge des lésions précancéreuses est limité et le traitement du cancer est souvent difficile pour les patients. Comme les cancers du col de l’utérus, la plupart des cas de cancer anal sont associés à une infection par le virus du papillome humain (VPH). Avec l’augmentation de l’incidence du cancer anal et étant donné la disponibilité des moyens de prévention tels que le dépistage et la vaccination contre le VPH, il semble important, d’un point de vue de santé publique, d’estimer le poids économique de ce cancer en France.
Une analyse rétrospective a été réalisée à partir de données extraites d’une base de données hospitalières française – le Programme de médicalisation des systèmes d’information (PMSI) – afin d’estimer le nombre et le coût des prises en charge des patients hospitalisés pour un cancer anal en 2006. Les informations sur les séances de radiothérapie effectuées dans les hôpitaux privés ont été obtenues à partir de la base de données « Statistiques annuelles des établissements de santé » (SAE). Les coûts d’hospitalisation, du point de vue de l’assurance maladie, ont été extraits des tarifs officiels pour les groupes homogènes de malades, dans les établissements publics et privés. Le coût des soins ambulatoires et les coûts indirects ont été estimés à partir de données de la littérature.
En 2006, 3711 patients ont été hospitalisés pour un cancer anal en France. La plupart était des femmes (69 %). Les coûts annuels d’hospitalisation pour le cancer anal ont été estimés à 20 326 868 €. Le coût total annuel pour l’assurance maladie (incluant les coûts hospitaliers, ambulatoires et les indemnités journalières) a été établi à 38 249 981 €.
Cette étude, la première à examiner le poids économique du cancer anal en France, montre que les coûts de prise en charge de cancer sont élevés et similaires à ceux de la prise en charge du cancer du col de l’utérus (44 millions d’euros). D’autres recherches seront nécessaires afin d’évaluer le coût de la prise en charge des signes précurseurs, qui sont généralement traités en ambulatoire. La vaccination prophylactique contre le VPH pourrait réduire significativement l’incidence de cette maladie et les coûts qui lui sont associés.
HPV antibody levels and clinical efficacy following administration of a prophylactic quadrivalent HPV vaccine
2008, Vaccine
Citation Excerpt :
The lifetime risk of infection with the Human Papillomavirus (HPV) exceeds 50% [1,2]. HPV infection can cause epithelial dysplasia and cancer of the cervix, a significant proportion of cancers of the genitalia (both genders), anal canal, and the oropharynx, as well as benign tumors of the genitalia (condylomata acuminata) and the larynx (recurrent respiratory papillomatosis [RRP]) [3–8]. HPV types are defined by sequence variation in the gene encoding the L1 protein, the major constituent of the viral capsid.
The efficacy of the quadrivalent Human Papillomavirus (HPV) vaccine is thought to be mediated by humoral immunity. We evaluated the correlation between quadrivalent HPV vaccine-induced serum anti-HPV responses and efficacy. 17,622 women were vaccinated at day 1, and months 2 and 6. At day 1 and at 6–12 months intervals for up to 48 months, subjects underwent Papanicolaou and genital HPV testing. No immune correlate of protection could be found due to low number of cases. Although 40% of vaccine subjects were anti-HPV 18 seronegative at end-of-study, efficacy against HPV 18-related disease remained high (98.4%; 95% CI: 90.5–100.0) despite high attack rates in the placebo group. These results suggest vaccine-induced protection via immune memory, or lower than detectable HPV 18 antibody titers.
Induction of immune memory following administration of a prophylactic quadrivalent human papillomavirus (HPV) types 6/11/16/18 L1 virus-like particle (VLP) vaccine
2007, Vaccine
Citation Excerpt :
Human papillomavirus (HPV) infection is associated with cancers of the cervix, vulva, vagina, anus, penis, and the oropharynx [1–5], as well as genital warts [6].
The duration of protection afforded by vaccines represents a critical test of their utility as public health interventions. Some vaccines induce long-term immunity, while others require booster doses. Vaccines that induce long-term protection are usually characterized by the generation of immune memory. Recent trials of a quadrivalent (types 6, 11, 16, 18) human papillomavirus (HPV) vaccine have demonstrated high efficacy through 5 years of follow-up. We evaluated the extent to which the vaccine is able to generate HPV type-specific immune memory.
A total of 552, 16–23-year-old women were enrolled in a double-blind, placebo-controlled study. At enrollment, subjects were randomized in a 1:1 ratio to receive three-dose regimens of quadrivalent HPV vaccine or placebo with 3 years’ follow-up. A subset of 241 subjects (n = 114 in the quadrivalent HPV vaccine group and n = 127 in the placebo group) underwent 2 further years of follow-up. All extension subjects received quadrivalent HPV vaccine at month 60 to examine the extent of immune memory in response to the primary vaccination series.
Serum anti-HPV levels declined post-vaccination, but reached a plateau at month 24 that remained stable through month 60. Administration of a challenge dose of vaccine induced a classic anamnestic response, with anti-HPV levels 1 week post-challenge reaching levels observed 1 month following the completion of the three-dose primary series. At 1 month post-challenge, anti-HPV responses were higher than those observed 1-month post-dose 3.
A three-dose regimen of quadrivalent HPV vaccine induces high efficacy and stable anti-HPV levels for at least 5 years. Vaccination also induces robust immune memory. These findings suggest that the efficacy of this vaccine will be long lasting.

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Regular ArticleThe role of human papillomaviruses in anogenital cancers

Abstract

Regular Article
The role of human papillomaviruses in anogenital cancers