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Human Papillomavirus Type Distribution in Invasive Cervical Cancer and High-Grade Cervical Intraepithelial Neoplasia Across 5 Countries in Asia
  1. Swee Chong Quek, MBBCh*,
  2. Boon Kiong Lim, MBBS, MRCOG,
  3. Efren Domingo, MD,
  4. Ruey Soon, MBBS, MRCOG§,
  5. Jong-Sup Park, MD, PhD,
  6. Thi Nhung Vu, MD, PhD,
  7. Eng Hseon Tay, MBBS, MMED, DGO,
  8. Quang Thanh Le, MMed#,
  9. Young-Tak Kim, MD, PhD**,
  10. Ba Quyet Vu, MD, PhD,,
  11. Ngoc Thanh Cao, MD, PhD,,
  12. Genara Limson, MD§§,
  13. Viet Thanh Pham, MD, PhD∥∥,
  14. Anco Molijn, MSc¶¶,
  15. Gunasekaran Ramakrishnan, MSc## and
  16. Jing Chen, MD***
  1. *Parkway Gynaecology Screening and Treatment Center, Singapore, Singapore;
  2. Department of Obstetrics and Gynecology, University Malaya Medical Centre, Kuala Lumpur, Malaysia;
  3. Department ofObstetrics and Gynecology, University of The Philippines, PhilippineGeneral Hospital, Manila, Philippines;
  4. §Department of Obstetrics and Gynecology, Hospital Likas, Kota Kinabalu, Sabah, Malaysia;
  5. Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea;
  6. Department of Obstetrics and Gynecology, Hung Vuong Hospital, Ho Chi Minh City, Vietnam;
  7. Thomson Women Cancer Center, Singapore;
  8. #Department of Obstetrics and Gynecology, Tu Du Hospital, Ho Chi Minh City, Vietnam;
  9. **Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea;
  10. ††Department of Gynaecological Oncology, National Hospital for Obstetrics and Gynaecology, Hanoi, Vietnam;
  11. ‡‡Department of Obstetrics and Gynecology, Hue College of Medicine and Pharmacy, Hue, Vietnam;
  12. §§Department of Obstetrics & Gynecology, Makati Medical Center, Makati, Philippines;
  13. ∥∥Department of Mother and Child Health, Ministry ofHealth, Vietnam;
  14. ¶¶DDL Diagnostic Laboratory, Rijswijk, The Netherlands;
  15. ##GlaxoSmithKline Pharmaceuticals, Bangalore, India; and
  16. ***GlaxoSmithKline Pte Ltd, Singapore, Singapore.
  1. Address correspondence and reprint requests to Jong-Sup Park, MD, PhD, Department of Obstetrics and Gynaecology, Catholic University Medical College, 505 Banpodong, Seochogu, Seoul, 137-040, Republic of Korea. E-mail: jspark{at}


Objective Independent, prospective, multicenter, hospital-based cross-sectional studies were conducted across 5 countries in Asia, namely, Malaysia, Vietnam, Singapore, South Korea, and the Philippines. The objectives of these studies were to evaluate the prevalence of human papillomavirus (HPV) types (high risk and others including coinfections) in women with invasive cervical cancer (ICC) and high-grade precancerous lesions.

Methods Women older than 21 years with a histologic diagnosis of ICC and cervical intraepithelial neoplasia [CIN 2 or 3 and adenocarcinoma in situ (AIS)] were enrolled. Cervical specimens were reviewed by histopathologists to confirm the presence of ICC or CIN 2/3/AIS lesion and tested with short PCR fragment10-DNA enzyme immunoassay-line probe assay for 14 oncogenic HPV types and 11 non-oncogenic HPV types. The prevalence of HPV 16, HPV 18, and other high-risk HPV types in ICC [including squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (ADC/ASC)] and CIN 2/3/AIS was estimated.

Results In the 5 Asian countries, diagnosis of ICC was confirmed in 500 women [SCC (n = 392) and ADC/ASC (n = 108)], and CIN 2/3/AIS, in 411 women. Human papillomavirus DNA was detected in 93.8% to 97.0% (84.5% for the Philippines) of confirmed ICC cases [94.0%–98.7% of SCC; 87.0%–94.3% (50.0% for the Philippines) of ADC/ASC] and in 93.7% to 100.0% of CIN 2/3/AIS. The most common types observed among ICC cases were HPV 16 (36.8%–61.3%), HPV 18 (12.9%–35.4%), HPV 52 (5.4%–10.3%), and HPV 45 (1.5%–17.2%), whereas among CIN 2/3/AIS cases, HPV 16 (29.7%–46.6%) was the most commonly observed type followed by HPV 52 (17.0%–66.7%) and HPV 58 (8.6%–16.0%).

Conclusions This article presents the data on the HPV prevalence, HPV type distribution, and their role in cervical carcinogenesis in 5 Asian countries. These data are of relevance to public health authorities for evaluating the existing and future cervical cancer prevention strategies including HPV-DNA testing–based screening and HPV vaccination in these Asian populations.

  • Asia
  • Cervical intraepithelial neoplasia
  • Epidemiology
  • Human papillomavirus
  • Invasive cervical cancer

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  • A core writing team (CWT) was formed to take lead in driving the development of this publication. The main responsibilities of the CWT were to review, recommend, and endorse decisions relating to the manuscript on behalf of all coauthors. Members of the CWT were Swee Chong Quek, Boon Kiong Lim, Efren Domingo, Ruey Soon, Jong-Sup Park, and Jing Chen. Other than the first author (Swee Chong Quek) and last author (Jing Chen) who were decided by a voting exercise by the CWT, the other members of the CWT are listed ahead of other co-authors and in accordance to the number of subjects they had recruited, with the one with the highest recruitment number listed first.

  • GlaxoSmithKline Biologicals SA was the funding source for all of the 5 studies mentioned in this article and was involved in all stages of the conduct and analysis of the studies. GlaxoSmithKline Biologicals SA also took charge of all costs associated to the development and the publishing of the present article. [Study eTrack numbers: 110425 (Malaysia); 110994 (Philippines); 106714 (Singapore); 110676 (South Korea); 110428 (Vietnam)].