AIM: This work describes the human papillomavirus (HPV) prevalence and the HPV type distribution in a large series of vaginal intraepithelial neoplasia (VAIN) grades 2/3 and vaginal cancer worldwide. METHODS: We analysed 189 VAIN 2/3 and 408 invasive vaginal cancer cases collected from 31 countries from 1986 to 2011. After histopathological evaluation of sectioned formalin-fixed paraffin-embedded samples, HPV DNA detection and typing was performed using the SPF-10/DNA enzyme immunoassay (DEIA)/LiPA25 system (version 1). A subset of 146 vaginal cancers was tested for p16(INK4a) expression, a cellular surrogate marker for HPV transformation. Prevalence ratios were estimated using multivariate Poisson regression with robust variance. RESULTS: HPV DNA was detected in 74% (95% confidence interval (CI): 70-78%) of invasive cancers and in 96% (95% CI: 92-98%) of VAIN 2/3. Among cancers, the highest detection rates were observed in warty-basaloid subtype of squamous cell carcinomas, and in younger ages. Concerning the type-specific distribution, HPV16 was the most frequently type detected in both precancerous and cancerous lesions (59%). p16(INK4a) overexpression was found in 87% of HPV DNA positive vaginal cancer cases. CONCLUSIONS: HPV was identified in a large proportion of invasive vaginal cancers and in almost all VAIN 2/3. HPV16 was the most common type detected. A large impact in the reduction of the burden of vaginal neoplastic lesions is expected among vaccinated cohorts.

3rd Faculty of Medicine and Faculty Hospital King's Wineyards Prague Czech Republic

Cancer Institute of Colombia Colombia

Centro de Investigación Epidemiológica en Salud Sexual y Reproductiva CIESAR Hospital General San Juan de Dios HGSJDD Guatemala Guatemala

Centro de Oncología Preventiva Universidad de Chile Santiago Chile

CHU Reims Hopital Maison Blanche Laboratoire Pol Bouin Reims France; INSERM UMR S903 Reims France

DDL Diagnostic Laboratory Rijswijk The Netherlands

Department of Gynaecology and Obstetrics Medical University of Vienna Comprehensive Cancer Center Vienna Austria

Faculty of Medicine Eduardo Mondlane University and Maputo Central Hospital Maputo Mozambique

German Cancer Research Center Heidelberg Germany

Hospital Oncológico Quito Ecuador

Hospital Universitari de Bellvitge Barcelona Spain

Instituto de Ginecologia da Universidad Federal Do Rio de Janeiro UFRJ Rio de Janeiro Brazil

Instituto Nacional de Cancerología Bogotá Colombia

Instituto Potosino de Investigación Científica y Tecnológica AC San Luis Potosí Mexico

Jagiellonian University Medical College Krakow Poland

Klinikum Wolfsburg Wolfsburg Germany

Laboratoire Cerba Department de Pathologie Paris France

Laboratorio de Anatomia Patológica del Hospital de la Mujer Montevideo Uruguay

Manchester Royal Infirmary Manchester United Kingdom

Medical University of Lublin Lublin Poland

Mexican Oncology Hospital IMSS Mexico DF Mexico

National Cancer Center Seoul South Korea

Queen Elizabeth Hospital Sheriff Hill UK

Unit of Infections and Cancer Cancer Epidemiology Research Program Catalan Institute of Oncology IDIBELL L'Hospitalet de Llobregat Barcelona Spain

Unit of Infections and Cancer Cancer Epidemiology Research Program Catalan Institute of Oncology IDIBELL L'Hospitalet de Llobregat Barcelona Spain; CIBER en Epidemiología y Salud Pública Spain

Unit of Infections and Cancer Cancer Epidemiology Research Program Catalan Institute of Oncology IDIBELL L'Hospitalet de Llobregat Barcelona Spain; Hospital General de L'Hospitalet Barcelona Spain

WestMead Hospital Sydney Australia

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The presence of high-risk human papillomavirus (HPV) E6/E7 mRNA transcripts in a subset of sinonasal carcinomas is evidence of involvement of HPV in its etiopathogenesis