National Institute of Health

Scientists from Korea National Institute of Health investigate risk factors and disease progressions rates associated with cervical cancer-causing HPV infections among Korean women

Human papillomavirus (HPV) infections are the leading cause for cervical cancer development and progression. Recognizing the HPV type present in cervical lesions and the progression risk associated with it is crucial for planning preventative measures. In a new systematic review, researchers from Korea National Institute of Health identify the most prevalent HPV types posing high risks for cancer progression in Korean women, opening doors to a better HPV prevention program.

Image Caption: Researchers from KNIH investigated the progression and development of cervical cancer associated with persistent human papillomavirus (HPV) infections, revealing new insights.

Image Credit: Kateryna Kon from Shutterstock.

Cervical cancer is the fourth most common cancer in women and results in infections and lesions in the cervix. In 2018 alone, almost 570,000 cases of cervical cancer and 311,000 deaths from the disease were reported. Cervical cancer is primarily caused by the human papillomavirus (HPV), with HPV type 16 (HPV-16) and HPV-18 causing 70% of cervical cancer and precancerous lesions.

However, the prevalence of HPV types varies from region to region. For instance, HPV-33 is predominant in Europe, whereas HPV-52, 53, and 58 prevail in Asia. In South Korea, HPV-16 along with the prevalent Asian HPV types have been associated with high-risk HPV infections (HR-HPV).

To understand the major risk factors associated with cervical cancer, it is necessary to identify the types of HPV prevalent in cervical lesions. Many South Korean HPV cohort studies have indicated that even the progression rate of abnormal lesions varied depending on the specific HPV type. Vaccines are accordingly designed to target specific HR-HPV types. Knowing the prevalent HPV type among a demographic is, therefore, crucial for monitoring the effectiveness of a vaccine.

To this end, researchers from the Korea National Institute of Health filled in the gaps with a recent article published in the Virology Journal. The team, led by Dr. Byeong-Sun Choi, conducted a systematic review to investigate the presence of high and low-risk HPV types found in abnormal cervical lesions. Dr. Choi explains, “The number of incidences of cervical cancer in Korea has decreased from 4,443 cases in 1999 to 3,500 in 2018. However, it is still the eighth most common cancer in women. Our research aims to address this issue by understanding the disease better and fine-tuning the vaccination efforts.” The approval for this study was obtained from the institutional review board (IRB) of the Korea Disease Control and Prevention Agency (KDCA) (approved no. 2018–06-02-P-A).

To estimate HPV prevalence, the team collected results for Pap smear—a test used to check for abnormalities in the cervix that are indicative of cancer—from seven medical literature databases up to July 2019, and looked at the Korea HPV Cohort study data to evaluate the risk of cancer progression. Additionally, they assessed the risk of disease progression in 686 HPV-positive women.

Based on 23 studies included in the review, HPV-16, -58, -53, -70, -18, and -68 were the six most prevalent genotypes. HPV-16 was the most prevalent, followed by HPV-58, -53, -70, -18, and -68. In women with high-grade squamous intraepithelial lesions, including cancer, HPV-16, -18, and -58 were the most prevalent.

In the longitudinal cohort study, the hazard ratio of disease progression from atypical squamous cells of uncertain significance to high-grade squamous intraepithelial lesions was significantly higher among those with persistent HPV-58 and HPV-16 infections.

These insights could go a long way in assisting the development of better HPV prevention programs. “Our study has made it possible to confirm the distribution of HPV based on the stage and risk of disease progression from continuous infection with major HPV types. The results can not only be used as a basis for a National Immunization Program for HPV but also guide future follow-up research on the role of HPV and vaccination in cancer development,” concludes Dr. Choi.

We certainly hope his visions are not too far from being realized!

Reference

About Korea National Institute of Health

The Korea National Institute of Health (KNIH), one of the major operating components of the Korea Disease Control and Prevention Agency, leads the nation’s medical research. Over the past seven decades, the KNIH has made unwavering efforts to enhance the public’s health and innovate biomedical research. The KNIH seeks to eradicate diseases and make people healthier. The KNIH establishes a scientific basis and evidence underlying health policy as well as provides national research infrastructures. We also promote public health research. To this end, we make efforts to enrich a health research environment by granting funds to research projects and keeping our resources, data, and facilities more open and accessible to researchers.

Website: http://www.nih.go.kr/eng/

About Dr. Byeong‑Sun Choi

Dr. Byeong-Sun Choi is the Director of Division of Chronic Viral Disease, Center for Emerging Virus Research, National Institute of Infectious Disease, since 2020. He is also the vice-president for The Korean Society for AIDS. His research interest lies in the field of chronic viral research. He has published 80 papers and has 25 patents to his name. With the help of his co-workers, he aims to establish the infrastructures for HIV-1 latency study in Korea, involving the delivery of therapeutic drugs targeting latent HIV, and an in vivo humanized latent HIV animal model.