Cervical screening and risk of adenosquamous and rare histological types of invasive cervical carcinoma: population based nested case-control study

Objectives To examine the association of cervical cytology screening with the risk of adenosquamous cell carcinoma (ASC) and rare histological types of invasive cervical carcinoma (RICC), using comprehensive registry data, and to assess tumour human papillomavirus status of ASC and RICC. Design Nationwide, population based, nested case-control study. Setting Sweden. Participants All cases of invasive cervical carcinoma in Sweden during 2002-11 (4254 confirmed cases after clinical and histopathological review). 338 cases were neither squamous cell carcinoma nor adenocarcinoma, including 164 cases of ASC and 174 cases of RICC (glassy cell carcinoma, clear cell carcinoma, small cell carcinoma, neuroendocrine cell carcinoma, large cell carcinoma, and undifferentiated carcinoma). 30 birth year matched controls from the general Swedish population were matched to each case by applying incidence density sampling. Main outcome measures Conditional logistic regression was used to calculate odds ratios, interpreted as incidence rate ratios, for risk of ASC and RICC in relation to screening status and screening history, adjusted for education. Human papillomavirus distribution of ASC and RICC was based on available archival tumour tissues from most Swedish pathology biobanks. Results Women with two screening tests in the previous two recommended screening intervals had a lower risk of ASC (incidence rate ratio 0.22, 95% confidence interval 0.14 to 0.34) and RICC (0.34, 0.21 to 0.55), compared with women without any test. High risk human papillomavirus was detected in 148/211 (70%) cases with valid human papillomavirus results from tumour tissues. The risk reduction among women with tumours that were positive (incidence rate ratio 0.28, 0.18 to 0.46) and negative (0.27, 0.13 to 0.59) for high risk human papillomavirus was similar, compared with women who did not attend any test. Conclusions Cervical screening is associated with reduced risk of ASC and RICC, and most ASC and RICC are positive for high risk human papillomavirus. This evidence provides a benchmark for evaluating future cervical screening strategies.

Genotype of human papilloma virus in invasive cervical carcinoma at Dr. Soetomo Hospital Surabaya

Objectives: To identify the variants of genotype HPV that most often found in ICC at Dr Soetomo Hospital Surabaya.Materials and Methods: This was an explorative study with cross sectional approach. Specimens used were 30 formalin fix parrafin embedded from squamous cell carcinoma (SCC), adenocarcinoma (AD) dan adenosquamous carcinoma (AS) cervival cancer parients at Dr Soetomo Hospital Surabaya around Januari-Desember 2013, then used for DNA virus extraction and continued for PCR and HPV genotyping.Result : The result of HPV genotyping showed 10 positives from SCC, 6 positives and 4 negatives from AD, and 9 positives and 1 negative from AS. HPV infections in SCC were single infection by HPV 16, 18, 45, 56, and multiple infection by HPV 16+45, in AD were single infection by HPV 16,18, anad multiple infection by HPVhr+hr 68b+72 and HPVlr+hr 6+18+45, and in AS were single infection by HPVhr 16, 18, 45 and mutiple infection by HPV lr+hr 6+59.Conclusion : Infections HPV in ICC were single infection by HPV16, 18, 45, 56 and mutiple infection by HPV16+45, 68b+72, 6+18+45, 6+59. HPV 18 has highest prevalence in ICC patient from Dr Soetomo Hospital, followed by HPV16, 6, 45, 56, 59.