Estimating the epidemiological burden of pathologies associated with 9 human papillomavirus genotypes in Spain: Literature review

• Published in: Vacunas (Barcelona. Internet. English ed.) 2017-07, Vol.18 (2), p.36-42
• Main Authors: López, N., Viayna, E., San-Martin, M., Perulero, N.
• Format: Article
• Language: English
• Subjects: Burden of disease; Cancer; Carga de enfermedad; Cáncer; Genital warts; Human papillomavirus; Lesiones precancerosas; Nonavalent vaccine; Precancerous lesions; Vacuna nonavalente; Verrugas genitales; Virus del papiloma humano
• ISSN: 2445-1460; 2445-1460
• DOI: 10.1016/j.vacune.2017.08.001

To evaluate the epidemiology related to human papillomavirus (HPV) infection in Spain, attributable to the genotypes targeted by the quadri- and nonavalent vaccines. Medline, Embase and Cochrane were searched in order to identify studies of prevalence of genotypes targeted by the quadri- and nonavalent vaccines in genital warts, precancerous lesions and cancer of cervix, vulva, vagina, anus and penis and head and neck cancer. Fraction attributable (FA) to HPV infection and to genotypes targeted by both vaccines was estimated for precancerous lesions of cervix and cancer of cervix, vulva, vagina and penis following the Insinga and Wentzensen methodology. Out of the 1922 identified references, 34 publications on genotypes prevalence were included. Contribution of the 5 additional genotypes targeted by the nonavalent vaccine ranged from 8.6% for penile cancer to 23.2% for cervical precancerous lesions. The 88.5% of the cases for cancer of cervix would be attributable to the 9 genotypes in the nonavalent vaccine. For cancer of vulva and vagina, the percentage of HPV+ cases attributable to genotypes in the nonavalent vaccine would be 87.5% and 89.2% respectively. Only two studies were identified about genotypes of HPV in head and neck cancer, which did not provide enough information to estimate the FA of the genotypes. The 9 genotypes included in the nonavalent vaccine are responsible at least of the cancer and precancerous lesions related to HPV infection in our country. These diseases represent an important burden for the National Health Service. Evaluar la epidemiología asociada al virus del papiloma humano (VPH) en España, atribuible a los genotipos incluidos en las vacunas tetra y nonavalente. Se realizó una revisión bibliográfica de Medline, Embase y Cochrane para identificar estudios de prevalencia de los genotipos incluidos en las vacunas tetra y nonavalente, en verrugas genitales, lesiones precancerosas y cáncer de cérvix, vulva, vagina, ano, pene y cáncer de cabeza y cuello. Se estimó la fracción atribuible (FA) a los genotipos de ambas vacunas en lesiones precancerosas de cérvix y cáncer de cérvix, vulva, vagina y pene siguiendo la metodología de Insinga y Wentzensen. De las 1.922 referencias identificadas, se incluyeron en la revisión 34 sobre prevalencia de genotipos. La contribución de los 5 genotipos adicionales de la vacuna nonavalente oscilaba entre el 8,6% para cáncer de pene y el 23,2% para lesiones precancerosas de cérvix. Para cáncer de cér