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Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence

BACKGROUND Cervical cancer is a predominantly human papillomavirus (HPV)‐driven disease worldwide. However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C sin...

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Published in:Cancer 2017-07, Vol.123 (13), p.2459-2466
Main Authors: Alsbeih, Ghazi A., Al‐Harbi, Najla M., Bin Judia, Sara S., Khoja, Hatim A., Shoukri, Mohamed M., Tulbah, Asma M.
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container_end_page 2466
container_issue 13
container_start_page 2459
container_title Cancer
container_volume 123
creator Alsbeih, Ghazi A.
Al‐Harbi, Najla M.
Bin Judia, Sara S.
Khoja, Hatim A.
Shoukri, Mohamed M.
Tulbah, Asma M.
description BACKGROUND Cervical cancer is a predominantly human papillomavirus (HPV)‐driven disease worldwide. However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C single nucleotide polymorphism (SNP) presumed to affect cancer incidence. METHODS Patients treated between 1990 and 2012 were reviewed, and a series of 232 invasive cervical cancer cases were studied and compared with 313 matched controls without cancer. SNP was genotyped by way of direct sequencing. HPV linear array analysis was used to detect and genotype HPV in tumor samples. RESULTS The incidence of cervical cancer revealed bimodal peaks at 42.5 years, with a slighter rebound at 60.8 years. Among all cases, 77% were HPV‐positive and 16 HPV genotypes were detected—mostly genotypes 16 (75%) and 18 (9%)—with no difference by age, histology, or geographical region. Although the TP53 G72C genotype was not associated with overall cervical cancer risk, it was significantly associated with HPV positivity (odds ratio, 0.57; 95% confidence interval, 0.36‐0.90; P = .016). Furthermore, the variant C allele was significantly overtransmitted in the population (P 
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However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C single nucleotide polymorphism (SNP) presumed to affect cancer incidence. METHODS Patients treated between 1990 and 2012 were reviewed, and a series of 232 invasive cervical cancer cases were studied and compared with 313 matched controls without cancer. SNP was genotyped by way of direct sequencing. HPV linear array analysis was used to detect and genotype HPV in tumor samples. RESULTS The incidence of cervical cancer revealed bimodal peaks at 42.5 years, with a slighter rebound at 60.8 years. Among all cases, 77% were HPV‐positive and 16 HPV genotypes were detected—mostly genotypes 16 (75%) and 18 (9%)—with no difference by age, histology, or geographical region. Although the TP53 G72C genotype was not associated with overall cervical cancer risk, it was significantly associated with HPV positivity (odds ratio, 0.57; 95% confidence interval, 0.36‐0.90; P = .016). Furthermore, the variant C allele was significantly overtransmitted in the population (P &lt; .0003). CONCLUSION Cervical cancer incidence displays bimodal curve peaking at a young age with secondary rebound at older age. The combination of relative low HPV infection and variant TP53 72C allele overtransmission provide a plausible explanation for the low incidence of cervical cancer in our population. Therefore, HPV screening and host SNP genotyping may provide more relevant biomarkers to gauge the risk of developing cervical cancer. Cancer 2017;123:2459–66. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Cervical cancer incidence shows bimodal peaks at 43 years and relative rebound at 61 years of age. A reduced rate of human papillomavirus infection and overtransmission of the TP53 72C variant lower cancer incidence.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.30635</identifier><identifier>PMID: 28393355</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adenocarcinoma - epidemiology ; Adenocarcinoma - genetics ; Adenocarcinoma - virology ; Adult ; Age ; Age Distribution ; Aged ; Alleles ; Biomarkers ; Cancer ; cancer predisposition ; Carcinoma, Squamous Cell - epidemiology ; Carcinoma, Squamous Cell - genetics ; Carcinoma, Squamous Cell - virology ; Cervical cancer ; Cervix ; Confidence intervals ; Female ; Gene polymorphism ; Genetic Predisposition to Disease ; Genotype ; Genotypes ; Genotyping ; Health risk assessment ; Health risks ; Histology ; HPV genotyping ; Human papillomavirus ; Humans ; Incidence ; Infections ; Invasiveness ; Medical screening ; Middle Aged ; Odds Ratio ; Oncology ; Original ; p53 Protein ; Papillomaviridae ; Papillomavirus Infections - epidemiology ; Papillomavirus Infections - genetics ; Papillomavirus Infections - virology ; Polymorphism ; Polymorphism, Single Nucleotide ; Population genetics ; Saudi Arabia - epidemiology ; Sequences ; Single-nucleotide polymorphism ; TP53 polymorphism ; Tumor Suppressor Protein p53 - genetics ; Uterine Cervical Neoplasms - epidemiology ; Uterine Cervical Neoplasms - genetics ; Uterine Cervical Neoplasms - virology</subject><ispartof>Cancer, 2017-07, Vol.123 (13), p.2459-2466</ispartof><rights>2017 The Authors. published by Wiley Periodicals, Inc. on behalf of</rights><rights>2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.</rights><rights>2017 American Cancer Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4485-e5f37f96af534aa1685df9833882991e5ecbb69c47fb66e0e99e03792ff0d3063</citedby><cites>FETCH-LOGICAL-c4485-e5f37f96af534aa1685df9833882991e5ecbb69c47fb66e0e99e03792ff0d3063</cites><orcidid>0000-0002-2128-6293</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28393355$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alsbeih, Ghazi A.</creatorcontrib><creatorcontrib>Al‐Harbi, Najla M.</creatorcontrib><creatorcontrib>Bin Judia, Sara S.</creatorcontrib><creatorcontrib>Khoja, Hatim A.</creatorcontrib><creatorcontrib>Shoukri, Mohamed M.</creatorcontrib><creatorcontrib>Tulbah, Asma M.</creatorcontrib><title>Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND Cervical cancer is a predominantly human papillomavirus (HPV)‐driven disease worldwide. However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C single nucleotide polymorphism (SNP) presumed to affect cancer incidence. METHODS Patients treated between 1990 and 2012 were reviewed, and a series of 232 invasive cervical cancer cases were studied and compared with 313 matched controls without cancer. SNP was genotyped by way of direct sequencing. HPV linear array analysis was used to detect and genotype HPV in tumor samples. RESULTS The incidence of cervical cancer revealed bimodal peaks at 42.5 years, with a slighter rebound at 60.8 years. Among all cases, 77% were HPV‐positive and 16 HPV genotypes were detected—mostly genotypes 16 (75%) and 18 (9%)—with no difference by age, histology, or geographical region. Although the TP53 G72C genotype was not associated with overall cervical cancer risk, it was significantly associated with HPV positivity (odds ratio, 0.57; 95% confidence interval, 0.36‐0.90; P = .016). Furthermore, the variant C allele was significantly overtransmitted in the population (P &lt; .0003). CONCLUSION Cervical cancer incidence displays bimodal curve peaking at a young age with secondary rebound at older age. The combination of relative low HPV infection and variant TP53 72C allele overtransmission provide a plausible explanation for the low incidence of cervical cancer in our population. Therefore, HPV screening and host SNP genotyping may provide more relevant biomarkers to gauge the risk of developing cervical cancer. Cancer 2017;123:2459–66. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Cervical cancer incidence shows bimodal peaks at 43 years and relative rebound at 61 years of age. A reduced rate of human papillomavirus infection and overtransmission of the TP53 72C variant lower cancer incidence.</description><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - genetics</subject><subject>Adenocarcinoma - virology</subject><subject>Adult</subject><subject>Age</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Alleles</subject><subject>Biomarkers</subject><subject>Cancer</subject><subject>cancer predisposition</subject><subject>Carcinoma, Squamous Cell - epidemiology</subject><subject>Carcinoma, Squamous Cell - genetics</subject><subject>Carcinoma, Squamous Cell - virology</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>Gene polymorphism</subject><subject>Genetic Predisposition to Disease</subject><subject>Genotype</subject><subject>Genotypes</subject><subject>Genotyping</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Histology</subject><subject>HPV genotyping</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Invasiveness</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Oncology</subject><subject>Original</subject><subject>p53 Protein</subject><subject>Papillomaviridae</subject><subject>Papillomavirus Infections - epidemiology</subject><subject>Papillomavirus Infections - genetics</subject><subject>Papillomavirus Infections - virology</subject><subject>Polymorphism</subject><subject>Polymorphism, Single Nucleotide</subject><subject>Population genetics</subject><subject>Saudi Arabia - epidemiology</subject><subject>Sequences</subject><subject>Single-nucleotide polymorphism</subject><subject>TP53 polymorphism</subject><subject>Tumor Suppressor Protein p53 - genetics</subject><subject>Uterine Cervical Neoplasms - epidemiology</subject><subject>Uterine Cervical Neoplasms - genetics</subject><subject>Uterine Cervical Neoplasms - virology</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp9kcuKFDEUhoMoTju68QEk4EaEGnOpVFU2ghTeYFAZRnAX0qmT6QyppEyqauhn8KVN2-OgLlzlhPOd_1x-hJ5SckYJYa9MMOmMk4aLe2hDiWwrQmt2H20IIV0lav7tBD3K-bp8Wyb4Q3TCOi45F2KDflzAsBgYcNIz4Gjxbhl1wJOenPdx1KtLS8YuWDCziwHrMOArCDA7g-MKaU465NHlfEiW8ssvguOW9XiKfj_GNO0KuOrkdJixjzeQsIG0OqM9NjqUuIgbN0AJH6MHVvsMT27fU_T13dvL_kN1_vn9x_7NeWXquhMVCMtbKxttBa-1pk0nBis7zruOSUlBgNluG2nq1m6bBghICYS3kllLhsOZTtHro-60bEcYDISyhVdTcqNOexW1U39ngtupq7gqUdoTUheBF7cCKX5fIM-qXMCA9zpAXLKiXdfwhjAhC_r8H_Q6LimU9RSVjNQN47Qt1MsjZVLMOYG9G4YSdfBYHTxWvzwu8LM_x79Df5taAHoEbpyH_X-kVP-pvziK_gSEhbSL</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Alsbeih, Ghazi A.</creator><creator>Al‐Harbi, Najla M.</creator><creator>Bin Judia, Sara S.</creator><creator>Khoja, Hatim A.</creator><creator>Shoukri, Mohamed M.</creator><creator>Tulbah, Asma M.</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2128-6293</orcidid></search><sort><creationdate>20170701</creationdate><title>Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence</title><author>Alsbeih, Ghazi A. ; Al‐Harbi, Najla M. ; Bin Judia, Sara S. ; Khoja, Hatim A. ; Shoukri, Mohamed M. ; Tulbah, Asma M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4485-e5f37f96af534aa1685df9833882991e5ecbb69c47fb66e0e99e03792ff0d3063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenocarcinoma - epidemiology</topic><topic>Adenocarcinoma - genetics</topic><topic>Adenocarcinoma - virology</topic><topic>Adult</topic><topic>Age</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Alleles</topic><topic>Biomarkers</topic><topic>Cancer</topic><topic>cancer predisposition</topic><topic>Carcinoma, Squamous Cell - epidemiology</topic><topic>Carcinoma, Squamous Cell - genetics</topic><topic>Carcinoma, Squamous Cell - virology</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Confidence intervals</topic><topic>Female</topic><topic>Gene polymorphism</topic><topic>Genetic Predisposition to Disease</topic><topic>Genotype</topic><topic>Genotypes</topic><topic>Genotyping</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Histology</topic><topic>HPV genotyping</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infections</topic><topic>Invasiveness</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Oncology</topic><topic>Original</topic><topic>p53 Protein</topic><topic>Papillomaviridae</topic><topic>Papillomavirus Infections - epidemiology</topic><topic>Papillomavirus Infections - genetics</topic><topic>Papillomavirus Infections - virology</topic><topic>Polymorphism</topic><topic>Polymorphism, Single Nucleotide</topic><topic>Population genetics</topic><topic>Saudi Arabia - epidemiology</topic><topic>Sequences</topic><topic>Single-nucleotide polymorphism</topic><topic>TP53 polymorphism</topic><topic>Tumor Suppressor Protein p53 - genetics</topic><topic>Uterine Cervical Neoplasms - epidemiology</topic><topic>Uterine Cervical Neoplasms - genetics</topic><topic>Uterine Cervical Neoplasms - virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alsbeih, Ghazi A.</creatorcontrib><creatorcontrib>Al‐Harbi, Najla M.</creatorcontrib><creatorcontrib>Bin Judia, Sara S.</creatorcontrib><creatorcontrib>Khoja, Hatim A.</creatorcontrib><creatorcontrib>Shoukri, Mohamed M.</creatorcontrib><creatorcontrib>Tulbah, Asma M.</creatorcontrib><collection>Wiley Open Access Journals</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alsbeih, Ghazi A.</au><au>Al‐Harbi, Najla M.</au><au>Bin Judia, Sara S.</au><au>Khoja, Hatim A.</au><au>Shoukri, Mohamed M.</au><au>Tulbah, Asma M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>123</volume><issue>13</issue><spage>2459</spage><epage>2466</epage><pages>2459-2466</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>BACKGROUND Cervical cancer is a predominantly human papillomavirus (HPV)‐driven disease worldwide. However, its incidence is unexplainably low in western Asia, including Saudi Arabia. Using this paradigm, we investigated the role of HPV infection rate and host genetic predisposition in TP53 G72C single nucleotide polymorphism (SNP) presumed to affect cancer incidence. METHODS Patients treated between 1990 and 2012 were reviewed, and a series of 232 invasive cervical cancer cases were studied and compared with 313 matched controls without cancer. SNP was genotyped by way of direct sequencing. HPV linear array analysis was used to detect and genotype HPV in tumor samples. RESULTS The incidence of cervical cancer revealed bimodal peaks at 42.5 years, with a slighter rebound at 60.8 years. Among all cases, 77% were HPV‐positive and 16 HPV genotypes were detected—mostly genotypes 16 (75%) and 18 (9%)—with no difference by age, histology, or geographical region. Although the TP53 G72C genotype was not associated with overall cervical cancer risk, it was significantly associated with HPV positivity (odds ratio, 0.57; 95% confidence interval, 0.36‐0.90; P = .016). Furthermore, the variant C allele was significantly overtransmitted in the population (P &lt; .0003). CONCLUSION Cervical cancer incidence displays bimodal curve peaking at a young age with secondary rebound at older age. The combination of relative low HPV infection and variant TP53 72C allele overtransmission provide a plausible explanation for the low incidence of cervical cancer in our population. Therefore, HPV screening and host SNP genotyping may provide more relevant biomarkers to gauge the risk of developing cervical cancer. Cancer 2017;123:2459–66. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Cervical cancer incidence shows bimodal peaks at 43 years and relative rebound at 61 years of age. A reduced rate of human papillomavirus infection and overtransmission of the TP53 72C variant lower cancer incidence.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28393355</pmid><doi>10.1002/cncr.30635</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2128-6293</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adenocarcinoma - epidemiology
Adenocarcinoma - genetics
Adenocarcinoma - virology
Adult
Age
Age Distribution
Aged
Alleles
Biomarkers
Cancer
cancer predisposition
Carcinoma, Squamous Cell - epidemiology
Carcinoma, Squamous Cell - genetics
Carcinoma, Squamous Cell - virology
Cervical cancer
Cervix
Confidence intervals
Female
Gene polymorphism
Genetic Predisposition to Disease
Genotype
Genotypes
Genotyping
Health risk assessment
Health risks
Histology
HPV genotyping
Human papillomavirus
Humans
Incidence
Infections
Invasiveness
Medical screening
Middle Aged
Odds Ratio
Oncology
Original
p53 Protein
Papillomaviridae
Papillomavirus Infections - epidemiology
Papillomavirus Infections - genetics
Papillomavirus Infections - virology
Polymorphism
Polymorphism, Single Nucleotide
Population genetics
Saudi Arabia - epidemiology
Sequences
Single-nucleotide polymorphism
TP53 polymorphism
Tumor Suppressor Protein p53 - genetics
Uterine Cervical Neoplasms - epidemiology
Uterine Cervical Neoplasms - genetics
Uterine Cervical Neoplasms - virology
title Reduced rate of human papillomavirus infection and genetic overtransmission of TP53 72C polymorphic variant lower cervical cancer incidence
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