TY - JOUR
T1 - HPV-16 infection and cervical cancer
T2 - Modeling the influence of duration of infection and precancerous lesions
AU - Baussano, Iacopo
AU - Ronco, Guglielmo
AU - Segnan, Nereo
AU - French, Katherine
AU - Vineis, Paolo
AU - Garnett, Geoff P.
N1 - Funding Information:
I.B. was supported by the Compagnia San Paolo-FIRMS (Center for Experimental Research and Medical Studies) . G.G. has acted as consultant for and/or received grants for other studies from Sanofi Pasteur MSD , Merck , and GSK . None of these companies had any role whatsoever in the current study.
PY - 2010/3
Y1 - 2010/3
N2 - The patterns of transmission, clearance, and progression of HPV infection and the related precancerous lesions are key to accurately model cervical cancer epidemiology and prevention. We have developed an age-structured dynamic model of the transmission of HPV-16 infection. This mathematical model accounts, for the first time, for the effect of infection and precancerous lesions duration on the natural history of HPV-16 infection and precancerous lesions. The model's output has been fitted to contemporaneous sets of data from Turin, Italy, to estimate parameters that have had been indirectly tested by comparing them with other estimates reported in the literature. The average probability of HPV-16 infection transmission per sexual partnership was about 40%. The HPV-16 clearance and progression rates decreased as the length of time with infection increased, clearance ranging between 1.6 per woman-year (in the first 6 months of infection) and 0.036 (after more than 6 years of infection), and progression between 0.072 and 0.018 per woman-year. The rate of clearance of precancerous lesions (CIN2+) was inversely dependent on age, while the progression of CIN2+ toward invasive cervical cancer increased as the precancerous lesions persisted. The present study also suggests that an exclusive role of women's age in shaping the rate of progression to cancer is unlikely. These results should inform future analyses. Including more accurately the role of the duration of infection and precancerous lesions as determinants of the cervical cancer occurrence in models of cervical cancer control may influence predictors of the effectiveness of intervention strategies.
AB - The patterns of transmission, clearance, and progression of HPV infection and the related precancerous lesions are key to accurately model cervical cancer epidemiology and prevention. We have developed an age-structured dynamic model of the transmission of HPV-16 infection. This mathematical model accounts, for the first time, for the effect of infection and precancerous lesions duration on the natural history of HPV-16 infection and precancerous lesions. The model's output has been fitted to contemporaneous sets of data from Turin, Italy, to estimate parameters that have had been indirectly tested by comparing them with other estimates reported in the literature. The average probability of HPV-16 infection transmission per sexual partnership was about 40%. The HPV-16 clearance and progression rates decreased as the length of time with infection increased, clearance ranging between 1.6 per woman-year (in the first 6 months of infection) and 0.036 (after more than 6 years of infection), and progression between 0.072 and 0.018 per woman-year. The rate of clearance of precancerous lesions (CIN2+) was inversely dependent on age, while the progression of CIN2+ toward invasive cervical cancer increased as the precancerous lesions persisted. The present study also suggests that an exclusive role of women's age in shaping the rate of progression to cancer is unlikely. These results should inform future analyses. Including more accurately the role of the duration of infection and precancerous lesions as determinants of the cervical cancer occurrence in models of cervical cancer control may influence predictors of the effectiveness of intervention strategies.
KW - Cervical cancer
KW - Human papillomavirus
KW - Mathematical modeling
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=77950626560&partnerID=8YFLogxK
U2 - 10.1016/j.epidem.2010.02.002
DO - 10.1016/j.epidem.2010.02.002
M3 - Article
SN - 1755-4365
VL - 2
SP - 21
EP - 28
JO - Epidemics
JF - Epidemics
IS - 1
ER -
