br Correspondence to Unit of Infections and Cancer
Correspondence to: Unit of Infections and Cancer, Cancer Epidemiology Research Programme, Institut Català d′Oncologia—Catalan Institute of Oncology, Gran Via de l′Hospitalet, 199-203, 08908 L′Hospitalet de Llobregat, Barcelona, Spain. E-mail addresses: [email protected] (Y.-T. Kim), [email protected] (B. Serrano), [email protected] (J.-K. Lee), [email protected] (H. Lee), [email protected] (S.-W. Lee), [email protected] (C. Freeman), [email protected] (J.-K. Oh), [email protected] (L. Alemany), [email protected] (F.-X. Bosch), [email protected] (L. Bruni). 1 Equally contributed.
Available online 30 December 2018
known as high-risk (HR) HPVs may lead to precancerous lesions and cancers . HR HPVs are not only responsible for virtually all cervical cancers cases, but also causally related with a variable fraction of other anogenital cancers (vulvar, vaginal, penile and anal) and a subset of head and neck cancers, particularly BODIPY 493/503 of tongue cancer, tonsil cancer and other oropharyngeal cancer sites [4,5]. The last classification of the International Agency of Research in Cancer (IARC) defined 12 HPV types as carcinogenic to humans, namely HPVs 16/18/31/33/35/39/ 45/51/52/56/58/59 (Group 1) . Within them, HPV16 and HPV18 stand out for their highest carcinogenic capacity .
In recent years, several studies have examined the prevalence and the burden of HPV-related diseases within the Korean population; however, variations in the prevalence and type distribution have been observed. Further, the arrival of the 4-valent HPV vaccine (Gardasil®) in 2007 and the 2-valent HPV vaccine (Cervarix™) in 2008 marked a change in strategy in HPV prevention. Finally, the recent introduction of the 9-valent HPV vaccine (Gardasil®9) could significantly impact on HPV-related disease burden in Korea.
The aim of this review is therefore to provide an overview of the global burden of HPV infection and HPV-related disease in Korea and to estimate the potential public health impact of HPV vaccines on HPV-related cancer in the country. In addition, we aimed to discuss current cervical cancer preventive practices in the country. Special emphasis is given to cervical cancer, as it accounts for more than 80% of cancers attributable to HPV infection . Consideration is also given to genital warts, one major cause of morbidity worldwide, caused mainly by low-risk (LR) HPV6 and HPV11.
2. Material and methods
The purpose of Allele review was to describe and discuss the state of knowledge regarding the burden of HPV infection and HPV-related disease in Korea.
Cancer burden statistics were retrieved from GLOBOCAN 2018 and from Statistics Korea [1,2]. Region-specific rates and information regarding time trends were based on data from Statistics Korea and from Cancer in Five Continents (CI5C Volume XI) [1,8]. The CI5C in-cludes information from: a) Korea Central Cancer Registry (KCCR): The KCCR began as a hospital-based nationwide cancer registry, initiated by the Ministry of Health and Welfare in 1980. It is responsible for col-lecting and managing nationwide cancer registry data, providing technical and financial support to the regional cancer registries, pro-viding training for cancer registers, and providing annual nationwide cancer statistics; b) the following population-based regional cancer re-gistries: 1. Busan Cancer Registry (BSCR), 2. Daegu Cancer Registry (DCR), 3. Daejeon Cancer Registry (DJCR), 4. Gwangju Cancer Registry (GCR), 5) Incheon Cancer Registry (ICR), 6) Jejudo Cancer Registry (JCR), 7) Kangwha Cancer Registry (KCR), 8) Seoul Cancer Registry (SCR), 9) Ulsan Cancer Registry (UCR).
A comprehensive search of peer-reviewed biomedical literature was conducted to assess the burden of HPV-related disease and HPV type distribution by using MEDLINE (1950 to present), Asian Pacific Journal of Cancer Prevention (APJCP), KoreaMed Synapse (1933 to present) and Google Scholar. Journal articles, reports, and various other types of communication published between January 1933 and October 2018 pertaining to “HPV”, and “Korea” were considered. In addition, the reference lists of retrieved articles were evaluated and included when appropriate.
In addition, in order to assess the potential impact of the nine types (HPVs 16/18/31/33/45/52/58/6/11) included in HPV vaccines (2-valent, 4-valent and 9-valent) to HPV-related cancer cases in the Korean population, we used data from an international project on HPV-related lesions designed and coordinated by the Catalan Institute of Oncology (ICO) (Barcelona-Spain) in collaboration with DDL Diagnostic Laboratory (Rijswijk-Netherlands) [9–14]. Briefly, formalin-fixed par-affin-embedded (FFPE) specimens from consecutive cases were