Carmen L Charlton
Medicine & Dentistry-Laboratory Medicine & Pathology
University of Alberta
PhD, D(ABMM), M(ASCP)CM
Summary of research:
The role of Human Papillomavirus (HPV) in invasive cervical cancer (ICC) has been well documented, with approximately 50 different HPV types associated with infections of the genital, anal and the oropharengeal mucosa (Bosche et al., 2008; D'Souza et al., 2007; Zubach et al., 2012). A recent meta-analysis estimates HPV to cause >85% of all ICC worldwide, of which >70% were attributed to two different genotypes; 16 and 18 (Smith, 2007). Type specific identification of HPV genotypes therefore plays an important role in early diagnosis and treatment of pre-cancerous lesions, as HPV 16 and 18 have been linked to persistent infection and lesion progression (Khan et al., 2005). The quadravalent HPV vaccine (Gardiasil®) was incorporated into the routine vaccination schedule for Alberta in 2008 to protect against HPV genotypes 6, 11, 16 and 18. All females entering grade 5 are eligible for the vaccine, including a 3 year catch up period offered to grade 9 girls. Currently the circulating HPV genotypes in the province of Alberta are unknown. As the first cohort of females to receive the vaccine have not reached the age of HPV screening (they will turn 15 in 2013), this is an ideal time to determine the baseline for HPV in the province. Ideally, by establishing a long term enhanced surveillance system the relative prevalence of these genotypes can be monitored. It is expected that the rate of cervical cancer will significantly decrease with vaccine implementation, however concern exists that non-16 non-18 genotypes may increase in the population as seen with the pneumococcal serotypes following PCV13 vaccination.