| 51. |
- Dillner, Joakim, et al.
(author)
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Monitoring of human papillomavirus vaccination.
- 2011
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In: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; Dec, s. 17-25
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Journal article (peer-reviewed)abstract
- Persistent infection with oncogenic human papillomavirus (HPV) is a necessary causal factor in the development of cervical cancer. Moreover, HPV, predominately type 16 and to a lesser degree type 18, is linked causally to varying proportions of other anogenital cancers (vulva, vagina, penis, anus) as well as cancers elsewhere in the body (oropharynx, larynx, conjunctiva). HPV types 6 and 11 cause most of genital warts and recurrent respiratory papillomatosis. Effective prophylactic vaccines have been developed. In this review, we address briefly the immunological aspects of HPV infection and the results of HPV vaccination trials. Internationally standardized monitoring and evaluation of prophylactic HPV vaccination programmes will be essential for arriving at the most cost-effective strategies for cancer control.
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| 52. |
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| 53. |
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| 54. |
- Dillner, Joakim, et al.
(author)
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Svensk konsensus om vaccination mot cervixcancer. Vaccinprogram bör införas i grundskolan med sikte på att utrota HPV16/18
- 2006
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In: Läkartidningen. - 0023-7205. ; 103:44, s. 9-3377
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Journal article (peer-reviewed)abstract
- Vaccination against the Human Papillomavirus (HPV) has recently been approved as a means to prevent cervical cancer. The Swedish Institute for Infectious Disease Control and the Swedish Society for Obstetrics & Gynecology arranged a consensus conference to discuss design of future cervical cancer prevention programs. Conclusions include that preventive programs should aim at eradication of oncogenic HPV 16/18 infection and that the potentially preventable cervical cancers should no longer occur. Necessary prerequisites include adoption of a population-based vaccination program in primary school, an HPV vaccination registry and coordination of cervical cancer preventive efforts on vaccination and cervical screening.
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| 55. |
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| 56. |
- Dillner, Joakim, et al.
(author)
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Translational Mini-Review Series on Vaccines: Monitoring of human papillomavirus vaccination.
- 2007
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In: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; 148:2, s. 199-207
-
Research review (peer-reviewed)abstract
- Persistent infection with oncogenic human papillomavirus (HPV) is a necessary cause of cervical cancer. Moreover, HPV type 16 (and to a lesser degree HPV type 18) is linked with more rare cancers, namely cancer of the vulva, vagina, penis, anus, oropharynx and larynx. Effective prophylactic vaccines have been developed. In this review, we briefly address immunological aspects of HPV infection and the results of HPV vaccination trials. Internationally standardized monitoring and evaluation of prophylactic HPV vaccination programmes will be essential for arriving at the most (cost-)effective strategies for cancer control.
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| 57. |
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| 58. |
- Dillner, Lena, et al.
(author)
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Randomized healthservices study of human papillomavirus-based management of low-grade cytological abnormalities.
- 2011
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In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; okt, s. 151-159
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Journal article (peer-reviewed)abstract
- Human Papillomavirus (HPV)-based management of women with borderline (ASCUS) or mildly abnormal (CINI) cervical cytology has been extensively studied in the research setting. We wished to assess safety and healthcare resource use of a real-life healthcare policy using HPV triaging.All 15 outpatient clinics involved in the organized population-based screening program in Stockholm, Sweden screening program were randomized to either continue with prior policy (colposcopy of all women with ASCUS/CINI) or to implement a policy with HPV triaging and colposcopy only of HPV-positive women. The trial enrolled the 3319 women that were diagnosed with ASCUS (n=1335) or CINI (n=1984) in Stockholm during 17(th) March 2003 to 16(th) January 2006. Detection of high-grade cervical lesions (CINII+) and health care cost consumption was studied by registry linkages.The proportion of histopathology-verified CINII+ was similar for the 2 policies (395/1752 women (22.5%; 95% Confidence interval (CI): 20,6-24,6%) had CINII+ diagnosed with HPV triaging policy, 318/1567 women (20.3%; 95%CI: 18,3-22,4%)) had CINII+ with colposcopy policy). 64% of women with ASCUS and 77% of women with CINI were HPV-positive. HPV-positivity was age-dependent, with 81% of women below 35 years of age and 44% of women above 45 years of age testing HPV-positive. HPV triaging was cost-effective only above 35 years of age.In conclusion, a real-life randomised healthservices study of HPV triaging of women with ASCUS/CINI demonstrated similar detection of CINII+ as colposcopy of all women.
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| 59. |
- Dillner, Lena, et al.
(author)
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Strengthening prevention programs to eliminate cervical cancer in the Nordic countries.
- 2008
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 87:5, s. 489-498
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Research review (peer-reviewed)abstract
- Disease trend studies based on birth cohort analysis and serological studies indicate that recent generations have a higher prevalence of oncogenic Human Papilloma Virus (HPV) types, and are likely to be at higher risk of cancer than previous generations. This implies that prevention strategies to protect young populations from HPV-associated cancers need to be strengthened, and hence organized implementation of vaccination and better screening programs are being considered. In this context, randomized large-scale policy evaluations will be instrumental in accelerating disease control and improve effective prevention programs. This report shares experiences from Nordic countries with examples of prevention strategies through vaccination and cervical screening. The same principles as set up for organized programs and new HPV technologies may apply for screening and vaccination as key tools to eliminate cervical cancer in the Nordic countries and globally.
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| 60. |
- Eklund, Carina, et al.
(author)
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A global proficiency study of Human Papillomavirus genotyping.
- 2010
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In: Journal of Clinical Microbiology. - 1098-660X. ; 48:11, s. 4147-4155
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Journal article (peer-reviewed)abstract
- Internationally comparable quality assurance of Human Papillomavirus (HPV) DNA detection and typing methods is essential for evaluation of HPV vaccines and effective monitoring and implementation of HPV vaccination programs. Therefore, the World Health Organisation (WHO) HPV Laboratory Network (LabNet) designed an international proficiency study. Following announcement at the WHO website, responding laboratories performed HPV typing using one or more of their usual assays on 43 coded samples composed of titration series of purified plasmids of sixteen HPV types (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68). A detection of at least 50 International Units (IU) of HPV16 or HPV18 DNA and of 500 genome equivalents (GE) of the other 14 HPV types (in samples with single and multiple HPV types) was considered proficient. Fifty-four laboratories worldwide submitted a total of 84 data sets. There were more than 21 HPV genotyping assays used. Commonly used methods were Linear Array, Lineblot, Inno-LiPa, Clinical-Array, type-specific real-time PCR, PCR-Luminex and microarray assays. The major oncogenic HPV types (HPV16 and 18) were detected in 89.7% (70/78) and 92.2% (71/77) of data sets, respectively. HPV types 56, 59 and 68 were the least commonly detected types (in less than 80 % of data sets). Twenty-eight data sets reported multiple false positive results and were considered non-proficient. In conclusion, we found that international proficiency studies, traceable to International Standards, allow a standardised quality assurance of different HPV typing assays and enables a comparison of data generated from different laboratories worldwide.
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