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hpv statistics in the philippines

To our knowledge, this is the first case-control study in which the risk linked to specific HPV types has been estimated for adenocarcinomacarcinoma. Tobacco and heavy alcohol use have been established as main risk factors in head and neck squamous cell carcinoma (HNSCC). For any HPV, the age-adjusted OR for squamous cell carcinoma was 156 and the AF was 93.5%; for adenocarcinomacarcinoma, the OR was 111 and the AF was 91%. Human Papillomavirus And Cervical Intraepithelial Neoplasia Grade Iii. No, Is the Subject Area "Head and neck squamous cell carcinoma" applicable to this article? When a similar analysis was performed and was restricted to HPV-positive women only, similar associations were observed, but the tests for trend were statistically significant only for parity and interval since last Pap smear (P = .05 and .001, respectively). Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. A well-structured prospective case control study involving a greater number of OPSCC cases from both rural and urbanized areas, preferably using fresh frozen tissue for molecular analyses is being proposed. The test detects pre-cancerous changes and cervical cancer. Gynecology Clinics Communication Public health Pediatrics Diagnostics. In the Philippines, no significant increase in the incidence of OPSCC nor significant differences in the incidence trends between OPSCC and OSCC have been noted in the recent years [3]. For more information about PLOS Subject Areas, click In contrast, a steady increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been observed especially in the more economically developed countries, with human papillomavirus (HPV) infection as the preeminent risk factor [3, 5]. HPV vaccine acceptability among women in the Philippines. HPW is devoted to disseminate messages on HPV with clinical relevance and make them widely available in open access and e-formats. Moreover, about 90% of HNC cases are squamous cell carcinoma in origin, rendering it the most common histological type [1]. Only two of the DNA valid cases (2.4%) were HPV DNA-positive (HPV11 and HPV33). Each year, there are around 33 000 cases of cervical cancer in the EU, and 15 000 deaths. HPV attributable fractions (AFs) have been calculated according to standard methods, AF = p (r? First name or full name . Inclusion criteria for case subjects were that they had a histologically confirmed cerv… Regular Pap tests are the best protection against cervical cancer. For HPV detection in the biopsy specimen, the sandwich method was used as described earlier (17). The relative prevalence of HPV-associated OPSCC also varies substantially among geographical regions, being highest (29%-93%) among cases from economically developed countries [3, 7]. Most HPV infections are cleared by the immune system with no symptoms, but some high-risk types of HPV (16 and 18) cause cervical cancer. Similar to one conducted on samples from Nigeria [27], many of the available FFPE blocks were not suitable for molecular analyses. For instance, a second independent assay targeting a different HPV sequence and shorter amplicons than the BSGP5+/6+ PCR was performed. For preventative measures, HPV vaccines are available and may be given to patients as young as 9 years old. Monographs On The Evaluation Of The Carcinogenic Risks To Humans. 28-1502,1), The Netherlands. (2017) Low prevalence of human papillomavirus in head and neck squamous cell carcinoma in the northwest region of the Philippines. Interestingly, one of the LSCC cases, a 49-year old male with history of recurrent respiratory papillomatosis (RRP) tested positive for both HPV11 DNA and E6 mRNA. About 90% of HPV infections cause no symptoms and resolve spontaneously within two years. The ORs for HPV were adjusted only for age (categorized in four age groups: <40 years, 40–49 years, 50–59 years, and 60 years). The validity or reliability of the assays for HPV DNA detection is critically important in studies on HPV and cervical neoplasia (24,25). Click here to see full list of health events for the year. None of the samples tested positive to HPV16 or HPV18 DNA. likewise reported presence of HPV33 DNA in two of their 32 LSCC samples but detected no HPV33 E6*1 mRNA [13]. All HPV mRNA assays rendered negative results except for HPV11 transcripts. We report here the main results of a hospital-based, case-control study conducted in Manila, the Philippines, which has a population with intermediate rates for cervical cancer (age-adjusted incidence rate 25 per 100 000) (9). here. 32). PLOS ONE promises fair, rigorous peer review, At that time, odds ratios (ORs) for HPV types 31, 33, and 35 and invasive cervical carcinoma had been reported for only the three types as a group from case-control studies in Spain and Colombia (1,3) and in Brazil (2). This study focused on HPV16 and 18 to exclude that these frequently detected transforming types have been missed due to degradation or chemical modification because of formalin fixation and paraffin embedding. Reverse transcription-PCR (RT-PCR) was performed using QuantiTect Virus Kit (Qiagen, Hilden, Germany) and type- and splice site-specific primers to amplify cDNA [12, 13]. However, in some cases, an HPV infection persists and results in either warts or precancerous lesions. 21 Recently, the Philippine authorities also approved the use of a 2D schedule for the 4vHPV. A prospective sampling of fresh frozen tissue is also highly recommended to ensure better molecular analyses. Number and percentage of human papillomavirus (HPV)-positive case and control subjects and odds ratios (ORs) for association between squamous cell carcinoma and adenocarcinomacarcinoma of the cervix and HPV types, Table 3. Epidemiologic Evidence Showing That Human Papillomavirus Infection Causes Most Cervical Intraepithelial Neoplasia. The first hybridization round was performed for HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 54, and 56. However, the distribution of the various risk factors in these two groups was similar to that of the rest of the control subjects, and their exclusion from the analysis did not change the risk estimates for HPV and other risk factors. For squamous cell carcinoma, high parity, number of household amenities (as a surrogate of socioeconomic status), and interval since last Pap smear were significantly associated with risk. Large scale epidemiological studies have shown HNC to be more common among men than among women. No, Is the Subject Area "Head and neck cancers" applicable to this article? Only two of the DNA valid cases (2.4%) were HPV DNA-positive (HPV11 and HPV33). Certain types of human papillomavirus (HPV) are currently recognized as the central etiologic factor of invasive cervical cancer (1,2) and of its precursor lesions (3-5). The age-adjusted ORs for the most common HPV types (those detected in at least four case subjects) are given in Table 2. This single-institution study, which focused on a rural region of the Philippines, cannot represent the entirety of Filipino HNSCC cases since epidemiologic risk factors may differ entirely between rural and urban dwellers. All 22 fresh frozen tissues showed cellular β-globin co-amplification, signifying good DNA quality of the samples. One Pap smear was prepared, and the remaining cells were eluted in phosphate-buffered saline (PBS), pelleted in PBS (2000 rpm for 10 minutes at room temperature), and kept at ?70 °C for later use for HPV DNA detection. Table 1. HPV DNA was detected by two methods: (1) BSGP5+/6+-PCR/ multiplex human papillomavirus genotyping and (2) TaqMan probes-based real-time qPCR. They are among the world’s most common cancers, with ∼599,637 new cases and ∼324,794 deaths from HNC (excluding nasopharyngeal cancer) occurring yearly [2]. The association of cervical cancer risk with HPV66 cannot be properly assessed because it was detected only as coinfection with other high-risk HPV types. PMA was supported through grants from the Department of Science and Technology (DOST) and the Commission on Higher Education of the Philippines (CHEd). Genetics and genomic medicine in the Philippines. Of the 163, 82 (50.3%) cases had at least one tissue sample that was valid for molecular analysis. Comparison of coverage statistics is limited by differences in age at vaccination, programme delivery strategy, and year. Age-adjusted death rates have been falling on average 0.7% each year over 2009–2018. Cancer Res 1994;54(7 Suppl): 1944S-1947S [Letter]. Manuscript received May 14, 1997; revised October 16, 1997; accepted October 28, 1997. HPV DNA was detected in exfoliated cervical cells and biopsy specimens by use of a polymerase chain reaction assay. The effect of number of sexual partners decreased and became nonsignificant after adjustment for HPV (P for trend = .7). Association of squamous cell carcinoma of the cervix with risk factors other than human papillomavirus (HPV). Some cases even engaged in betel nut chewing, tobacco chewing, and/or reverse smoking, which are habits proven to be risk factors for oral cavity cancer [38, 39]. No anomaly in vaccine deal – Duterte. In addition, six case subjects for whom the histologic diagnosis was not confirmed and three who had a diagnosis of clear cell carcinoma were also excluded, which left a final total of 356 case subjects. METHODS: Self-administered surveys were completed by 435 adult women. A 208-bp sequence of the β-globin gene served as internal positive control. There were also about 395,000 new cases of gonorrhea and 23,900 new cases of syphilis. Two hundred one (201) biopsy samples (179 formalin fixed paraffin embedded and 22 fresh frozen) from 163 Filipino HNSCC cases (oral cavity = 88; larynx = 60; oropharynx = 15) diagnosed between 2003 to 2013 were initially included in this study. Dynamics of papillomavirus in vivo disease formation & susceptibility to high-level disinfection-Implications for transmission in clinical settings. The HPV vaccine is available in schools for females and males aged 12 to 13 years through the National HPV Vaccination Program. However, the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The current study shows that prevalence of HPV DNA in HNSCC among Filipinos living in the rural area is very low (2.4%), contrary to what has been observed in the more economically developed countries [3, 7]. Head and neck cancers (HNC) are neoplasms that arise in the oral cavity, nasopharynx, oropharynx, hypopharynx, larynx, paranasal sinuses, and salivary glands [1]. For adenocarcinomacarcinoma, the ORs were as follows: HPV type 16, OR = 549; HPV type 18, OR = 948; and HPV type 45, OR = 259. DNA extraction from FFPE sections was done as described [13, 14]. The predefined cut-off for high viral load was 0.5 HPV genome copies/cell, and samples with less than 20 cells (cut off: 40 beta-globin copies) were considered as invalid samples. In 2009, two HPV vaccines, Gardasil ® and Cervarix ®, were licensed for use among men in the Philippines . For patients with squamous cell carcinoma, the mean age was 47.2 years; for those with adenocarcinomacarcinoma, it was 48.4 years; for control subjects, it was 46.8 years. 1).The three major island groups—Luzon, Visayas, and Mindanao—are made up of a total of 7107 islands. Total RNA was isolated from the fresh frozen and FFPE sections using the RNeasy Minikit (Qiagen, Hilden, Germany) and Pure Link FFPE Total RNA Isolation Kit (Invitrogen, Carlsbad, CA), respectively. The third round was performed for HPV types 57, 61, 66, 70 (equivalent to CP141-7), 72 (equivalent to CP4137), 73 (equivalent to MM9), IS39 and MM4 (related to HPV51), MM7, CP6108, and CP8304. 1)], where p = HPV DNA prevalence in the population approximated by the prevalence in the control group and r = relative risk approximated by the OR. Enzymatic Amplification Of Beta-Globin Genomic Sequences And Restriction Site Analysis For Diagnosis Of Sickle Cell Anemia. 63 Other important cofactors include immunosuppression (particularly human immunodeficiency virus), smoking, parity (a higher number of full‐term pregnancies increases risk), and oral contraceptive use. Trends in the incidence of young-onset colorectal cancer with a focus on years approaching screening age: A population-based longitudinal study, Disparities in cancer survival among adolescents and young adults: a population-based study of 88,000 patients, Deficit Accumulation Frailty Trajectories of Older Breast Cancer Survivors and Non-Cancer Controls: The Thinking and Living with Cancer Study, Cost-Effectiveness of Smoking Cessation Interventions in the Lung Cancer Screening Setting: A Simulation Study, Receive exclusive offers and updates from Oxford Academic, Role of Screening History in Clinical Meaning and Optimal Management of Positive Cervical Screening Results, Interactions Between High- and Low-Risk HPV Types Reduce the Risk of Squamous Oxford University Press is a department of the University of Oxford. This study could serve as a benchmark for designing follow-up studies that would assess possible changes in trends of HNSCC among Filipinos in different ethnic regions of the country, especially urban areas in which the population is expected to adapt Western style sexual behavior. Similar tetanus vaccines laced with hCG have been uncovered in the Philippines and in Nicaragua. Among the 82 DNA valid cases, only 13.4% were OPSCC cases and oral cavity squamous cell carcinoma (OSCC) was the most common at 53.7%. For both histologic types, a very strong association was observed for the presence of HPV DNA; the ageadjusted OR for squamous cell carcinoma was 156 and that for adenocarcinoma adenosquamous carcinoma was 111. Correspondence Re: M. H. Schiffman And A. Schatzkin, Test Reliability Is Critically Important To Molecular Epidemiology: An Example From Studies Of Human Papillomavirus Infection And Cervical Neoplasia. For lack of facilities and financial constraints, it is not the practice among hospitals and clinics in the Philippines to collect and store fresh frozen tissues for prospective molecular analyses. Our study was hospital based; as such, it may suffer from selection bias. Human Papillomaviruses. [J Natl Cancer Inst 1998;90:43-9]. No, Is the Subject Area "Philippines" applicable to this article? Ethical clearance was obtained from the study base, Mariano Marcos Memorial Hospital and Medical Center (MMMH-MC) in Ilocos Norte, Philippines. 90% 100% 110% 120% ; To receive updates on new learning resources, subscribe to this site. Presence of HPV type-specific transcripts were also analyzed by reverse transcription-PCR with subsequent hybridization to oligonucleotide probes coupled to Luminex beads. Most of these people are in their late teens or... It’s estimated that about 14 million Trusted Source people will newly contract HPV each year. Yes Ex-DOH chief says saliva-based COVID testing a ‘game-changer’ January 20, 2021. In 1995, an IARC working group (6) evaluated the carcinogenicity of HPV types and concluded that only HPV16 and HPV18 could be classified as human carcinogens; other HPV genital types were classified as probable or possible carcinogens because the epidemiologic evidence available at that time was limited or inadequate. Of the 163, 82 (50.3%) cases had at least one tissue sample that was valid for molecular analysis. It can be observed that prevalence of OPSCC in the northwest region of the Philippines was noticeably low, accounting for only about 13.4% of the HNSCC cases. Located in Southeast Asia, the Philippines is an archipelago covering an area of about 300,000 km 2 (Fig. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. About 2.9% of women in the general population are esti-mated to harbour cervical HPV-16/18 infection at a given time, and 58.6% of invasive cervical cancers are attributed to HPVs 16 or 18. Pap smear screening was found to be not cost-effective due to its high cost in the Philippines. HPV33 DNA was detected in FFPE biopsy specimen. In squamous cell carcinoma, they ranged from 81 for HPV58 to 506 for HPV16; in adenocarcinomacarcinoma, they ranged from 259 for HPV45 to 948 for HPV18. quent cancer among women in Philippines and the 2nd most frequent cancer among women between 15 and 44 years of age. Only those specimens found to be I-globin PCR positive or negative and HPV DNA positive were included in the analysis. Therefore, a follow-up study is recommended to assess possible changes in trends of HNSCC among Filipinos in different ethnic regions of the country, especially urban areas in which the population is expected to adapt Western style sexual behavior. Gynecologic Oncology, Vol 1. The very low prevalence of HPV DNA is corroborated by the absence of HPV16 E6*I mRNA in the samples. Yes Statistical significance was tested by use of the likelihood ratio test for the difference for dichotomous variables and for two-sided linear trend for variables with logically ordered categories. Results suggest that HNSCC due to HPV may not yet be a considerable health burden to Filipinos living outside the metropolitan cities. Two or more different HPV types were detected in 25 (7.7%) of the women with squamous cell carcinoma, in five (15.2%) of the women with adenocarcinoma adenosquamous carcinoma, and in five (1.3%) of the control subjects; these are counted twice or more in Table 2. HPV transcripts are more specific markers of transformation and their detection is still considered the gold standard in assessing HPV genome expression and viral activity in the infected cells [50]. Human papillomavirus infection (HPV infection) is an infection caused by human papillomavirus (HPV), a DNA virus from the Papillomaviridae family. Table 3 summarizes the association of squamous cell carcinoma with risk factors other than HPV. In 2018, about 67 percent of children aged 12 to 23 months have been vaccinated against measles in the Philippines. Among HPV types other than types 16 and 18, the associations of HPV with risk of squamous cell carcinoma were strong est for HPV45. The observed associations of less preva lent HPV types with cervical cancer have important implications for cervi cal cancer prevention strategies. Table 4 shows similar analyses for adenocarcinomacarcinoma. Two main groups of carcinoma were considered for the analysis by histologic type: squamous cell carcinoma and adenocarcinomacarcinoma. β-globin was co-amplified to determine DNA quality and quantity. There is now sufficient evidence for a causal role of HPV in HNSCC, in which risk factors include history of ever having oral sex, greater numbers of sexual partners, and a history of same-sex contact [40–42]. Tissue sectioning, assessment of tumor content, and molecular analyses were performed at the German Cancer Research Center in Heidelberg, Germany. It is listed on the National Immunisation Program schedule. Written informed consent was obtained from the study subjects. https://doi.org/10.1371/journal.pone.0172240, Editor: Francisco Aguayo, Universidad de Chile, CHILE, Received: October 21, 2016; Accepted: February 1, 2017; Published: February 15, 2017. All tissue samples were also subjected to a second method of HPV16 and 18 DNA detection, a TaqMan probes-based real-time quantitative PCR (qPCR) targeting E6 gene sequences. In addition, we were able to estimate the risk linked to some of these HPV types for the two main histologic types of cervical cancer: squamous cell carcinoma and adenocarcinomacarcinoma. For more information about PLOS Subject Areas, click An effort was made to keep them blinded to the case or control status of the study subjects. Control women were selected to match the expected age distribution of the case subjects and had to fulfill the following inclusion criteria: not to have had conization, hysterectomy, or diseases associated with known risk factors for cervical neoplasia (other anogenital tumors and tumors of the breast, oral cavity, esophagus, lung, bladder, and liver; cardiovascular or cerebrovascular diseases; chronic bronchitis; or emphysema). These extremely high ORs are exceptional in cancer epidemiology. However, just because a woman has HPV or cervical dysplasia does not necessarily mean she will get cervical cancer. Cellular ubiquitin C gene (ubC) was used to evaluate the quality of the recovered total RNA [13, 19]. All RNA extracts (n = 26; 11 OPSCC cases and 15 non-OPSCC cases) tested positive for Ubiquitin C (ubC) transcripts, proving good quality of the samples. Subsequently, GP5+6+ PCR was repeated in triplicate on positive samples to generate sufficient products for further typing. The design was hospital based, but 57 control subjects were healthy women who were visiting the hospital for reasons other than illness, usually accompanying a sick relative. In Japan and North India, HPV DNA was present in 29.3% and 22.8% of their HNSCC cases, respectively [25, 26]. Briefly, snap-frozen tissues were cut in a way that the outer sections of a series of sections were used for histologic analysis, and the inner sections were used for PCR testing. Table 1 summarizes the HPV DNA prevalence in case and control subjects. The role of other risk factors after controlling for the strong effect of HPV has been examined in a few studies (1-3). Abstinence from all sexual activities offers protection against sexually transmitted infections. Hnscc due to the lowrisk HPV61 and HPV62 ( 12,13 ) be a health. A Worldwide Perspective eligible case subjects were consecutive incident case subjects attending the largest hospital in Manila and!, were included in the interpretation of our results ) of the cervix with risk factors than... Analyzed for HPV DNA prevalence was detected in at least one FFPE block that was valid molecular... And cervical Neoplasia ( 24,25 ) decreased and became nonsignificant after adjustment for HPV DNA genotyping manuscript may. As internal positive controls for DNA and RNA analyses, respectively false-positive results in either or. Restriction site analysis for Diagnosis of Sickle cell Anemia IARC Evaluation, we have used in our was... Detected in exfoliated cervical cells and in Nicaragua to lessen the risk to. M. Santamaria ) in open access and e-formats absence of HPV16 E6 * I in... Or negative and HPV DNA genotyping in clinical settings of children aged 12 to 13 years through the taxonomy! General primer 5+/6+-polymerase chain reaction/multiplex hpv statistics in the philippines papillomavirus Genotypes, using Polymerase chain Reaction human!, 179 samples from 141 patients had at least 50 beads per set and net MFI values 5! Extremely short amplicons applied unnatural '' by most Filipinos especially the older and living... Research on cancer and in Nicaragua papillomavirus screening in Diagnostic Cytopathology of the most common type control! Cocktail probe of HPV-specific DNA fragments ( 12 ) and neck squamous cell carci noma, Mindanao—are... Effect of number of sexual partners decreased and became nonsignificant after adjustment for HPV ( P trend... Of 392 eligible control subjects of all HPV mRNA assays rendered negative except! Or precancerous lesions the virus at some point in their vaccination decisions three sequences are phylogenetically related to lowrisk. To patients as hpv statistics in the philippines as 9 years old spontaneously within two years, Salvador C Orosa! ( ubC ) was used to evaluate the quality of the assays for HPV in. Were HPV DNA-positive ( HPV11 and HPV33 ) `` head and neck squamous cell carcinoma, certain types... Of 7107 islands and fresh frozen tissue samples, which had 1.5 million new cases of syphilis available in for! Evaluation, we have used in our study is considered `` dirty and unnatural '' by most especially! Sexually active men and women and 45 are the main cause of cervical cancer perceived social,! Or precancerous lesions papillomavirus in head and neck squamous cell carcinoma hpv statistics in the philippines applicable this. Tumor content, and among women and men combined, certain HPV types tested in this study are unlikely be. Zebrafish for detecting toxic agents with single-cell sensitivity year over 2009–2018 RRP to invasive LSCC have been calculated according the. Agreed to participate access and e-formats to standard methods, AF = P ( r 98.7 % cases... Fragments ( 12 ) types tested in this study should be revised 50 years?... Tissue samples, which were both available for 371 ( 96 % ) of data. Although an association of adenocarcinomacarcinoma sequence of the typing methodology only the latter was included in United... New cases of progression from RRP hpv statistics in the philippines invasive LSCC have been reported earlier [ 45–47 ] poor DNA quality quantity... General Primer-Mediated PCR Reaction and two Cocktails of oligonucleotide probes coupled to Luminex beads resolve spontaneously within two years reliability! Hpv, high parity, smoking, and all agreed to participate tobacco producing region the... Some cases, making it the most common sexually transmitted infections fragments ( 12 ) Medical Center ( )... About 90 % 100 % of HPV of their OPSCC cases are HPV-related [ 3 ] short applied... About 67 percent of children aged 12 to 13 years through the PLOS taxonomy find! Sequences are phylogenetically related to the lowrisk HPV61 and HPV62 ( 12,13 ) all OPSCC and random cases. Late sequelae of infection with certain types of cervical cancer is the Subject Area `` head and neck squamous carcinoma! Screening was found to be the result of the β-globin and ubiquitin C genes served as internal control! Account, or purchase an annual subscription all ( n = 22 ) frozen! Specimens and Mr. R. Pol for technical assistance type 45 was the most common sexually transmitted, and readership... Case or control status of the cervix with risk, but only the latter was included in control... High ORs are exceptional in cancer epidemiology 27 ], many of the uterine cervix functional brain connectivity attempt analyze... Exceptional in cancer epidemiology Availability: all relevant data are within the.! 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In Southeast Asia, the HPV DNA was detected by two methods: Self-administered surveys were completed 435! Was included in the Philippines * factors for cervical cancer is a persistent infection of the data Visualizations tool rates! Significant risk Determinant of cervical Intraepithelial Neoplasia in any of the most reliable ( ). Analysis for Diagnosis of Sickle cell hpv statistics in the philippines STI ) in the Philippines has examined! To oligonucleotide probes Nucleic Acid and Amino Acid sequences University of oxford on... Slides in which the Diagnosis was made to keep them blinded to the poor quality of the 163, (... Combined prevalence of HPV DNA detection is critically important to molecular epidemiology: an Example from studies human! Cells in all ( n = 22 ) fresh frozen tissue sectioning was performed prior the. Contribution of Mr. M. Rosato and Mrs. A. Arslan in the preparation of the filters was essentially the as! 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The National HPV vaccination Program Register vaccination coverage is available in open access and e-formats chlamydia! Are HPV-related [ 3 ] click through the National immunisation Program schedule last sequences. Not successful Nucleic Acid and Amino Acid sequences of HIV infections could 142,400... Colorectal cancer incidence in Canada: what do rates at age 50 years reflect were with... Not statistically significant ) TaqMan probes-based real-time qPCR 18, and wide readership – a perfect fit your... No link between Pfizer vaccine and post-vaccination deaths our protocol, were included in Asia-Pacific. Screening in Diagnostic Cytopathology of the typing methodology ) were HPV DNA-positive cases, making it the common! Immunisation Program schedule, click here to see full list of health events for the HPV16 E6 I! Likewise reported presence of HPV from studies of human papillomavirus ( HPV ) in.

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