High-risk human papillomavirus status and prognosis in invasive cervical cancer: a nationwide cohort study. Dataset 2

High-risk human papillomavirus (hrHPV) infection is established as the major cause of invasive cervical cancer (ICC). However, whether hrHPV status in the tumor is associated with subsequent prognosis of ICC is controversial. We aim to evaluate the association between tumor hrHPV status and ICC prognosis using national registers and comprehensive human papillomavirus (HPV) genotyping. In this nationwide population-based cohort study, we identified all ICC diagnosed in Sweden during the years 2002–2011 (4,254 confirmed cases), requested all archival formalin-fixed paraffin-embedded blocks, and performed HPV genotyping. Twenty out of 25 pathology biobanks agreed to the study, yielding a total of 2,845 confirmed cases with valid HPV results. Cases were prospectively followed up from date of cancer diagnosis to 31 December 2015, migration from Sweden, or death, whichever occurred first. The main exposure was tumor hrHPV status classified as hrHPV-positive and hrHPV-negative. The primary outcome was all-cause mortality by 31 December 2015. Five-year relative survival ratios (RSRs) were calculated, and excess hazard ratios (EHRs) with 95% confidence intervals (CIs) were estimated using Poisson regression, adjusting for education, time since cancer diagnosis, and clinical factors including age at cancer diagnosis and International Federation of Gynecology and Obstetrics (FIGO) stage. Of the 2,845 included cases, hrHPV was detected in 2,293 (80.6%), and we observed 1,131 (39.8%) deaths during an average of 6.2 years follow-up. The majority of ICC cases were diagnosed at age 30–59 years (57.5%) and classified as stage IB (40.7%). hrHPV positivity was significantly associated with screen-detected tumors, young age, high education level, and early stage at diagnosis (p < 0.001). The 5-year RSR compared to the general female population was 0.74 (95% CI 0.72–0.76) for hrHPV-positive cases and 0.54 (95% CI 0.50–0.59) for hrHPV-negative cases, yielding a crude EHR of 0.45 (95% CI 0.38–0.52) and an adjusted EHR of 0.61 (95% CI 0.52–0.71). Risk of all-cause mortality as measured by EHR was consistently and statistically significantly lower for cases with hrHPV-positive tumors for each age group above 29 years and each FIGO stage above IA. The difference in prognosis by hrHPV status was highly robust, regardless of the clinical, histological, and educational characteristics of the cases. The main limitation was that, except for education, we were not able to adjust for lifestyle factors or other unmeasured confounders. In conclusion, women with hrHPV-positive cervical tumors had a substantially better prognosis than women with hrHPV-negative tumors. hrHPV appears to be a biomarker for better prognosis in cervical cancer independent of age, FIGO stage, and histological type, extending information from already established prognostic factors. The underlying biological mechanisms relating lack of detectable tumor hrHPV to considerably worse prognosis are not known and should be further investigated. Purpose: To compile a comprehensive survival and HPV genotyping data and provide a large-scale population-based evaluation of the association between tumor high risk HPV status and prognosis of invasive cervical cancer. This is an aggregated dataset (popmort_agg_2000_2015.dta) including the average survival rates of the Swedish female population, by age, for years 2000-2015. The dataset is generated based on the age-, gender- and calender year- specific survival rates of the Swedish population during the same calendar period. The dataset included 4 variables: • Sex: Gender (all female): 2=female. • _age: Age (in years) • _year: Calendar year • Prob: Survival probability in corresponding age and calendar year高危型人乳头瘤病毒（high-risk human papillomavirus, hrHPV）感染已被证实是浸润性宫颈癌（invasive cervical cancer, ICC）的主要致病因素。然而，肿瘤组织中的hrHPV状态是否与浸润性宫颈癌的后续预后相关，目前仍存在争议。本研究旨在利用国家登记数据与全面的人乳头瘤病毒（human papillomavirus, HPV）基因分型技术，评估肿瘤hrHPV状态与浸润性宫颈癌预后之间的关联。 本项基于全国人群的队列研究中，我们筛选出2002年至2011年间瑞典境内确诊的所有浸润性宫颈癌病例（共4254例确诊病例），收集了所有存档的福尔马林固定石蜡包埋组织块，并开展HPV基因分型检测。25家病理生物样本库中有20家同意参与本研究，最终获得2845例具备有效HPV检测结果的确诊病例。研究对象自癌症确诊之日起接受前瞻性随访，直至2015年12月31日、离开瑞典或死亡（以最先发生的事件为准）。本研究的主要暴露因素为肿瘤hrHPV状态，分为hrHPV阳性与hrHPV阴性两类。主要结局指标为截至2015年12月31日的全因死亡率。研究计算了5年相对生存率（relative survival ratios, RSRs），并采用泊松回归估计了带95%置信区间（confidence intervals, CIs）的超额危险比（excess hazard ratios, EHRs），校正因素包括受教育程度、确诊后时间，以及确诊年龄、国际妇产科联盟（International Federation of Gynecology and Obstetrics, FIGO）分期等临床因素。 在纳入的2845例病例中，2293例（80.6%）检测到hrHPV，平均随访6.2年间共观察到1131例（39.8%）死亡。大部分浸润性宫颈癌病例确诊时年龄为30~59岁（57.5%），且分期为IB期（40.7%）。hrHPV阳性与筛查检出肿瘤、年轻年龄、高受教育程度及确诊时分期较早显著相关（p < 0.001）。与普通女性人群相比，hrHPV阳性病例的5年相对生存率为0.74（95% CI 0.72~0.76），hrHPV阴性病例则为0.54（95% CI 0.50~0.59），粗超额危险比为0.45（95% CI 0.38~0.52），校正后超额危险比为0.61（95% CI 0.52~0.71）。在29岁以上的各年龄组以及IA期以上的各FIGO分期中，hrHPV阳性肿瘤病例的全因死亡风险（以超额危险比衡量）始终显著更低。无论病例的临床、组织学特征与受教育程度如何，基于hrHPV状态的预后差异均具有高度稳健性。本研究的主要局限性在于，除受教育程度外，无法对生活方式因素或其他未测量的混杂因素进行校正。 综上，宫颈肿瘤hrHPV阳性的女性患者预后显著优于hrHPV阴性者。hrHPV似乎可作为宫颈癌预后良好的生物标志物，且该关联不受年龄、FIGO分期及组织学类型的影响，补充了已确立的预后因素相关信息。目前尚不明确肿瘤组织中无法检测到hrHPV与极差预后之间的潜在生物学机制，有待进一步研究。 研究目的： 整合全面的生存数据与HPV基因分型数据，开展大规模基于人群的研究，评估肿瘤高危型HPV状态与浸润性宫颈癌预后之间的关联。 本数据集为聚合数据集（popmort_agg_2000_2015.dta），包含2000年至2015年间瑞典女性人群按年龄分组的平均生存率。该数据集基于同期瑞典人群按年龄、性别及日历年份划分的特异性生存率生成。 数据集共包含4个变量： • 性别（Sex）：性别（所有研究对象均为女性）：2=女性。 • 年龄（_age）：年龄（单位：岁） • 日历年份（_year）：日历年份 • 生存概率（Prob）：对应年龄与日历年份下的生存概率