A multi-center survey of age of sexual debut and sexual behavior in Chinese women: Suggestions for optimal age of human papillomavirus vaccination in China

Abstract

Objective Cervical cancer is the second most common cancer among women worldwide, and over 85% of cervical cancers occur in developing countries such as China. Lack of resources for nationwide cervical cancer screening in China makes vaccination against oncogenic strains of HPV particularly important. Knowledge of age at sexual debut and sexual behavior is essential prior to implementation of a national vaccination program. Methods and materials A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China to assess age at sexual debut and sexual behavior. 98.6% of the 11,852 recruited women aged 15–59 years were included in the analysis. Data were collected using a short, nurse-administered questionnaire and analyzed using standard descriptive statistics and survival analysis. Results In urban areas, more than ten percent of the 15–19 year old age group were already sexually active at the time of interview; this number increased to nearly 44% in the 20–24 year old age group. Chinese young women with an occupation were more likely to be sexually active compared to female students of the same age, irrespective of area of residence. The crude median sexual debut age for the youngest age group was 17 years, earlier than the sexual debut age reported by older cohorts. Younger age cohorts had an earlier menarche age than older cohorts and were more likely to have more sexual partners than older women, and more likely to have partners with more than one female partner. Conclusion There is a trend towards earlier sexual debut and riskier sexual behaviors in younger age groups of Chinese women. These findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China.

How university students view human papillomavirus (HPV) vaccination: A cross-sectional study in Jinan, China

“…Findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China. 23 Perceived susceptibility to HPV-related cancers contributed significantly to the acceptance of HPV vaccine among undergraduates in our study. This is consistent with findings from other countries in the pacific region.…”

“…23 HPV prevalence and cervical intraepithelial neoplasia (CIN) were high in young women in China. For example a study in Jiangsu Province found that among women aged 18 to 24 This study indicated cervical disease burden was relatively high among young women aged 18-25 and educational interventions targeting female adolescents and strategies to subsidize vaccine costs were needed to ensure the effectiveness of vaccination campaigns in China.…”

“…5 The quadrivalent vaccine (Gardasil) covers HPV 6,11,16 and 18. It is efficacious in preventing many of the above mentioned morbidities in both men and women. For example, Gardasil was efficacious to prevent nearly 100% of cervical cancers among women aged [18][19][20][21][22][23][24]6 90% of genital lesions among heterosexual men aged [16][17][18][19][20][21][22][23][24][25][26]7 78% of ano-genital warts and 75% of anal intraepithelial neoplasia among MSM. 8 Its safety was also warranted in above-mentioned populations.…”

Cervical Cancer Screening Among Adult Women in China, 2010

“…Recently, researchers found that HPV testing on self-collected cervical specimens may be a more effective means to screen for cervical cancer. This method may be effective in rural China, where there are shortages of cytopathologists and health care workers for screening by Pap test or VIA [29,30]. A multicenter population-based study in China showed that HPV prevalence in the entire study population was 14.3%.…”

Can the careHPV test performed in mobile units replace cytology for screening in rural and remote areas?

“…1,2 Persistent high-risk human papillomavirus (hr-HPV) infection is associated with high-grade cervical intraepithelial neoplasia of type 2 or higher (CIN21) and its progression toward invasive CC. [3][4][5][6] Molecular tests for HPV DNA or RNA have been designed to identify hr-HPV in cervical samples; these tests are both reliable and reproducible and can be implemented more easily than cytological analysis. [7][8][9][10][11][12][13][14] New guidelines for CC screening recommend the combined use of HPV testing and cytology over the use of cytology alone.…”