Human papillomavirus infection in Shenyang City, People's Republic of China: a population-based study

Abstract

To investigate the prevalence of, and risk factors for, cervical infection with human papillomavirus (HPV) in Shenyang City, People's Republic of China, we interviewed and obtained cervical cell samples from 685 women aged 15 -59 years enumerated from local population lists. Human papillomavirus DNA was detected in cervical cell samples using a GP5 þ /6 þ -based PCR assay for 44 HPV types. Human papillomavirus prevalence was 16.8% overall and 13.6% among women without cervical abnormalities (16.6% and 12.4%, respectively, age-standardised to the world standard population), with no significant trends in HPV prevalence by age group. Of the 32 types identified, high-risk HPV types predominated in all age groups, HPV16 being the most common (3.4% of all women), followed by HPV52 (2.5%) and 58 (1.9%). Multiple-type infections accounted for 31.3% of all infected women. Not being married, reporting multiple sexual partners and husband's extramarital sexual relationships were all significantly associated with being HPV-positive. The disclosure of a relatively high HPV prevalence in Shenyang, in comparison with other worldwide populations, raises important questions concerning the prevention of cervical cancer in China, especially given the promising efficacy of prophylactic HPV vaccines.

Human papillomavirus infection in women with and without cervical cancer in Nepal

“…HPV52 and 58, however, were not as predominant as in similar surveys in China [16][17][18]. We also confirmed that the type distribution Major strengths of our present study include a large and population-based sample, the use of a standardized and well-validated HPV test allowing comparisons with similar studies around the world [9] and the presence of a concurrent series of women with ICC drawn from the same study area.…”

“…The agespecific curve of HPV prevalence in Nepal resembled the flat age curves reported previously in some low-resource countries in Asia and Africa [15][16][17][18]24], albeit at a lower level of HPV prevalence. It clearly differed, on the other hand, from the steep decrease in HPV prevalence seen by age in high-and medium-resource countries in Europe, the Americas, and Asia [23,25].…”

“…The major finding of this present study, the first undertaken in Nepal, is that the burden of HPV infection in the general population (8.6%) is somewhat lower than that observed in previous studies performed using the same HPV testing protocol in neighboring countries (e.g., 17% in Tamil Nadu, India, [15] and 15-18% range in three provinces in China [16][17][18]), and much less than in the high-risk areas in Asia and Africa (e.g., 35% in Mongolia [19] and 51% in Guinea [20]). Nevertheless, HPV prevalence remained greater than that in other areas in Asia (e.g., 2% in Hanoi, Vietnam [21], 4% in Songkla, Thailand [22]), and in Europe [23].…”

“…As in previous IARC HPV prevalence surveys in Asia [15][16][17][18], the gynecological exam was acceptable only to married women, so, the HPV prevalence estimate represents that in married women only. Nevertheless, age at first marriage (median = 17 years, intraquartile range [15][16][17][18][19] was relatively early, and 91% of participants reported an age at first sexual intercourse that was the same as, or greater than, age at first marriage, suggesting that marriage is a good proxy for sexual activity in this population.…”

“…Nevertheless, age at first marriage (median = 17 years, intraquartile range [15][16][17][18][19] was relatively early, and 91% of participants reported an age at first sexual intercourse that was the same as, or greater than, age at first marriage, suggesting that marriage is a good proxy for sexual activity in this population. HPV16/18 prevalence, however, was highest among older women.…”