Prevalence of Cervical Human Papillomavirus (HPV) Infection in Vanuatu

Aruhuri, Bernadette; Tarivonda, Len; Tenet, Vanessa; Sinha, Rohit Anthony; Snijders, Peter J.F.; Clifford, Gary M.; Pang, Joseph; McAdam, Margaret; Meijer, Chris J.L.M.; Frazer, Ian H.; Franceschi, Silvia

doi:10.1158/1940-6207.capr-11-0515

Cited by 15 publications

(15 citation statements)

References 24 publications

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“…Only few other studies from the region have assessed coverage of cervical cancer screening, and with the exception of Guam, these studies confirm low coverage of cervical cancer screening in the Pacific Region (Mishra et al, 2001; Balajadia et al, 2008; McAdam et al, 2010; Aruhuri et al, 2012; Hernandez et al, 2013; Law et al, 2013). A recent study from the US Affiliated Guam, American Samoa, Northern Mariana Islands, Federated States of Micronesia and Marshall Islands) examined the practices, attitudes and knowledge of health care workers on cervical cancer screening (Townsend et al, 2014).…”

Section: Discussionmentioning

confidence: 78%

“…Only two studies from the Pacific Region have reported genotype prevalence in healthy women. Both studies were carried out among women in Vanuatu and may in the future serve as baseline for measuring vaccine effectiveness when the plans for HPV vaccine introduction in Vanuatu are implemented Jurisdictions (Palau, (McAdam et al, 2010; Aruhuri et al, 2012). …”

Section: Discussionmentioning

confidence: 99%

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Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Obel

McKenzie²,

Buenconsejo-Lum³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Objective To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Obel

McKenzie²,

Buenconsejo-Lum³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Findings can be confidently compared with other IARC HPV surveys that were conducted according to a similar sampling and HPV testing protocol. In this respect, the age-standardised HR HPV prevalence in Bhutan (18%) ranks below that of Guinea (31%) [12] and Mongolia (25%) [13], but is similar to the prevalence detected in Nigeria (18%) [14] and Vanuatu (19%) [15]. It is more elevated than that found in many other areas at high-risk for cervical cancer in Asia, including that in neighbouring countries of India (12%) [16], China (12-13%) [17-19] and Nepal (6%) [20].…”

Section: Discussionmentioning

confidence: 85%

Human papillomavirus infection in Bhutan at the moment of implementation of a national HPV vaccination programme

Tshomo¹,

Franceschi

Dorji³

et al. 2014

BMC Infect Dis

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BackgroundCervical cancer is the most common female cancer in Bhutan, the first low/middle-income country to implement a national human papillomavirus (HPV) vaccination programme.MethodsTo provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2,505 women aged 18–69 years from the general population, and biopsies from 211 cervical intraepithelial neoplasia grade 3 (CIN3) and 112 invasive cervical cancer (ICC) cases. Samples were tested for HPV using GP5+/6+ PCR.ResultsAmong the general population, HPV prevalence was 26%, being highest (33%) in women ≤24 years, but remaining above 15% in all age-groups. Determinants of HPV included age, marital status, and number of sexual partners. Among the eight percent with cytological abnormalities, 24 CIN3 and 4 ICC were histologically confirmed. Even after additional testing with a sensitive E7 PCR, no infections with vaccine-targeted HPV types were detected in the few vaccinated women (n = 34) compared to 6% prevalence in unvaccinated women of similar age (p = 0 · 215).ConclusionBased upon type-specific prevalence among biopsies, at least 70% of ICC in Bhutan are theoretically preventable by HPV16/18 vaccination, but screening programmes should be expanded among older women, who have an important underlying burden of CIN3 and ICC.

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“…The IARC has coordinated cervical cancer case series, cervical cancer case-control studies, and population-based HPV prevalence surveys in a large number of countries around the world (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35); also as-yet-unpublished studies from Fiji and Bhutan). The collection of samples has spanned a period of over 20 years from 1989 until 2012 and predates the introduction of HPV vaccines.…”

Section: Methodsmentioning

confidence: 99%

Human Papillomavirus 45 Genetic Variation and Cervical Cancer Risk Worldwide

Chen¹,

Heideman²,

Boon³

et al. 2014

J Virol

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Human papillomavirus 45 (HPV45) is a member of the HPV18-related alpha-7 species and accounts for approximately 5% of all cervical cancer cases worldwide. This study evaluated the genetic diversity of HPV45 and the association of HPV45 variants with the risk of cervical cancer by sequencing the entire E6 and E7 open reading frames of 300 HPV45-positive cervical samples from 36 countries. A total of 43 HPV45 sequence variants were identified that formed 5 phylogenetic sublineages, A1, A2, A3, B1, and B2, the distribution of which varied by geographical region. Among 192 cases of cervical cancer and 101 controls, the B2 sublineage was significantly overrepresented in cervical cancer, both overall and in Africa and Europe separately. We show that the sequence analysis of E6 and E7 allows the classification of HPV45 variants and that the risk of cervical cancer may differ by HPV45 variant sublineage. IMPORTANCEThis work describes the largest study to date of human papillomavirus 45 (HPV45)-positive cervical samples and provides a comprehensive reference for phylogenetic classification for use in epidemiological studies of the carcinogenicity of HPV45 genetic variants, particularly as our findings suggest that the B2 sublineage of HPV45 is associated with a higher risk of cervical cancer.

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Prevalence of Cervical Human Papillomavirus (HPV) Infection in Vanuatu

Cited by 15 publications

References 24 publications

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Human papillomavirus infection in Bhutan at the moment of implementation of a national HPV vaccination programme

Human Papillomavirus 45 Genetic Variation and Cervical Cancer Risk Worldwide

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