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Baseline assessment of prevalence and geographical distribution of HPV types in Chile using self-collected vaginal samples.

Ferreccio C, Corvalán A, Margozzini P, Viviani P, González C, Aguilera X, Gravitt PE - BMC Public Health (2008)

Bottom Line: High-risk and low-risk HPV rates were inversely correlated between the regions.High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age.Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: P. Universidad Católica de Chile, Escuela de Medicina, Santiago Chile. cferrec@med.puc.cl

ABSTRACT

Background: Chile has broad variations in weather, economics and population from the far desert north (Region 1) to the cold, icy south (Region 12). A home-based self-collected vaginal sampling was nested in the 2003 Chilean population-based health survey in order to explore the possibility of a type-specific geographical variation for human papillomavirus

Methods: The population was a national probability sample of people 17 years of age and over. Consenting women provided self-collected cervicovaginal swabs in universal collection media (UCM). DNA was extracted and typed to 37 HPV genotypes using PGMY consensus PCR and line blot assay. Weighted prevalence rates and adjusted OR were calculated.

Results: Of the 1,883 women participating in the health survey, 1,219 (64.7%) provided a cervicovaginal sample and in 1,110 (56.2% of participants and 66.5% of those eligible) the samples were adequate for analysis. Refusal rate was 16.9%. HPV prevalence was 29.2% (15.1% high-risk HPV and 14.1% low-risk HPV). Predominant high-risk types were HPV 16, 52, 51, 56 and 58. Predominant low-risk HPVs were HPV 84, CP6108, 62, 53 and 61. High-risk and low-risk HPV rates were inversely correlated between the regions. High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age.

Conclusion: Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions.

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Regional distribution high-risk and low-risk HPV in the population of Chile's 13 Regions.
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Figure 2: Regional distribution high-risk and low-risk HPV in the population of Chile's 13 Regions.

Mentions: Total HPV infection (high-risk plus low-risk HPVs) varied from 43.5% (95% IC, 23.5–65.9) in Region I (the northernmost region) to 25% (96% CI, 15.6–36.6) in Region V (Figure 2). Prevalence of high-risk (either single or multiple) and low-risk HPVs (single or multiple low-risk only) rates were inversely correlated between the regions (Pearson correlation -0.62 p= 0.023). Although not statistically significant the age distribution varied between the regions with the lowest mean age in Region I and the highest in Region XII (mean age in years 38.6 and 45.0, respectively). When weighted and age-adjusted, this inverse association between high and low-risk HPVs decreased and lost its statistical significance (age adjusted partial correlation -0.36 p = 0.25). Based on the relative contribution of a high-risk HPV to the total burden of HPV, four distinct macroregions were identified: the North (adjacent to Peru and Bolivia), Central, South, and Extreme South (Patagonia). The OR of having high-risk HPVs was 2.8 (95% CI 1.4–5.7), 0.9 (95% CI 0.6–1.5), 0.6 (95% CI 0.3–0.98) and 1.09 (95% CI 0.4–3.0), for the North, Central, South and Extreme South areas respectively. The mean ages of the population were: 39.8, 42.7, 41.1 and 40.0 for North, Central, South and Extreme South regions, respectively. Neither high-risk HPV nor low-risk HPV was associated with cervical cancer mortality (Pearson correlation 0.2 and 0.1 respectively; test for trend, p = 0.29 and 0.37, respectively). In 2004, according to the ministry of health statistics, the Papanicolaou coverage for women 35–64 years old varied from 54.7% in the Metropolitan South-eastern Health Service to 87.3% in the Metropolitan Central Health Service. Nevertheless, Papanicolaou coverage was not significantly associated with either high-risk (Pearson correlation 0.15 p = 0.6) or low-risk HPV (Pearson correlation -0.35 p = 0.23).


Baseline assessment of prevalence and geographical distribution of HPV types in Chile using self-collected vaginal samples.

Ferreccio C, Corvalán A, Margozzini P, Viviani P, González C, Aguilera X, Gravitt PE - BMC Public Health (2008)

Regional distribution high-risk and low-risk HPV in the population of Chile's 13 Regions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2291464&req=5

Figure 2: Regional distribution high-risk and low-risk HPV in the population of Chile's 13 Regions.
Mentions: Total HPV infection (high-risk plus low-risk HPVs) varied from 43.5% (95% IC, 23.5–65.9) in Region I (the northernmost region) to 25% (96% CI, 15.6–36.6) in Region V (Figure 2). Prevalence of high-risk (either single or multiple) and low-risk HPVs (single or multiple low-risk only) rates were inversely correlated between the regions (Pearson correlation -0.62 p= 0.023). Although not statistically significant the age distribution varied between the regions with the lowest mean age in Region I and the highest in Region XII (mean age in years 38.6 and 45.0, respectively). When weighted and age-adjusted, this inverse association between high and low-risk HPVs decreased and lost its statistical significance (age adjusted partial correlation -0.36 p = 0.25). Based on the relative contribution of a high-risk HPV to the total burden of HPV, four distinct macroregions were identified: the North (adjacent to Peru and Bolivia), Central, South, and Extreme South (Patagonia). The OR of having high-risk HPVs was 2.8 (95% CI 1.4–5.7), 0.9 (95% CI 0.6–1.5), 0.6 (95% CI 0.3–0.98) and 1.09 (95% CI 0.4–3.0), for the North, Central, South and Extreme South areas respectively. The mean ages of the population were: 39.8, 42.7, 41.1 and 40.0 for North, Central, South and Extreme South regions, respectively. Neither high-risk HPV nor low-risk HPV was associated with cervical cancer mortality (Pearson correlation 0.2 and 0.1 respectively; test for trend, p = 0.29 and 0.37, respectively). In 2004, according to the ministry of health statistics, the Papanicolaou coverage for women 35–64 years old varied from 54.7% in the Metropolitan South-eastern Health Service to 87.3% in the Metropolitan Central Health Service. Nevertheless, Papanicolaou coverage was not significantly associated with either high-risk (Pearson correlation 0.15 p = 0.6) or low-risk HPV (Pearson correlation -0.35 p = 0.23).

Bottom Line: High-risk and low-risk HPV rates were inversely correlated between the regions.High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age.Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: P. Universidad Católica de Chile, Escuela de Medicina, Santiago Chile. cferrec@med.puc.cl

ABSTRACT

Background: Chile has broad variations in weather, economics and population from the far desert north (Region 1) to the cold, icy south (Region 12). A home-based self-collected vaginal sampling was nested in the 2003 Chilean population-based health survey in order to explore the possibility of a type-specific geographical variation for human papillomavirus

Methods: The population was a national probability sample of people 17 years of age and over. Consenting women provided self-collected cervicovaginal swabs in universal collection media (UCM). DNA was extracted and typed to 37 HPV genotypes using PGMY consensus PCR and line blot assay. Weighted prevalence rates and adjusted OR were calculated.

Results: Of the 1,883 women participating in the health survey, 1,219 (64.7%) provided a cervicovaginal sample and in 1,110 (56.2% of participants and 66.5% of those eligible) the samples were adequate for analysis. Refusal rate was 16.9%. HPV prevalence was 29.2% (15.1% high-risk HPV and 14.1% low-risk HPV). Predominant high-risk types were HPV 16, 52, 51, 56 and 58. Predominant low-risk HPVs were HPV 84, CP6108, 62, 53 and 61. High-risk and low-risk HPV rates were inversely correlated between the regions. High-risk HPV prevalence was highest among the youngest women, whereas low-risk HPV increased slightly with age.

Conclusion: Self-obtained vaginal sampling is adequate for monitoring HPV in the community, for identifying high-risk areas, and for surveying the long term impact of interventions.

Show MeSH
Related in: MedlinePlus