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Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study.

Hibbitts S, Jones J, Powell N, Dallimore N, McRea J, Beer H, Tristram A, Fielder H, Fiander AN - Br. J. Cancer (2008)

Bottom Line: Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status.Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18).The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. hibbittssj@cf.ac.uk

ABSTRACT
In this cross-sectional population-based study we determine human papillomavirus (HPV) prevalence in South Wales to provide comprehensive baseline data for future assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. Liquid-based cytology samples from women attending routine cervical screening were collected (n=10 000: mean age 38 years, 93% cytology negative, and 64.8% from the 50% least deprived LSOA according to social deprivation score (SDS)). High-Risk (HR) and Low-Risk HPV screening was performed using HPV PCR-EIA with genotyping of HR positives and data correlated with age, SDS and cytology. Overall HPV prevalence was 13.5% (9.3% age standardised) and the most frequent HR types were HPV 16, 31, 18 and 58. In HR HPV-positive cases 42.4% had a single HR type and they were predominant in women with severe cytological abnormalities. Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status. HPV prevalence increased significantly with degree of dyskaryosis from 7% in cytology negative samples to 80% in samples with severe cytological abnormalities (P-value <0.0001). Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18). The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

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Related in: MedlinePlus

HR HPV type-specific prevalence by cytology grade in cases with a single HR type (n=430). HPV prevalence calculated as a percentage of the total number of women in the study population classified as negative (n=8434), borderline (n=426) and dyskaryotic (n=219) cytology.
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fig2: HR HPV type-specific prevalence by cytology grade in cases with a single HR type (n=430). HPV prevalence calculated as a percentage of the total number of women in the study population classified as negative (n=8434), borderline (n=426) and dyskaryotic (n=219) cytology.

Mentions: In HR HPV-positive cases (n=1015) the most prevalent HR genotypes detected were 16 (31.4%), 31 (22.6%), 18 (21.7%) and 58 (19.8%). The proportion of HR HPV cases attributable to types included in currently licensed prophylactic HPV vaccines (HPV 16 and HPV 18) was 46% overall (n=471 out of 1015) and 70% (n=28 out of 40) for cases with severe cytological abnormalities. Here, 42% (n=430 out of 1015; 95% CI 39.4–45.5%) of HR HPV-positive cases had an infection with a single HR type and in these women HPV 16 was the predominant genotype (n=143 out of 430). The remaining 58% (n=585 out of 1015; 95% CI 54.5–60.6%) had multiple HR types and HPV 18 was the most predominant type detected (n=201 out of 585). The prevalence of each HPV genotype in cases with a single HR infection was compared with cases containing multiple HR types and no statistically significant differences were found for HPV 16, 51 or 66 (χ2 test; P=0.2594, P=0.3461 and P=0.6142 respectively). All other genotypes were statistically significantly more common in cases with multiple HR types compared with those with a single HR type (Figure 1). In cases with a single HR type the genotype distribution in each cytology grade (negative, borderline and dyskaryotic) was assessed. HPV 16 was the only genotype significantly more prevalent in cases with dyskaryosis (mild, moderate or severe) compared with borderline and negative cases (Figure 2; χ2 test; P=0.0395 and P>0.0001 respectively).


Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study.

Hibbitts S, Jones J, Powell N, Dallimore N, McRea J, Beer H, Tristram A, Fielder H, Fiander AN - Br. J. Cancer (2008)

HR HPV type-specific prevalence by cytology grade in cases with a single HR type (n=430). HPV prevalence calculated as a percentage of the total number of women in the study population classified as negative (n=8434), borderline (n=426) and dyskaryotic (n=219) cytology.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600697&req=5

fig2: HR HPV type-specific prevalence by cytology grade in cases with a single HR type (n=430). HPV prevalence calculated as a percentage of the total number of women in the study population classified as negative (n=8434), borderline (n=426) and dyskaryotic (n=219) cytology.
Mentions: In HR HPV-positive cases (n=1015) the most prevalent HR genotypes detected were 16 (31.4%), 31 (22.6%), 18 (21.7%) and 58 (19.8%). The proportion of HR HPV cases attributable to types included in currently licensed prophylactic HPV vaccines (HPV 16 and HPV 18) was 46% overall (n=471 out of 1015) and 70% (n=28 out of 40) for cases with severe cytological abnormalities. Here, 42% (n=430 out of 1015; 95% CI 39.4–45.5%) of HR HPV-positive cases had an infection with a single HR type and in these women HPV 16 was the predominant genotype (n=143 out of 430). The remaining 58% (n=585 out of 1015; 95% CI 54.5–60.6%) had multiple HR types and HPV 18 was the most predominant type detected (n=201 out of 585). The prevalence of each HPV genotype in cases with a single HR infection was compared with cases containing multiple HR types and no statistically significant differences were found for HPV 16, 51 or 66 (χ2 test; P=0.2594, P=0.3461 and P=0.6142 respectively). All other genotypes were statistically significantly more common in cases with multiple HR types compared with those with a single HR type (Figure 1). In cases with a single HR type the genotype distribution in each cytology grade (negative, borderline and dyskaryotic) was assessed. HPV 16 was the only genotype significantly more prevalent in cases with dyskaryosis (mild, moderate or severe) compared with borderline and negative cases (Figure 2; χ2 test; P=0.0395 and P>0.0001 respectively).

Bottom Line: Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status.Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18).The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. hibbittssj@cf.ac.uk

ABSTRACT
In this cross-sectional population-based study we determine human papillomavirus (HPV) prevalence in South Wales to provide comprehensive baseline data for future assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. Liquid-based cytology samples from women attending routine cervical screening were collected (n=10 000: mean age 38 years, 93% cytology negative, and 64.8% from the 50% least deprived LSOA according to social deprivation score (SDS)). High-Risk (HR) and Low-Risk HPV screening was performed using HPV PCR-EIA with genotyping of HR positives and data correlated with age, SDS and cytology. Overall HPV prevalence was 13.5% (9.3% age standardised) and the most frequent HR types were HPV 16, 31, 18 and 58. In HR HPV-positive cases 42.4% had a single HR type and they were predominant in women with severe cytological abnormalities. Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status. HPV prevalence increased significantly with degree of dyskaryosis from 7% in cytology negative samples to 80% in samples with severe cytological abnormalities (P-value <0.0001). Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18). The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.

Show MeSH
Related in: MedlinePlus