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Yu YQ, Jiang MY, Dang L, Feng RM, Bangura MS, Chen W, Qiao YL. Changes in High-Risk HPV Infection Prevalence and Associated Factors in Selected Rural Areas of China: A Multicenter Population-Based Study. Front Med (Lausanne) 2022; 9:911367. [PMID: 35903319 PMCID: PMC9319042 DOI: 10.3389/fmed.2022.911367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe Chinese government has taken action to prevent cervical cancer by implementing the National Cervical Cancer Screening Programme in Rural Areas (NACCSPRA), which was launched in 2009. Numerous studies have demonstrated that long-term cervical cancer screening alters human papillomavirus (HPV) infection rates and cervical disease detection. Nearly 80 million women have been screened over 10 years, representing <30% of the target population; however, in some rural areas, such as Ordos City of Inner Mongolia Autonomous Region, Xiangyuan County of Shanxi Province, and Jinyun County, and Jingning County of Zhejiang Province, programs for prevention and treatment of cervical cancer have been implemented. Numerous studies have demonstrated that long-term cervical cancer screening alters rates of human papillomavirus (HPV) infection and cervical disease detection. In this study, we aimed to determine the infection rates of high-risk HPV (hrHPV) and the detection rate of cervical lesions; and changes in factors associated with cervical cancer, to provide scientific data to inform efforts to eliminate cervical cancer in rural areas.MethodsThis was a cross-sectional, population-based, and multi-center survey. Populations from three rural areas of China (Ordos City of Inner Mongolia Autonomous Region, Xiangyuan County of Shanxi Province, and Jinyun County and Jingning County of Zhejiang Province) were selected and 9,332 women aged 20–64 years old were invited to participate in cervical cancer screening by both cytology and HPV testing. The outcomes assessed were: infection rates with hrHPV, HPV16, 18, 16/18, and other 12 hrHPV types (HPV 31,33,35,39,45,51,52,56,58,59,66 and 68); detection rates of cytological and histological lesions; and factors associated with HPV infection.ResultsA total of 9,217 women aged 45.62 ± 8.02 years were included in this study. Infection rates with hrHPV, HPV 16, 18, 16/18, and other 12 hrHPV types were 16.3%, 3.0%, 1.5%, 4.3%, and 13.6%, respectively. There were significant differences among the age-specific HPV infection rates (P < 0.05). Infection rates with hrHPV, 16, 18, 16/18, and the other 12 hrHPV types showed a single peak infection mode, with a peak age of 56–65 years old. Age, marital status, number of live births, education level, reproductive disease history, and a history of alcohol consumption were risk factors for hrHPV infection. The detection rate of cytological abnormalities was 12.98% in the study and was higher in women older than 56 years old. The detection rates of cervical intraepithelial neoplasia CIN2+ and CIN3+ in the population were 1.45% and 0.77%, respectively. The highest incidence rates of CIN2+ and CIN3+ were 32.12% and 17.51%, respectively, in the 41–45 years old group.ConclusionInfection rates with hrHPV, HPV16, and cervical lesions among our screening population were lower than the mean level in rural areas of China. Infection rates with hrHPV, HPV16, 18, and 16/18 showed a single-peak infection pattern, with the peak age of infection being 56-65 years old. Risk factors for hrHPV infection were age, history of alcohol consumption, marital status, reproductive diseases, education level, and the number of live births. Based on these data, we recommend that cervical cancer screening be offered to women older than 30 years in rural areas, particularly those aged 41–45 years.
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Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Ming-Yue Jiang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Dang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui-Mei Feng
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Mohamed S. Bangura
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Dalian Medical University, Dalian, China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Wen Chen
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences and Peking Union Medical College School of Population Medicine and Public Health, Beijing, China
- *Correspondence: You-Lin Qiao
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Cao X, Liu S, Jia M, Chen H, Zhao D, Dong B, Guo Z, Ren L, Zhang S, Sun X. Performance of HPV16/18 in Triage of Cytological Atypical Squamous Cells of Undetermined Significance. Anal Cell Pathol (Amst) 2019; 2019:4324710. [PMID: 31934532 PMCID: PMC6942702 DOI: 10.1155/2019/4324710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/17/2019] [Indexed: 11/23/2022] Open
Abstract
CONTEXT Human papillomavirus (HPV) testing is widely used in cervical cancer screening in women; however, its efficiency in triaging women with atypical squamous cells of undetermined significance (ASC-US) needs to be validated. OBJECTIVE To evaluate the performance of HPV16/18 in the triage of women with ASC-US. METHODS Women presenting for routine cervical cancer screening had cervical specimens collected, with which both liquid-based cytology (LBC) and hrHPVs were examined; those with ASC-US cytology underwent colposcopy. HPV16/18 and 12 other types were tested with domestic hybridization capture and chemiluminescence signal amplification (DH3). Performance characteristics of HPV test (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for identification of cervical intraepithelium neoplasma (CIN) grade 2 or worse (CIN2+), and CIN grade 3 or worse (CIN3+)) were determined using standard statistical tests. RESULTS 317 women with ASC-US were eligible for the study. HrHPV prevalence was 15.77% (50/317); HPV16/18 prevalence was 3.61% (20/317). Sensitivity and specificity of HPV16/18 for detection of CIN 2+ were 64.71% and 97% and 64.29% and 96.37% for detection of CIN 3+, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) of HPV16/18 were 55.00% and 97.98% for CIN2+ and 45.00% and 98.32% for CIN3+, respectively. CONCLUSION HPV16/18 can be considered as an effective method to triage women with ASC-US as its good clinical performance. TRIAL REGISTRATION This trial is registered with Henan Cancer Hospital Medical Ethics Committee on July 5, 2016 (http://www.anti-cancer.com.cn), with registry no.: 2016037.
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Affiliation(s)
- Xiaoqin Cao
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Shuzheng Liu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Manman Jia
- Gynecologic Oncology Department, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Hongmin Chen
- Gynecologic Oncology Department, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Dongmei Zhao
- Pathology Department, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Bing Dong
- Molecular Pathology Department, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Zhen Guo
- Central Laboratory, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Lingyan Ren
- Pathology Department, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Xibin Sun
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
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Wang J, Tang D, Wang K, Wang J, Zhang Z, Chen Y, Zhang X, Ma C. HPV genotype prevalence and distribution during 2009-2018 in Xinjiang, China: baseline surveys prior to mass HPV vaccination. BMC WOMENS HEALTH 2019; 19:90. [PMID: 31286939 PMCID: PMC6615222 DOI: 10.1186/s12905-019-0785-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/19/2019] [Indexed: 01/10/2023]
Abstract
Background The aim of this paper was to conduct a baseline survey of HPV infection in unvaccinated women in Xinjiang Uyghur Autonomous Region before the mass use of HPV vaccine. Methods Between 2008 and 2018, the HPV genotype detected by a PCR-based hybridization gene chip assay of 37,722 women who were from Gynecology Department and Health Management Center of the First Affiliated Hospital of Xinjiang Medical University were tested HPV genotype by a PCR-based hybridization gene chip assay. All statistical analysis methods were performed with this statistical software including Python version 3.6.1, R Software 3.5.1 and Excel 2011. Results The total positive rate for HPV was 14.02%, the most prevalent genotypes were HPV 16 (3.79%), HPV 52 (2.47%), HPV 58 (1.76%), HPV 53 (1.35%) and HPV 31 (0.72%). The single infection (11.34%) and high-risk HPV (HR-HPV) infection (9.72%) was the main prevalence of HPV. Age-specific HPV distribution was presented as a bimodal curve, while the youngest age group (≤25 years) presented the highest HPV infection rate (20.78%), which was followed by a second peak for the 36–40 age group. According to the ethnic stratification, the HPV infection prevalence ranging from the high to low was: Mongol (16.36%), Hui (15.15%), Kazak (14.47%), Han (14.43%), Other (14.37%), Uygher (10.96%). From 2009 to 2013, the HPV infection rate fluctuated but did not changed much. It peaked in 2014 and then fell significantly, reached the bottom point in 2017 and rose slightly in 2018. In 2015, the infection rate of HPVl6 and 52 in the population was almost the same (both 3.40%) the infection rate of HPV52 type (3.31%) was higher than that of HPVl6 type (2.18%) and became the dominant type in 2016. Conclusions We present data regarding the prevalence and type distribution of HPV infection, which could serve as the valuable reference to guide nationwide cervical cancer screening. These baseline data enable the estimates of maximum HPV vaccine impact across time and provide critical reference measurements which are important to the assess of clinical benefits and potential harms in HPV vaccination and the increase in non-vaccine HPV types.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of PPTHIDCA(Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia) / Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Dandan Tang
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Kai Wang
- Department for College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jialu Wang
- Department of Medical laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhaoxia Zhang
- Department of Medical laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yanxia Chen
- State Key Laboratory of PPTHIDCA(Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia) / Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xueliang Zhang
- Department for College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Cailing Ma
- State Key Laboratory of PPTHIDCA(Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia) / Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
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Ponce-Benavente L, Rejas-Pinelo P, Aguilar-Luis MA, Palomares-Reyes C, Becerra-Goicochea L, Pinillos-Vilca L, Silva-Caso W, Costa LE, Weilg P, Alvitrez-Arana J, Bazán-Mayra J, Del Valle-Mendoza J. Frequency and coinfection between genotypes of human papillomavirus in a population of asymptomatic women in northern Peru. BMC Res Notes 2018; 11:530. [PMID: 30064521 PMCID: PMC6069864 DOI: 10.1186/s13104-018-3644-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/24/2018] [Indexed: 12/17/2022] Open
Abstract
Objective Describe the prevalence of HPV genotypes via PCR and DNA sequencing in 397 women who attended to the gynecological outpatient center in the Hospital Regional Docente de Cajamarca from March to September 2017. Results A positive PCR result for HPV was observed in 121 cervical samples. A high-risk genotype was found in 63.6% (77/121) of patients, a probably oncogenic type in 23.1% (28/121) and a low-risk type in 7.4%. Among the high-risk genotypes, HPV-31 was the most common one present in 20% (21/77), followed by HPV-16 in 11.4% (12/77). Coinfections between two or more genotypes were observed in 12 cases. Electronic supplementary material The online version of this article (10.1186/s13104-018-3644-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luis Ponce-Benavente
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Patricia Rejas-Pinelo
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular, Instituto de Investigación Nutricional, Lima, Peru.,Instituto de Investigación de Enfermedades Infecciosas, Lima, Peru
| | - Carlos Palomares-Reyes
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | | | - Wilmer Silva-Caso
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Pablo Weilg
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Juan Alvitrez-Arana
- Instituto de Investigación de Enfermedades Infecciosas, Lima, Peru.,Hospital Regional Docente de Cajamarca, Cajamarca, Peru
| | | | - Juana Del Valle-Mendoza
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. .,Laboratorio de Biología Molecular, Instituto de Investigación Nutricional, Lima, Peru.
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