Risk factors associated with human papillomavirus prevalence and cervical neoplasia among Cameroonian women
Risk factors associated with human papillomavirus prevalence and cervical neoplasia among Cameroonian women
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DOI：
10.1016/j.canep.2015.11.008
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发表时间：
2016-02-01
影响因子：
2.6
通讯作者：
Petignat, Patrick
中科院分区：
文献类型：
--
作者：
Catarino, Rosa;Vassilakos, Pierre;Petignat, Patrick
背景资料：本研究采用以社区为基础的宫颈癌筛查高危型人乳头瘤病毒（HPV），以确定人口和生活方式因素与HPV的患病率和宫颈上皮内瘤变2级或更糟（CIN 2+）。方法：妇女（n = 838）年龄在25-65岁，招募在喀麦隆的两个连续的研究。从参与者中获得人口统计学和历史数据，并使用实时PCR自行收集标本进行HPV检测。HPV阳性妇女进行活检和宫颈内刮除术。结果：HPV感染率和自报HIV感染率分别为39.0%和9.2%。HPV阳性妇女中有18例（9.3%）CIN 2+病变。家庭主妇感染HPV的风险较高（OR = 1.60，p = 0.010）。HIV合并感染（aOR = 3.44，p < 0.001）和激素避孕（aOR = 1.97，p = 0.007）与HPV患病率增加相关。HPV阳性的妇女在性交时使用避孕套的CIN 2+的风险较低（aOR = 0.15，p = 0.029）。CIN 2 -3病变见于年龄小于50岁的女性，中位年龄为36岁（31-44岁）。HPV-16/18阳性妇女发生CIN 2+的风险增加4.65倍（p = 0.015）。结论：年轻、单身妇女和家庭主妇是HPV感染的高危人群。在资源匮乏的环境中，宫颈癌的预防战略应针对30-50岁的妇女进行HPV筛查，并应将治疗和随访重点放在HPV-16/18阳性妇女身上。需要进一步的研究来澄清是否需要注意其他风险因素。(C)2015爱思唯尔有限公司版权所有。
Background: This study used community-based cervical cancer screening for high-risk humanpapillomavirus (HPV) to determine demographic and lifestyle factors associated with HPV prevalence and cervical intraepithelial neoplasia grade 2 or worse (CIN2+).Methods: Women (n = 838) aged 25-65 years were recruited in two sequential studies in Cameroon. Demographic and historical data were obtained from participants and specimens were self-collected for HPV-testing using real-time PCR. HPV-positive women underwent biopsy and endocervical curettage. Associations were determined using bivariate analysis and logistic regression.Results: HPV and self-reported HIV prevalence were 39.0% and 9.2%, respectively. Eighteen (9.3%) CIN2+ lesions were found among HPV-positive women. Housewives had a higher risk of being HPV infected (OR = 1.60, p = 0.010). HIV co-infection (aOR = 3.44, p < 0.001) and hormonal contraception (aOR = 1.97, p = 0.007) were associated with increased HPV prevalence. HPV-positive women who used condoms during sexual intercourse were at lower risk of CIN2+ (aOR = 0.15, p = 0.029). CIN2-3 lesions were found in women younger than 50 years, with a median age of 36 years (31-44). HPV-16/18-positive women had a 4.65-fold increased risk of CIN2+ (p = 0.015).Conclusions: Young, single women and housewives were at higher risk of HPV infection. Preventive strategies for cervical cancer in low-resource settings should target women aged 30-50 years for HPV screening, and should focus treatment and follow-up on HPV-16/18-positive women. Further studies are needed to clarify if other risk factors require attention. (C) 2015 Elsevier Ltd. All rights reserved.