Urbanization and baseline prevalence of genital infections including Candida, Trichomonas, and human papillomavirus and of a disturbed vaginal ecology as established in the Dutch Cervical Screening Program
Urbanization and baseline prevalence of genital infections including Candida, Trichomonas, and human papillomavirus and of a disturbed vaginal ecology as established in the Dutch Cervical Screening Program
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DOI：
10.1067/mob.2002.123605
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发表时间：
2002-08-01
影响因子：
9.8
通讯作者：
Kok, LP
中科院分区：
文献类型：
--
作者：
Boon, ME;Claasen, HHV;Kok, LP
目的：在缺乏乳酸杆菌的情况下球状杆菌的过度生长（细菌性阴道病）被认为是阴道生态系统“紊乱”的标志。本研究的目的是确定生殖器感染和阴道生态系统紊乱的基线患病率及其与城市化的关系。 研究设计：在荷兰国家筛查计划的背景下，1 个细胞学实验室对超过 190,000 份宫颈涂片进行了筛查。对无症状并在市级单位法定档案中登记的妇女进行了邀请筛查。城市化（居住地）源自邮政编码。为了调查与城市化相关的患病率趋势，采用了 Schaafsma 方法。结果：每 1000 名接受筛查的女性中，细菌性阴道病得分最高（36.1），其次是念珠菌（12.6）。人乳头瘤病毒、细菌性阴道病和滴虫的较高患病率与城市化有关，而念珠菌则不然。结论：人乳头瘤病毒和滴虫在居住在大城市的女性中更常见，而在荷兰，大城市也是癌前细胞学证据的高危人群。我们关于细菌性阴道病基线流行模式的研究结果支持了细菌生态系统紊乱在宫颈癌发生中的重要性的假设。
OBJECTIVE: An overgrowth of coccoid bacilli in the absence of lactobacilli (bacterial vaginosis) is considered a sign of a "disturbed" vaginal ecologic system. The aim of this study was to establish the baseline prevalence of genital infections and of a disturbed vaginal ecologic system and their relationship to urbanization.STUDY DESIGN: More than 190,000 cervical smears were screened by 1 cytology laboratory in the context of the Dutch national screening programs. The women who were symptom free and had been registered in the statutory files of municipal units were screened by invitation. Urbanization (place of residence) was derived from the postal code. To investigate a trend in prevalence in relation to urbanization, Schaafsma's method was used.RESULTS: Bacterial vaginosis had the highest score per 1000 screened women (36.1), followed by Candida (12.6). Higher prevalence of human papillomavirus, bacterial vaginosis, and Trichomonas was related to urbanization as was, whereas Candida was not.CONCLUSION: Human papillomavirus and Trichomonas are more frequently found in women who live in the large cities, which in The Netherlands also harbor the high-risk population for premalignant cytologic evidence. Our findings concerning the baseline prevalence pattern of bacterial vaginosis support the hypothesi's of the importance of a disturbed bacterial ecologic system in cervical carcinogenesis.