Human Papillomavirus infection in a sample of young women with normal PAP smear
Keywords:
HPV, Colombia, cytology, risk factorsAbstract
Introduction: Cancer of the cervix has the highest mortality rates due to cancer among Colombian women in reproductive age. Human papillomavirus infection is a necessary but not sufficient, etiologic factor in the development of cervical cancer: only a minority of infections progress towards cancer. There are other cofactors required for malignant transformation.
Objective: To establish the prevalence of HPV infection among 218 Colombian women aged 18-36, with normal cervical cytology results and to analyze some risk factors for infection.
Materials and methods: HPV DNA was detected in cervical scrapes by general primers GP5+/GP6+ based PCR. Information about factors associated to infection was obtained by personal interviews.
Results: HPV prevalence was 17.4%. Higher risk of infection was associated to having had more than five sexual partners (OR= 3.21; CI 95% 1.01-10.17), not having a regular sexual partner (OR= 2.65; CI 95% 1.16-6.03), and no use of condom by sexual partners (OR= 2.54; CI 95% 1.0-7.03). Women with children had lower risk than nulliparous women, and risk decreased as the number of pregnancies increased. We have not found a significant association between hpv infection and the other factors analyzed.
Conclusion: As observed in other countries, we found a high prevalence of HPV infection in young women with normal cytology results. We have found a higher risk of infection related to sexual factors such as number of sexual partners, regular sexual partner, parity, and partner’s condom use.
Author Biographies
María Mercedes Bravo, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, E.S.E., Bogotá, D.C., Colombia, Laboratorio de Inmunología
Olga Medina, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, E.S.E., Bogotá, D.C., Colombia, Laboratorio de Inmunología
Diana Melgarejo, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, E.S.E., Bogotá, D.C., Colombia, Laboratorio de Inmunología
Martha Lucía Serrano, Instituto Nacional de Cancerología
Instituto Nacional de Cancerología, E.S.E., Bogotá, D.C., Colombia, Laboratorio de Inmunología
References
Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001; 94(2): 153-156. https://doi.org/10.1002/ijc.1440
Medina M. Atlas de mortalidad por cáncer en Colombia 1990,1, Instituto Nacional de Cancerología; Santafé de Bogotá: Nuevas ediciones; 1994:76-77.
Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV et al. Human papilloma virus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189(1): 12-9.
https://doi.org/10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F
Holowaty P, Miller AB, Rohan T, To T. Natural history of dysplasia of the uterine cervix. J Natl Cancer Inst 1999; 91(3): 252-8. https://doi.org/10.1093/jnci/91.3.252
Muñoz N, Franceschi S, Bosetti C, Moreno V, Herrero R, Smith JS et al. Role of parity and human papillomavirus in cervical cancer: The IARC multicentric case-control study. Lancet 2002; 359(9312):1093-101. https://doi.org/10.1016/S0140-6736(02)08151-5
Moreno V, Bosch FX, Munoz N, Meijer CJ, Shah KV, Walboomers JM et al. Effect of oral contraceptives on risk of cervical cancer in women with human papilloma virus infection: The IARC multicentric case-control study. Lancet 2002; 359(9312): 1085-92. https://doi.org/10.1016/S0140-6736(02)08150-3
Scott M, Nakagawa M, Moscicki AB. Cell-mediated immune response to human papillomavirus infection. Clin Diagn Lab Immunol 2001; 8(2): 209-20. https://doi.org/10.1128/CDLI.8.2.209-220.2001
Castellsague X, Bosch FX, Munoz N. Environmental co-factors in HPV carcinogenesis. Virus Res 2002; 89(2): 191-9. https://doi.org/10.1016/S0168-1702(02)00188-0
Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M et al The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002; 287(16): 2114-9. https://doi.org/10.1001/jama.287.16.2114
Saiki RK, Scharf S, Faloona F, Mullis KB, Horn GT, Erlich HA et al. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. Science 1985; 230(4732): 1350-4. https://doi.org/10.1126/science.2999980
. Roda Husman AM, Walboomers JM, Van den Brule AJC, Meijer CJ, Snijders PJ. The use of general primers GP5 and GP6 elongated at their 3' ends with adjacent highly conserved sequences improves human papillomavirus detection by PCR. J Gen Virol 1995; 76 (Pt4):1057-62. https://doi.org/10.1099/0022-1317-76-4-1057
Lazcano-Ponce E, Herrero R, Munoz N, Cruz A, Shah KV, Alonso P et al. Epidemiology of HPV infection among Mexican women with normal cervical cytology. Int J Cancer 2001; 91(3): 412-20. https://doi.org/10.1002/1097-0215(20010201)91:3<412::AID-IJC1071>3.0.CO;2-M
Jacobs MV, Walboomers JM, Snijders PJ, Voorhorst FJ, Verheijen RH, Fransen-Daalmeijer N et al. Distribution of 37 mucosotropic h pv types in women with cytologically normal cervical smears: The agerelated patterns for high-risk and low-risk types. Int J Cancer 2000 Jl; 87(2): 221-7. https://doi.org/10.1002/1097-0215(20000715)87:2<221::AID-IJC11>3.0.CO;2-2
Séllors JW, Mahony JB, Kaczorowski J, Lytwyn A, Bangura H, Ghong S et al. Prevalence and predictors of human papillomavirus infection in women in Ontario, Canada. Survey of HPV in Ontario Women (SHOW) Group. CMAJ 2000; 163(5): 503-8.
Herrero R, Hildesheim A, Bratti C, Sherman ME, Hutchinson M, Morales J et al. Population-based study of human papillomavirus infection and cervical neoplasia in rural Costa Rica. J Natl Cancer Inst 2000; 92(6): 464-74. https://doi.org/10.1093/jnci/92.6.464
Molano M, Posso H, Weiderpass E, Van den Brule AJC, Ronderos M, Franceschi S et al. Prevalence and determinants of HPV infection among Colombian women with normal cytology. Br J Cancer 2002; 87 (3): 324-33. https://doi.org/10.1038/sj.bjc.6600442
Burk RD, Ho GY, Beardsley L, Lempa M, Peters M, Bierman R. Sexual behavior and partner characteristics are the predominant risk factors for genital human papillomavirus infection in young women. J Infect Dis 1996; 174(4): 679-89. https://doi.org/10.1093/infdis/174.4.679
Manhart LE, Koutsky LA. Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis. Sex Transm Dis 2002; 29(11): 725-35. https://doi.org/10.1097/00007435-200211000-00018
Herrero R, Brinton LA, Reeves WC, Brenes MM, Tenorio F, De Britton RC et al. Risk factors for invasive carcinoma of the uterine cervix in Latin America. Bull Pan Am Health Organ 1990; 24(3): 263-283.
Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA. Genital human papillomavirus infection: Incidence and risk factors in a cohort of female university students. Am J Epidemiol 2003; 157(3): 218-26. https://doi.org/10.1093/aje/kwf180
Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 1997; 102(5A):3-8. https://doi.org/10.1016/S0002-9343(97)00177-0
Juarez-Figueroa LA, Wheeler CM, Uribe-Salas FJ, Conde-Glez CJ, Zampilpa-Mejia LG, Garcia-Cisneros S et al. Human papilloma virus: A highly prevalent sexually transmitted disease agent among female sex workers from Mexico City. Sex Transm Dis 2001; 28(3): 125-30. https://doi.org/10.1097/00007435-200103000-00001
Kjaer SK, Svare El, Worm AM, Walboomers JM, Meijer CJ, Van den Brule AJC, Human papillomavirus infection in Danish female sex workers. Decreasing prevalence with age despite continuously high sexual activity. Sex Transm Dis 2000; 27(8): 438-45. https://doi.org/10.1097/00007435-200009000-00003
De Sanjose S, Bosch FX, Munoz N, Shah K. Social differences in sexual behaviour and cervical cancer, IARC Sci Publ 1997; 138: 309-17.
De Sanjose S, Bosch FX, Munoz N, Tafur L, Gili M, Izarzugaza I et al. Socioeconomic differences in cervical cancer: Two case-control studies in Colombia and Spain. Am J Public Health 1996; 86(11): 1532-8. https://doi.org/10.2105/AJPH.86.11.1532
Munoz N, Franceschi S, Bosetti C, Moreno V, Herrero R, Smith IS et al. Role of parity and human papilloma virus in cervical cancer: The IARC multicentric case-control study. Lancet 2002; 359(9312): 1093-101. https://doi.org/10.1016/S0140-6736(02)08151-5
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