Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia.

Autor:	Pärna K; Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia kersti.parna@ut.ee., Nygård M; Department of Research, Cancer Registry of Norway, Oslo, Norway., Tisler A; Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia., Toompere K; Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia., Naaber P; SYNLAB Estonia, Tallinn, Estonia.; Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia., Ratnik K; SYNLAB Estonia, Tallinn, Estonia.; Department of Human Genetics, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia., Ķīvīte Urtāne A; Institute of Public Health, Rīga Stradiņš University, Rīga, Latvia.; Department of Public Health and Epidemiology, Rīga Stradiņš University, Rīga, Latvia., Zodzika J; Institute of Public Health, Rīga Stradiņš University, Rīga, Latvia.; Department of Obstetrics and Gynaecology, Rīga Stradiņš University, Rīga, Latvia., Stankūnas M; Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania., Baltzer N; Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden., Uusküla A; Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Jun 01; Vol. 13 (6), pp. e069558. Date of Electronic Publication: 2023 Jun 01.
DOI:	10.1136/bmjopen-2022-069558
Abstrakt:	Objectives: To describe age-specific and type-specific carcinogenic human papillomavirus (HPV) prevalence prior to large-scale effect of HPV vaccines in Estonia and to analyse the risk factors associated with carcinogenic HPV. Design: Cross-sectional study using self-administered questionnaire and self-collected vaginal swabs for detection of HPV infection. Setting: Estonian Biobank database. Participants: Stratified random sample of women aged 30-33, 57-60 and 67-70 years living in one of the three largest counties in Estonia. Of 3065 women approached, 1347 (43.9%) returned questionnaires and specimens for HPV DNA detection. Outcome Measures: HPV prevalence and fully adjusted ORs with 95% CIs for risk factors. Results: HPV prevalence was highest among women aged 30-33 years (18.7%; 95% CI 15.8 to 21.9) followed by those aged 67-70 years (16.7%; 95% CI 12.4 to 22.0) and 57-60 years (10.2%; 95% CI 7.8 to 13.3). HPV16 and HPV56 were the most common among women aged 30-33 years (both 4.0%; 95% CI 2.7 to 5.9), and HPV68 was the most common among women aged 57-60 years (2.8%; 95% CI 1.5 to 4.7) and 67-70 years (6.4%; 95% CI 3.6 to 10.4). Vaccination with nonavalent vaccine would have halved the carcinogenic HPV prevalence among women aged 30-33 years. The odds of infection with carcinogenic HPV were higher among women with six or more sexual partners among younger (OR 2.99; 95% CI 1.54 to 5.81) and older (OR 3.80; 95% CI 1.25 to 11.55) women and lower (OR 0.35; 95% CI 0.17 to 0.72) among younger married women. Conclusions: This study demonstrated U-shaped age-specific genotype profile of carcinogenic HPV prevalence, indicating that public health providers should focus on developing exit strategies for the cervical cancer screening programme in Estonia with a possible extension of HPV testing beyond the current screening age of 65 years. Generalisability of the findings of this study may be affected by the low response rate. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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