Prevalence of type-specific human papillomavirus and pap results in Chinese women: a multi-center, population-based cross-sectional study
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To estimate the burden of human papillomavirus (HPV) infection among sexually active women in China.
We conducted a multi-center, population-based study between May 2006 and April 2007. A total of 4,215 women aged 17–54 years were surveyed from five geographical sites: Beijing, Shanghai, Shanxi, Henan, and Xinjiang. Direct endocervical exfoliated cells were collected from consenting participants for Sure Path liquid-based cytology (BD) and HPV testing. HPV testing was performed with Hybrid Capture II (Qiagen) with high-risk and low-risk probes, and Linear Array (Roche) was utilized for HPV genotyping.
Approximately 11 % of the study population had a cytological abnormality (ASCUS or worse). HPV prevalence in the entire study population was 14.3 % (age-standardized to the world standard female population 14.5 %). The most prevalent types found were HPV16 (2.9 %), HPV52 (1.7 %), HPV58 (1.5 %), HPV33 (1 %), and HPV18 (0.8 %). Patterns of HPV prevalence differed by age, geographic region, and cytology findings. However, HPV16 was predominant among all grades of cytological abnormalities for all areas.
Although HPV18 appeared to be less frequent among population-based samples of China, given the high prevalence of HPV 16 and 18 in high-grade squamous intraepithelial lesion (HSIL) or worse pap abnormalities, prophylactic HPV16/18 vaccines should substantially reduce the burden of cervical cancer in China.
KeywordsHuman papillomavirus Cervical cancer Type-specific prevalence China Population-based study
- 2.Ferlay J, Shin HR, Bray F, Forman D, Mathers C and Parkin DM. (2010) GLOBOCAN 2008, Cancer incidence and mortality worldwide: IARC Cancer Base No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr
- 3.Canfell K, Shi JF, Lew JB, Walker R, Zhao FH, Simonella L, Chen JF, Legood R, Smith MA, Nickson C, Qiao YL (2011) Prevention of cervical cancer in rural China: evaluation of HPV vaccination and primary HPV screening strategies. Vaccine 29(13):2487–2494. doi:10.1016/j.vaccine.2010.12.085 PubMedCrossRefGoogle Scholar
- 4.Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Munoz N (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189(1):12–19. doi:10.1002/(SICI)1096-9896(199909)189:1<12:AID-PATH431>3.0.CO;2-F PubMedCrossRefGoogle Scholar
- 6.Bioscience Division, Los Alamos National Laboratory, the Regents of the University of California. HPV sequence database: PV types and hosts _database online Available at: http://hpv-web.lanl.gov/stdgen/virus/cgi-bin/hpv_organisms.cgi?dbname_hpv Accessed August 23, 2004
- 9.Garland S, Park SN, Ngan HY, Frazer I, Tay EH, Chen CJ, Bhatla N, Pitts M, Shin HR, Konno R, Smith J, Pagliusi S, Park JS (2008) The need for public education on HPV and cervical cancer prevention in Asia. Opinions of experts at the AOGIN conference. Vaccine 26(43):5435–5440. doi:10.1016/j.vaccine.2008.07.077 PubMedCrossRefGoogle Scholar
- 10.Harper DM, Franco EL, Wheeler CM, Moscicki AB, Romanowski, Roteli-Martins CM, Jenkins D, Schuind A, Costa Clemens SA, Dubin G (2006) Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18 follow-up from a randomised control trial. Lancet 367(9518):1247–1255PubMedCrossRefGoogle Scholar
- 13.China national cause-of-death surveys. China Cancer Database Web site. Available at http://cancernet.cicams.ac.cn/data/epi/census
- 14.Stephen AL, Thompson CH, Tattersall MH, Cossart YE, Rose BR (2000) Analysis of mutations in the URR and E6/E7 oncogenes of HPV 16 cervical cancer isolates from central China. Int J Cancer 86(5):695–701. doi:10.1002/(SICI)1097-0215(20000601)86:5<695:AID-IJC15>3.0.CO;2-C PubMedCrossRefGoogle Scholar
- 15.Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat (2009). World population prospects: The 2008 Revision. Highlights. New York: United Nations. Available from http://www.un.org/esa/population
- 17.Dai M, Bao YP, Li N, Clifford GM, Vaccarella S, Snijders PJ, Huang RD, Sun LX, Meijer CJ, Qiao YL, Franceschi S (2006) Human papillomavirus infection in Shanxi Province, People’s Republic of China: a population-based study. Br J Cancer 95(1):96–101. doi:10.1038/sj.bjc.6603208 PubMedCrossRefGoogle Scholar
- 18.Wu RF, Dai M, Qiao YL, Clifford GM, Liu ZH, Arslan A, Li N, Shi JF, Snijders PJ, Meijer CJ, Franceschi S (2007) Human papillomavirus infection in women in Shenzhen City, People’s Republic of China, a population typical of recent Chinese urbanisation. Int J Cancer 121(6):1306–1311. doi:10.1002/ijc.22726 PubMedCrossRefGoogle Scholar
- 19.Li LK, Dai M, Clifford GM, Yao WQ, Arslan A, Li N, Shi JF, Snijders PJ, Meijer CJ, Qiao YL, Franceschi S (2006) Human papillomavirus infection in Shenyang City, People’s Republic of China: a population-based study. Br J Cancer 95(11):1593–1597. doi:10.1038/sj.bjc.6603450 PubMedCrossRefGoogle Scholar
- 22.Munoz N, Mendez F, Posso H, Molano M, van den Brule AJ, Ronderos M, Meijer C, Munoz A (2004) Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of Colombian women with normal cytological results. J Infect Dis 190(12):2077–2087. doi:10.1086/425907 PubMedCrossRefGoogle Scholar
- 27.de Sanjose S, Diaz M, Castellsague X, Clifford G, Bruni L, Munoz N, Bosch FX (2007) Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis 7(7):453–459. doi:10.1016/S1473-3099(07)70158-5 PubMedCrossRefGoogle Scholar
- 28.Herrero R, Castle PE, Schiffman M, Bratti MC, Hildesheim A, Morales J, Alfaro M, Sherman ME, Wacholder S, Chen S, Rodriguez AC, Burk RD (2005) Epidemiologic profile of type-specific human papillomavirus infection and cervical neoplasia in Guanacaste Costa Rica. J Infect Dis 191(11):1796–1807. doi:10.1086/428850 PubMedCrossRefGoogle Scholar