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01-03-2010 | Original paper

Human papillomavirus infection in women with and without cervical cancer in Nepal

Authors: Ang Tshering Lama Sherpa, Gary M. Clifford, Salvatore Vaccarella, Sadhina Shrestha, Mari Nygård, Balman Singh Karki, Peter J. F. Snijders, Chris J. L. M. Meijer, Silvia Franceschi

Published in: Cancer Causes & Control | Issue 3/2010

Abstract

Objectives

Cervical cancer is the most common malignancy among Nepalese women. Rational prevention measures are informed by epidemiological data on human papillomavirus (HPV) prevalence.

Methods

Cervical specimens were obtained from 932 married women aged 15–59 years from the general population of Bharatpur, Nepal, as well as from 61 locally diagnosed invasive cervical cancers (ICC). HPV was detected using a GP5+/6+ PCR-based assay.

Results

Among the general population, the overall prevalence of HPV was 8.6% (6.1% for high-risk types). Prevalence of abnormal Pap smears was 3.6%, including five high-grade squamous intraepithelial lesions. Residence in slum housing, lower education level, ≥3 sexual partners in a woman's lifetime, and husband’s extramarital affairs were significantly associated with HPV positivity. HPV prevalence was relatively constant across all age groups. HPV16 was the most common type, both among the general population (1.9%) and among 54 women with HPV-positive ICC (68.5%). HPV18 (22.2%) and 45 (5.6%) were also common in ICC.

Conclusions

Nepal has an intermediate burden of HPV infection, lower than many areas in India and China. Approximately 80% of cervical cancer in Nepal is theoretically preventable by HPV16/18 vaccines. In the meantime, screen-and-treat approaches should be encouraged to overcome difficulties that were encountered to recall women with screening-positive findings.

United Nations Educational Scientific and Cultural Organization (2006) EFA Global Monitoring Report. Available from URL: http://gmr.uis.unesco.org/selectindicators.aspx

The World Bank Group (2006) 2006 World Development Indicators. Table 2.7: Poverty. Available from URL: http://devdata.worldbank.org/wdi2006/contents/Section2.htm

World Health Organization (2006) The world health report 2006: working together for health. World Health Organization, Geneva

B.P. Koirala Memorial Cancer Hospital (Nepal) (2004) Annual report 2003. B.P. Koirala Memorial Cancer Hospital, Chitawan

Maucort-Boulch D, Franceschi S, Plummer M (2008) International correlation between human papillomavirus prevalence and cervical cancer incidence. Cancer Epidemiol Biomarkers Prev 17:717–720CrossRefPubMed

Kahn JA, Burk RD (2007) Papillomavirus vaccines in perspective. Lancet 369:2135–2137CrossRefPubMed

Qiao YL, Sellors JW, Eder PS et al (2008) A new HPV-DNA test for cervical-cancer screening in developing regions: a cross-sectional study of clinical accuracy in rural China. Lancet Oncol 9:929–936CrossRefPubMed

Sankaranarayanan R, Nene BM, Shastri SS et al (2009) HPV screening for cervical cancer in rural India. N Engl J Med 360:1385–1394CrossRefPubMed

Clifford GM, Gallus S, Herrero R et al (2005) Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 366:991–998CrossRefPubMed

10.

Roda Husman AM, Snijders PJ, Stel HV, van den Brule AJ, Meijer CJ, Walboomers JM (1995) Processing of long-stored archival cervical smears for human papillomavirus detection by the polymerase chain reaction. Br J Cancer 72:412–417PubMed

11.

Jacobs MV, Walboomers JM, Snijders PJ et al (2000) Distribution of 37 mucosotropic HPV types in women with cytologically normal cervical smears: the age-related patterns for high-risk and low-risk types. Int J Cancer 87:221–227CrossRefPubMed

12.

van den Brule AJ, Pol R, Fransen-Daalmeijer N, Schouls LM, Meijer CJ, Snijders PJ (2002) GP5+/6+ PCR followed by reverse line blot analysis enables rapid and high-throughput identification of human papillomavirus genotypes. J Clin Microbiol 40:779–787CrossRefPubMed

13.

Muñoz N, Bosch FX, de Sanjosé S et al (2003) Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 348:518–527CrossRefPubMed

14.

Doll R, Payne P, Waterhouse J (1966) Cancer incidence in five continents: a technical report. Springer-Verlag (for UICC), Berlin

15.

Franceschi S, Rajkumar R, Snijders PJF et al (2005) Papillomavirus infection in rural women in southern India. Br J Cancer 92:601–606CrossRefPubMed

16.

Dai M, Bao YP, Li N et al (2006) Human papillomavirus infection in Shanxi Province, People’s Republic of China: a population-based study. Br J Cancer 95:96–101CrossRefPubMed

17.

Li LK, Dai M, Clifford GM et al (2006) Human papillomavirus infection in Shenyang City, People’s Republic of China: a population-based study. Br J Cancer 95:1593–1597CrossRefPubMed

18.

Wu RF, Dai M, Qiao YL et al (2007) Human papillomavirus infection in women in Shenzhen City, People’s Republic of China, a population typical of recent Chinese urbanisation. Int J Cancer 121:1306–1311CrossRefPubMed

19.

Dondog B, Clifford GM, Vaccarella S et al (2008) Human papillomavirus infection in Ulaanbaatar, Mongolia: a population-based study. Cancer Epidemiol Biomarkers Prev 17:1731–1738CrossRefPubMed

20.

Keita N, Clifford GM, Koulibaly M et al (2009) HPV infection in women with and without cervical cancer in Conakry, Guinea. Br J Cancer 101:865–870

21.

Anh PT, Hieu NT, Herrero R et al (2003) Human papillomavirus infection among women in South and North Vietnam. Int J Cancer 104:213–220CrossRef

22.

Sukvirach S, Smith JS, Tunsakul S et al (2003) Population-based human papillomavirus prevalence in Lampang and Songkla, Thailand. J Infect Dis 187:1246–1256CrossRefPubMed

23.

De Vuyst H, Clifford GM, Li N, Franceschi S (2009) HPV infection in Europe. Eur J Cancer 45:2632–2639

24.

Thomas JO, Herrero R, Omigbodun AA et al (2004) Prevalence of papillomavirus infection in women in Ibadan, Nigeria: a population-based study. Br J Cancer 90:638–645CrossRefPubMed

25.

Franceschi S, Herrero R, Clifford GM et al (2006) Variations in the age-specific curves of human papillomavirus prevalence in women worldwide. Int J Cancer 119:2677–2684CrossRefPubMed

26.

Castle PE, Schiffman M, Herrero R et al (2005) A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica. J Infect Dis 191:1808–1816CrossRefPubMed

27.

Khan MJ, Castle PE, Lorincz AT et al (2005) The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst 97:1072–1079PubMedCrossRef

28.

Vaccarella S, Franceschi S, Herrero R et al (2006) Sexual behavior, condom use and HPV: pooled analysis of the International Agency for Research on Cancer HPV Prevalence Surveys. Cancer Epidemiol Biomarkers Prev 15:326–333CrossRefPubMed

29.

Bardin A, Vaccarella S, Clifford GM et al (2008) Human papillomavirus infection in women with and without cervical cancer in Warsaw, Poland. Eur J Cancer 44:557–564CrossRefPubMed

30.

Smith JS, Lindsay L, Hoots B et al (2007) Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a meta-analysis update. Int J Cancer 121:621–632CrossRefPubMed

31.

Agurto I, Arrossi S, White S et al (2005) Involving the community in cervical cancer prevention programs. Int J Gynaecol Obstet 89(Suppl 2):S38–S45CrossRefPubMed

32.

Murillo R, Almonte M, Pereira A et al (2008) Cervical cancer screening programs in Latin America and the Caribbean. Vaccine 26(Suppl 11):L37–L48CrossRefPubMed

33.

Garland SM, Cuzick J, Domingo EJ et al (2008) Recommendations for cervical cancer prevention in Asia Pacific. Vaccine 26(Suppl 12):M89–M98CrossRefPubMed

Title: Human papillomavirus infection in women with and without cervical cancer in Nepal
Authors: Ang Tshering Lama Sherpa
Gary M. Clifford
Salvatore Vaccarella
Sadhina Shrestha
Mari Nygård
Balman Singh Karki
Peter J. F. Snijders
Chris J. L. M. Meijer
Silvia Franceschi
Publication date: 01-03-2010
Publisher: Springer Netherlands
Published in: Cancer Causes & Control / Issue 3/2010
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-009-9467-z

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