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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Pre-vaccine era cervical human papillomavirus infection among screening population of women in west Austria

Authors: Wegene Borena, Margarethe Grünberger, Andreas Widschwendter, Karl Heinz Kraxner, Elisabeth Marth, Peter Mayr, Joerg Meier, Norman Ruth, Aida Tort Guerrero, Christian Marth, Dorothee Holm-von Laer

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

In order to evaluate the newly implemented gender-neutral HPV vaccination program, knowledge on the pre-vaccine prevalence of HPV infection is of paramount importance. Data on HPV infection among the women with no known previous cytological abnormalities are inexistent in Austria. This study presents data on the prevalence and distribution of HPV genotypes among women with no known cytological abnormalities in west Austria.

Methods

Women between 18 and 65 years of age attending annual cervical cancer screening examinations were included in the study. Data on socio-demographic and reproductive factors were collected using structured questionnaires. Corresponding cervical swab samples were tested for the presence of HPV DNA and were genotyped. Questionnaire data and HPV status were linked with the corresponding cytological findings.

Results

A total of 542 women were included in the study. The mean age of the study participants was 35.9 (SD = 11.5). The prevalence of HPV infection was 20.5 %. HPV 16 (6.5 %), HPV 33 (3.3 %) and HPV 31 (3.0 %) were the dominant genotypes detected. Multivariate analysis showed that women younger than 30 years of age, smokers, women with a higher number of lifetime sexual partners and those living in the eastern districts of the study region were at significantly higher risk of HPV infection.

Conclusions

With this study we present the first data on the prevalence of cervical HPV genotypes among a screening population in Austria. The results not only fill the missing information on HPV infection in this group of women in the country, they also provide baseline data for a future evaluation of the impact of the Austrian gender-neutral HPV immunization program. Moreover, our finding of higher HPV prevalence in the eastern compared to the western district of the study region may – at least partly – explain the east–west gradient in the standardized incidence rate of cervical cancer in the region.
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Literature
1.
go back to reference zur Hausen H. Papillomaviruses causing cancer: evasion from host-cell control in early events in carcinogenesis. J Natl Cancer Inst. 2000;3(92(9)):690–8.CrossRef zur Hausen H. Papillomaviruses causing cancer: evasion from host-cell control in early events in carcinogenesis. J Natl Cancer Inst. 2000;3(92(9)):690–8.CrossRef
2.
go back to reference Scheurer ME, Tortolero-Luna G, Adler-Storthz K. Human papillomavirus infection: biology, epidemiology, and prevention. Int J Gynecol Cancer. 2005;15(5):727–46.CrossRefPubMed Scheurer ME, Tortolero-Luna G, Adler-Storthz K. Human papillomavirus infection: biology, epidemiology, and prevention. Int J Gynecol Cancer. 2005;15(5):727–46.CrossRefPubMed
3.
go back to reference Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine. 2006;24 Suppl 1:S1–15.PubMed Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine. 2006;24 Suppl 1:S1–15.PubMed
4.
go back to reference Garland SM, Hernandez-Avila M, Wheeler CM, et al. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med. 2007;356(19):1928–43.CrossRefPubMed Garland SM, Hernandez-Avila M, Wheeler CM, et al. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med. 2007;356(19):1928–43.CrossRefPubMed
5.
go back to reference Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, Moreira Jr ED, Ngan Y, et al. Broad spectrum HPV vaccine study. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711–23.CrossRefPubMed Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, Moreira Jr ED, Ngan Y, et al. Broad spectrum HPV vaccine study. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711–23.CrossRefPubMed
7.
go back to reference Paavonen J, Naud P, Salmerón J, et al. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet. 2009;374(9686):301–14.CrossRefPubMed Paavonen J, Naud P, Salmerón J, et al. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet. 2009;374(9686):301–14.CrossRefPubMed
8.
go back to reference Tabrizi SN, Brotherton JM, Kaldor JM, et al. Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross-sectional study. Lancet Infect Dis. 2014;14(10):958–66. doi:10.1016/S1473-3099(14)70841-2.CrossRefPubMed Tabrizi SN, Brotherton JM, Kaldor JM, et al. Assessment of herd immunity and cross-protection after a human papillomavirus vaccination programme in Australia: a repeat cross-sectional study. Lancet Infect Dis. 2014;14(10):958–66. doi:10.​1016/​S1473-3099(14)70841-2.CrossRefPubMed
9.
go back to reference Harrison C, Britt H, Garland S, et al. Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study. PLoS One. 2014;9(9), e105967.CrossRefPubMedPubMedCentral Harrison C, Britt H, Garland S, et al. Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study. PLoS One. 2014;9(9), e105967.CrossRefPubMedPubMedCentral
10.
go back to reference Brotherton JM, Fridman M, May CL, et al. Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. Lancet. 2011;377(9783):2085–92.CrossRefPubMed Brotherton JM, Fridman M, May CL, et al. Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. Lancet. 2011;377(9783):2085–92.CrossRefPubMed
11.
go back to reference Bresse X, Goergen C, Prager B, et al. Universal vaccination with the quadrivalent HPV vaccine in Austria: impact on virus circulation, public health and cost-effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res. 2014;14(2):269–81.CrossRefPubMed Bresse X, Goergen C, Prager B, et al. Universal vaccination with the quadrivalent HPV vaccine in Austria: impact on virus circulation, public health and cost-effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res. 2014;14(2):269–81.CrossRefPubMed
13.
go back to reference Bachtiary B, Obermair A, Dreier B, et al. Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer. Int J Cancer. 2002;102(3):237–43.CrossRefPubMed Bachtiary B, Obermair A, Dreier B, et al. Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer. Int J Cancer. 2002;102(3):237–43.CrossRefPubMed
14.
go back to reference Birner P, Bachtiary B, Dreier B, et al. Signal-amplified colorimetric in situ hybridization for assessment of human papillomavirus infection in cervical lesions. Mod Pathol. 2001;14(7):702–9.CrossRefPubMed Birner P, Bachtiary B, Dreier B, et al. Signal-amplified colorimetric in situ hybridization for assessment of human papillomavirus infection in cervical lesions. Mod Pathol. 2001;14(7):702–9.CrossRefPubMed
15.
go back to reference Rössler L, Reich O, Horvat R, et al. Human papillomavirus in high-grade cervical lesions: Austrian data of a European multicentre study. Wien Klin Wochenschr. 2013;125(19–20):591–9.CrossRefPubMed Rössler L, Reich O, Horvat R, et al. Human papillomavirus in high-grade cervical lesions: Austrian data of a European multicentre study. Wien Klin Wochenschr. 2013;125(19–20):591–9.CrossRefPubMed
16.
go back to reference Oberaigner W, Mühlböck H, Harrasser L. Tumorregister Tirol, Bericht für das Diagnosejahr 2010. Innsbruck: IET-Bericht; 2013. Oberaigner W, Mühlböck H, Harrasser L. Tumorregister Tirol, Bericht für das Diagnosejahr 2010. Innsbruck: IET-Bericht; 2013.
17.
go back to reference Cirkel C, Barop C, Beyer DA. Method comparison between Munich II and III nomenclature for Pap smear samples. J Turk Ger Gynecol Assoc. 2015;16(4):203–7.CrossRefPubMedPubMedCentral Cirkel C, Barop C, Beyer DA. Method comparison between Munich II and III nomenclature for Pap smear samples. J Turk Ger Gynecol Assoc. 2015;16(4):203–7.CrossRefPubMedPubMedCentral
18.
go back to reference World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluationof Carcinogenic Risks to Humans, Volume 90 Human Papillomaviruses. 2007. World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluationof Carcinogenic Risks to Humans, Volume 90 Human Papillomaviruses. 2007.
20.
go back to reference Iftner T, Eberle S, Iftner A, et al. Prevalence of low-risk and high-risk types of human papillomavirus and other risk factors for HPV infection in Germany within different age groups in women up to 30 years of age: an epidemiological observational study. J Med Virol. 2010;82(11):1928–39.CrossRefPubMed Iftner T, Eberle S, Iftner A, et al. Prevalence of low-risk and high-risk types of human papillomavirus and other risk factors for HPV infection in Germany within different age groups in women up to 30 years of age: an epidemiological observational study. J Med Virol. 2010;82(11):1928–39.CrossRefPubMed
21.
go back to reference Dunne EF, Unger ER, Sternberg M, et al. Prevalence of HPV infection among females in the United States. JAMA. 2007;297(8):813–9.CrossRefPubMed Dunne EF, Unger ER, Sternberg M, et al. Prevalence of HPV infection among females in the United States. JAMA. 2007;297(8):813–9.CrossRefPubMed
22.
go back to reference Franceschi S, Rajkumar R, Snijders PJ, et al. Papillomavirus infection in rural women in southern India. Br J Cancer. 2005;14; 92(3):601–6.PubMed Franceschi S, Rajkumar R, Snijders PJ, et al. Papillomavirus infection in rural women in southern India. Br J Cancer. 2005;14; 92(3):601–6.PubMed
23.
go back to reference Idso C. Sexually transmitted infection prevention in newly single older women: a forgotten health promotion need. Journal for Nurse Practitioners. 2009;5(6):440–6.CrossRef Idso C. Sexually transmitted infection prevention in newly single older women: a forgotten health promotion need. Journal for Nurse Practitioners. 2009;5(6):440–6.CrossRef
26.
go back to reference Selvakumar R, Schmitt A, Iftner T, et al. Regression of papillomas induced by cottontail rabbit papillomavirus is associated with infiltration of CD8+ cells and persistence of viral DNA after regression. J Virol. 1997;71(7):5540–8.PubMedPubMedCentral Selvakumar R, Schmitt A, Iftner T, et al. Regression of papillomas induced by cottontail rabbit papillomavirus is associated with infiltration of CD8+ cells and persistence of viral DNA after regression. J Virol. 1997;71(7):5540–8.PubMedPubMedCentral
27.
go back to reference Abramson AL, Nouri M, Mullooly V, et al. Latent Human Papillomavirus infection is comparable in the larynx and trachea. J Med Virol. 2004;72(3):473–7.CrossRefPubMed Abramson AL, Nouri M, Mullooly V, et al. Latent Human Papillomavirus infection is comparable in the larynx and trachea. J Med Virol. 2004;72(3):473–7.CrossRefPubMed
29.
go back to reference Tjalma WA, Fiander A, Reich O, HERACLES/SCALE Study Group, et al. Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe. Int J Cancer. 2013;132(4):854–67. doi:10.1002/ijc.27713.CrossRefPubMed Tjalma WA, Fiander A, Reich O, HERACLES/SCALE Study Group, et al. Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe. Int J Cancer. 2013;132(4):854–67. doi:10.​1002/​ijc.​27713.CrossRefPubMed
31.
go back to reference Sarian LO, Hammes LS, Longatto-Filho A, et al. Increased risk of oncogenic human papillomavirus infections and incident high-grade cervical intraepithelial neoplasia among smokers: experience from the Latin American screening study. Sex Transm Dis. 2009;36(4):241–8.CrossRefPubMed Sarian LO, Hammes LS, Longatto-Filho A, et al. Increased risk of oncogenic human papillomavirus infections and incident high-grade cervical intraepithelial neoplasia among smokers: experience from the Latin American screening study. Sex Transm Dis. 2009;36(4):241–8.CrossRefPubMed
32.
go back to reference Syrjänen K, Shabalova I, Petrovichev N, et al. Smoking is an independent risk factor for oncogenic human papillomavirus (HPV) infections but not for high-grade CIN. Eur J Epidemiol. 2007;22(10):723–35.CrossRefPubMed Syrjänen K, Shabalova I, Petrovichev N, et al. Smoking is an independent risk factor for oncogenic human papillomavirus (HPV) infections but not for high-grade CIN. Eur J Epidemiol. 2007;22(10):723–35.CrossRefPubMed
33.
34.
go back to reference Kavanagh K, Pollock KG, Potts A, et al. Introduction and sustained high coverage of the HPV bivalent vaccine leads to a reduction in prevalence of HPV 16/18 and closely related HPV types. Br J Cancer. 2014;110(11):2804–11.CrossRefPubMedPubMedCentral Kavanagh K, Pollock KG, Potts A, et al. Introduction and sustained high coverage of the HPV bivalent vaccine leads to a reduction in prevalence of HPV 16/18 and closely related HPV types. Br J Cancer. 2014;110(11):2804–11.CrossRefPubMedPubMedCentral
Metadata
Title
Pre-vaccine era cervical human papillomavirus infection among screening population of women in west Austria
Authors
Wegene Borena
Margarethe Grünberger
Andreas Widschwendter
Karl Heinz Kraxner
Elisabeth Marth
Peter Mayr
Joerg Meier
Norman Ruth
Aida Tort Guerrero
Christian Marth
Dorothee Holm-von Laer
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3581-0

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