Canadian oncogenic human papillomavirus cervical infection prevalence: Systematic review and meta-analysis

Abstract

BackgroundOncogenic human papillomavirus (HPV) infection prevalence is required to determine optimal vaccination strategies. We systematically reviewed the prevalence of oncogenic cervical HPV infection among Canadian females prior to immunization.MethodsWe included studies reporting DNA-confirmed oncogenic HPV prevalence estimates among Canadian females identified through searching electronic databases (e.g., MEDLINE) and public health websites. Two independent reviewers screened literature results, abstracted data and appraised study quality. Prevalence estimates were meta-analyzed among routine screening populations, HPV-positive, and by cytology/histology results.ResultsThirty studies plus 21 companion reports were included after screening 837 citations and 120 full-text articles. Many of the studies did not address non-response bias (74%) or use a representative sampling strategy (53%).Age-specific prevalence was highest among females aged < 20 years and slowly declined with increasing age. Across all populations, the highest prevalence estimates from the meta-analyses were observed for HPV types 16 (routine screening populations, 8 studies: 8.6% [95% confidence interval 6.5-10.7%]; HPV-infected, 9 studies: 43.5% [28.7-58.2%]; confirmed cervical cancer, 3 studies: 48.8% [34.0-63.6%]) and 18 (routine screening populations, 8 studies: 3.3% [1.5-5.1%]; HPV-infected, 9 studies: 13.6% [6.1-21.1%], confirmed cervical cancer, 4 studies: 17.1% [6.4-27.9%].ConclusionOur results support vaccinating females < 20 years of age, along with targeted vaccination of some groups (e.g., under-screened populations). The highest prevalence occurred among HPV types 16 and 18, contributing a combined cervical cancer prevalence of 65.9%. Further cancer protection is expected from cross-protection of non-vaccine HPV types. Poor study quality and heterogeneity suggests that high-quality studies are needed.

The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology

“…Our study population consisted of women with various genital complaints and nearly half of the study participants (45.2%) presented HPV positivity which was significantly higher compared to studies from Turkey [16,17] and several western countries [18,19] and similar to some developing countries including Latin America and the Caribbean [20,21]. Apart from these elevated rates of HPV infection, we also found that HPV 16 and HPV 58 was associated with common abnormal cervical smear test results including high rates of ASCUS, LSIL and HSIL.…”

“…Briefly HPV genotyping performed by the F-HPV typing™ multiplex PCR (Molgentix SL, Barcelona, Spain). The assay uses 16 specific primers amplifying within E6 and E7 regions of the HPV genome and permits the detection of 13 high risk genotypes (16,18,31,33,35,39,45, 51, 52, 56, 58, 59 and 68) and two low-risk genotypes (6 and 11). The presence of DNA of these HPV subtypes were detected by multiplex PCR amplification using type specific primers [14,15].…”

“…Although genital HPV types have been subdivided into high-risk (HR-HPV) types (frequently associated with invasive CC) and low-risk (LR-HPV) types (found mainly in genital warts), there is still no consensus on categorization of many HPV subtypes with low prevalence according to CC risk. Current epidemiologic data identifies 15 HPV types as high-risk types (16,18,31,33,35,39,45, 51, 52, 56, 58, 59, 68, 73, and 82) and 12 types (6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108) as low-risk types [9]. Moreover, infection with two specific high-risk HPVs (HPV-16 and HPV-18) is reported to be linked with 90% of all uterine cervical cancers, and more than half of other anogenital tumors, and a small percentage of head and neck tumors [10].…”

Prevalência de infecção cervical por papilomavírus humano e neoplasia intraepitelial cervical em mulheres HIV-positivas e negativas

“…As mulheres positivas para o HIV apresentaram, neste estudo, 6,3% de infecções por múltiplos tipos de HPV, porcentagem menor do que os 64,8% encontrados em outros estudos 20,34 . De acordo com metanálise avaliando a prevalência da infecção cervical pelo HPV em várias regiões do mundo, a prevalência do HPV está fortemente relacionada à idade, tendo em vista que a infecção cervical pelo HPV é mais intensa nas mulheres jovens, com pico de prevalência igual ou inferior a 25 anos, diminuindo nas mulheres com mais idade 2 . De acordo com outro estudo, um segundo pico de prevalência foi observado em algumas regiões, em mulheres entre 35 e 50 anos, provavelmente referente a novas infecções relacionadas a mudanças no comportamento sexual dessas mulheres 8 .…”

“…A infecção pelo HPV é considerada a doença sexualmente transmissível (DST) mais prevalente no mundo. A relação entre o câncer de colo e a infecção pelo HPV está bem estabelecida na literatura, com detecção de HPV de alto risco em quase 100% dos casos 2 . Estudo de metanálise encontrou o HPV em 87% dos casos de câncer de toda a população mundial 3 .…”