Human papillomavirus infection by anatomical site among Greek men and women: a systematic review

Tsikis, Savas T; Hoefer, Lea; Charnot-Katsikas, Angella; Schneider, John A.

doi:10.1097/cej.0000000000000207

Cited by 9 publications

(13 citation statements)

References 61 publications

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“…Currently no data are available on HPV vaccination rates in men in Greece. The few cross-sectional studies on special male population groups studying the prevalence of sexually transmitted diseases (such as HIV positives, Men who have Sex with Men, partners of women with HPV lesions) have reported HPV prevalence 54.6%–78.4% for anal and 20.3–66.7% for penile cancers (most common HPV types, 6, 11, 16 and 18) [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

Riza

Karakosta

Tsiampalis

et al. 2020

IJERPH

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Cervical cancer can be largely preventable through primary and secondary prevention activities. Following the financial crisis in Greece since 2011 and the increased number of refugees/migrants since 2015 the proportion of vulnerable population groups in Greece increased greatly and the ability of the healthcare sector to respond and to cover the health needs of the population is put under tremendous stress. A cross-sectional study was designed to assess the characteristics of vulnerable women in Greece regarding cervical cancer risk factors, prevention through screening activities and Human Papilloma Virus (HPV) knowledge. Two cohorts of women aged 18 to 70 years were studied (142 in 2012 and 122 in 2017) who completed an interviewer-administered questionnaire based on the behavioural model for vulnerable populations. According to this model, the factors that affect the behaviour of women in relation with their knowledge, attitudes and beliefs towards cervical cancer and the HPV vaccine in our study sample are categorised in predisposing factors (age, educational status, nationality menopausal status and housing) and enabling factors (lack of insurance coverage). Results from both univariate and multivariate analyses show that older age, low educational background, refugee/migrant or ethnic minority (Roma) background, menopausal status, housing conditions and lack of insurance coverage are linked with insufficient knowledge on risk factors for cervical cancer and false attitudes and perceptions on cervical cancer preventive activities (Pap smear and HPV vaccine). This is the first study in Greece showing the lack of knowledge and the poor attitudes and perceptions on cervical cancer screening and the HPV vaccine in various groups of vulnerable women. Our results indicate the need of health education and intervention activities according to the characteristics and needs of each group.

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Section: Discussionmentioning

confidence: 99%

Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

Riza

Karakosta

Tsiampalis

et al. 2020

IJERPH

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“…Out of the 294 male patients included in this study, nearly half (49%) had an infection at a least one of the sites examined, with anal samples having the highest prevalence of HPV (33%). Previous studies conducted in Greece investigating male anal HPV prevalence have only looked at patients with a history of anal warts or anal carcinoma, and found HPV prevalence rates greater than 50% (Tsikis et al, 2015). The difference seen in our results could be due to the study population, as our study included asymptomatic but high risk men.…”

Section: Discussionmentioning

confidence: 99%

“…The epidemiology of HPV in Greek men is not well known as most Greek studies have focused on cervical HPV infection in women. A systematic review published by our group found that out of 50 studies on HPV prevalence and epidemiology in Greece, 20 studies have included a male population(Tsikis et al, 2015). However, the majority of these examined HPV frequency in oral and oropharyngeal cancer biopsies (n=13) while the remaining looked at HPV prevalence at anal and/or penile sites in symptomatic men.…”

Section: Introductionmentioning

confidence: 99%

“…However, the majority of these examined HPV frequency in oral and oropharyngeal cancer biopsies (n=13) while the remaining looked at HPV prevalence at anal and/or penile sites in symptomatic men. For these studies, testing was performed by commercially available test kits, and high risk subtypes may not have been well-delineated, apart from HPV types 16 and 18 (Tsikis et al, 2015). Moreover, these studies included a relatively small sample (<130), did not look at concordance at multiple sites, and did not specifically target men who may be at a higher risk for HPV infection.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors, prevalence, and site concordance of human papillomavirus in high-risk Greek men

Tsikis

Hoefer

Bethimoutis

et al. 2018

European Journal of Cancer Prevention

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The aim of this study was to determine the risk factors, genotype-specific prevalence, and concordance of human papillomavirus (HPV) infections at three anatomical sites in a cohort of high-risk Greek men. Patients were recruited from sexually transmitted infection and HIV clinics in Athens. Samples were obtained from oral, penile, and anal sites of 294 study participants and HPV testing was performed on 882 samples using next-generation sequencing. Patients also completed a questionnaire assessing risk factors for infection. The mean age of the participants was 33.1, 30% identified as men who have sex with men (MSM), and 21% were HIV positive. The prevalence of HPV was 49%; it was the highest at anal sites (33%) compared with 23% at penile sites (P=0.008) and 4% at oral sites (P<0.001). The most common HPV types in order of frequency were 6, 44, 16, 53, and 89. The genotype concordance rate was the highest between the penile and anal sites (7%), followed by 2% for anal-oral concordance. Identifying as MSM [adjusted odds ratios (aOR)=6.75, P<0.001] and being HIV positive (aOR=2.89, P=0.026) were significant risk factors for anal HPV infection, whereas alcohol use (aOR=0.45, P=0.002) was associated negatively with infection. The only significant risk factor for oral infection was an older age of sexual debut (aOR=1.32, P=0.038). Nearly half of our study participants tested positive in at least one of three anatomical sites. Using next-generation sequencing, we could identify high-risk types that are not covered by the current vaccine and would be missed by traditional HPV testing kits.

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“…Available data on Greek women suggest that infection rates may be up to 43% in certain populations. 4 Fortunately, many HPV infections and HPV-related cancers can be prevented through vaccination. Originally licensed for women, HPV vaccine recommendations have since been expanded in some countries to include boys ages 11-12, as well as catch up vaccination for young men.…”

Section: Introductionmentioning

confidence: 99%

HPV vaccine acceptability in high-risk Greek men

Hoefer

Tsikis

Bethimoutis

et al. 2017

Human Vaccines & Immunotherapeutics

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HPV is associated with malignancy in men, yet there is a lack of data on HPV knowledge, vaccine acceptability, and factors affecting vaccine acceptability in Greek men. This study aims to identify determinants of knowledge and willingness to vaccinate against HPV among high-risk Greek men. Men (n = 298) between the ages of 18 and 55 were enrolled from the STI and HIV clinics at "Andreas Syggros" Hospital in Athens, Greece from July-October 2015. Participants completed a survey on demographics, economic factors, sexual history, HPV knowledge, and vaccine acceptability. The majority of participants were younger than 40 (76.6%) and unmarried (84.6%). Our sample was 31.2% MSM (men who have sex with men), and 20.1% were HIV-positive. Most participants (>90%) were aware that HPV is highly prevalent in both men and women; however, fewer identified that HPV causes cancers in both sexes (68%) and that vaccination protects men and women (67%). Amongst participants, 76.7% were willing to vaccinate themselves against HPV, 71.4% an adolescent son, and 69.3% an adolescent daughter. HIV-positive men were more likely to be willing to vaccinate themselves (OR 2.83, p = .015), a son (OR 3.3, p = .015) or a daughter (3.01, p = .020). Higher income levels were associated with increased willingness to vaccinate oneself (OR 1.32, p = .027), a son (1.33, p = .032) or daughter (1.34, p = .027). Although there is a HPV knowledge gap, HPV vaccine acceptability is high despite lack of vaccine promotion to Greek men. Future studies should include lower-risk men to adequately inform public health efforts.

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Human papillomavirus infection by anatomical site among Greek men and women: a systematic review

Cited by 9 publications

References 61 publications

Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

Risk factors, prevalence, and site concordance of human papillomavirus in high-risk Greek men

HPV vaccine acceptability in high-risk Greek men

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