Prevalence of High-Risk Human Papillomavirus Among Older Women

Abstract

Objective To estimate the prevalence, genotypes, and individual-level correlates of high-risk human papillomavirus (HPV) among women aged 57–85. Methods Community-residing women (n=1550), aged 57–85, were drawn from a nationally-representative probability sample. In-home interviews and biomeasures, including a self-collected vaginal specimen, were obtained between 2005 and 2006. Specimens were analyzed for high-risk HPV DNA using probe hybridization and signal amplification (hc2); of 1,028 specimens provided, 1,010 were adequate for analysis. All samples testing positive were analyzed for HPV DNA by L1 consensus polymerase chain reaction followed by type-specific hybridization. Results The overall population-based weighted estimate of high-risk HPV prevalence by hc2 was 6.0% (95% confidence interval [CI] = 4.5 to 7.9). Current marital and smoking status, frequency of sexual activity, history of cancer, and hysterectomy were associated with high-risk HPV positivity. Among high-risk HPV+ women, 63% had multiple type infections. HPV 16 or 18 was present in 17.4% of all high-risk HPV+ women. The most common high-risk genotypes among high-risk HPV+ women were HPV 61 (19.1%), 31 (13.1%), 52 (12.9%), 58 (12.5%), 83 (12.3%), 66(12.0%), 51 (11.7%), 45 (11.2%), 56 (10.3%), 53 (10.2%), 16 (9.7%), and 62 (9.2%). Being married and having an intact uterus were independently associated with lower prevalence of high-risk HPV. Among unmarried women, current sexual activity and smoking were independently and positively associated with high-risk HPV infection. Conclusions In this nationally representative population, nearly 1 in 16 women aged 57–85 were found to have high-risk HPV and prevalence was stable across older age groups.

HPV infection among women in a representative rural and suburban population of the USA

“…It is noteworthy that the highest HPV-16 prevalence found in this series is similar to those reported from European countries [5,20,21]. This is at variance with 3 recent studies conducted in the USA that showed that HPV-62 and HPV-84 [6], HPV-52 [7], and HPV-61 [8] were the most common genotypes. Whether this difference is a function of the methodology used for HPV genotyping or represents a true geographic HPV genotype distribution awaits further investigation.…”

“…The carcinogenic risk of HPV infection is linked to certain high-risk HPV genotypes [2,3] and that HPV genotype prevalence varies in different populations [2][3][4][5][6][7][8]. The present study represents the first attempt to gather information on HPV infection rate and HPV genotypes prevalent in female patients who are under regular health care provided by private gynecologists outside the major cities in the USA.…”

“…HPV-62 and HPV-84 [6], HPV-52 [7], and HPV-61 [8] were the leading genotypes; the general HPV prevalence rate was as high as 44.8% [6].…”

“…Three HPV infection studies were recently conducted on self-collected vaginal swabs submitted by women visiting a mobile examination center [6], 14-to 17-year-old adolescents, mostly African-American, attending a primary care clinic [7], and 57-to 85-year-old women [8]. HPV-62 and HPV-84 [6], HPV-52 [7], and HPV-61 [8] were the leading genotypes; the general HPV prevalence rate was as high as 44.8% [6].…”

Human papillomavirus-type distribution in South African women without cytological abnormalities: a peri-urban study

“…8 The prevalence of high-risk HPV infections in older women in the current study population was almost eight times higher in women aged 60-70 years than that in women who were older than 57 years in the USA. 22 Utilising HPV testing as a screening method in the USA has become an acceptable alternative to cytology. Current recommendations are that screening is extended to three years if both HPV DNA and cytology are negative.…”