Burden of high-risk HPV infection in women in the United States and implications for anal cancer screening: NHANES (1999-2012).

Abstract

532 Background: High-risk Human Papilloma Virus (HPV) infections put women at risk for cervical, anal, vaginal, and vulvar cancers. HPV can spread from the genital region to the anus even in absence of sexual intercourse. As anal cancer is more prevalent in women, it is important to consider HPV transmission from the vagina to the anus. National surveys provide estimates of population-specific prevalence to identify the burden of high-risk HPV infection in women. Appreciating high-risk HPV infection in women and the potential for HPV spread from the genitals to the anus is crucial for cancer screening efforts. Methods: We calculated prevalence of HPV infections in women in the United States from 1999-2012 National Health and Nutrition Examination Survey (NHANES) to obtain a representative sample of the U.S. non-institutionalized civilian population. NHANES performs in-person interviews and physical examinations and collects biological samples at homes and mobile examination centers. We provided epidemiology of HPV infection and its types for women. Analysis was performed by SAS v9.3. Results: DNA-measured HPV from vaginal swabs showed 42.9% of women were HPV positive. We calculated odds ratios across demographic groups for high-risk HPV types (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82). Non-Hispanic White (NHW) women had the highest prevalence of high-risk HPV (62.5%). Other Hispanic women had lower odds of having high-risk HPV compared to NHW (OR=0.65; 95% CI=0.49, 0.88). Never married women had greater odds of high-risk infection than married women (1.61; 1.26, 2.06). Current smokers had greater odds than never smokers of high-risk infection (1.26; 1.00, 1.59). Conclusions: Our results show the burden and demographic disparities of high-risk HPV infection in women. Understanding the burden of potentially oncogenic HPV infections in the female genital region is important for cervical cancer screening and highlights a potential importance for anal cancer screenings in HPV positive women. Recognizing demographic disparities could lead research into risk factors and risk conditions that guide the preponderance of HPV infection and anal cancer in specific female populations.