Abstract
BackgroundThere are no data available on human papillomavirus (HPV) infections in women living in the Mississippi Delta, where cervical cancer incidence and mortality among African American women is among the highest in the United States. The aim of this analysis was to report the age-specific prevalence of HPV in this population.MethodsWe recruited 443 women, 26–65 years of age, from the general population of women living in the Mississippi Delta to participate; 252 women had been screened for cervical cancer within the last 3 years while 191 had not. Women underwent a pelvic exam and had clinician-collected Pap sample taken for the routine cervical cancer screening by cytology. Women were asked to collect a self-collected specimen at home and return it to the clinic. Both specimens were tested for HPV genotypes.ResultsFour hundred and six women (91.6%) had HPV genotyping results for the clinician-collected and self-collected specimens. The prevalence of carcinogenic HPV was 18.0% (95% CI: 14.4%-22.1%) for clinician-collected specimens and 26.8% (95% CI: 22.6%-31.4%) for self-collected specimens. The concordance for the detection of carcinogenic HPV between clinician-collected and self-collected specimens was only fair (kappa = 0.54). While the prevalence of carcinogenic HPV in either sample decreased sharply with increasing age (ptrend< 0.01), the prevalence of non-carcinogenic HPV did not, especially the prevalence of HPV genotypes in the alpha 3/4/15 phylogenetic group.ConclusionsThe prevalence of carcinogenic HPV in our sample of women living in the Mississippi Delta was greater than the prevalence reported in several other U.S. studies. The high carriage of HPV infection, along with lack of participation in cervical cancer screening by some women, may contribute to the high cervical cancer burden in the region.
Highlights
There are no data available on human papillomavirus (HPV) infections in women living in the Mississippi Delta, where cervical cancer incidence and mortality among African American women is among the highest in the United States
We previously reported that underscreened women were almost twice as likely to choose self-collection over free Pap testing, and twice as many of those who chose self-collection completed their screening compared those who chose free Pap testing [18]
We noted that in general the under-screened population had more HPV, albeit not significantly so; underscreened women were non-significantly more likely to have alpha 1/8/10 genotypes compared to screened women (OR = 1.9, 95% CI: 0.74-4.7)
Summary
There are no data available on human papillomavirus (HPV) infections in women living in the Mississippi Delta, where cervical cancer incidence and mortality among African American women is among the highest in the United States The aim of this analysis was to report the age-specific prevalence of HPV in this population. We previously reported that underscreened women were almost twice as likely to choose self-collection over free Pap testing, and twice as many of those who chose self-collection completed their screening compared those who chose free Pap testing [18] The goal of this specific analysis was examine the impact of age and anatomic site of specimen collection on the prevalence of HPV, as a proxy for specificity. We wanted to understand the potential impact of using selfcollection and HPV DNA testing on the patient
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