Abstract

Background:Cervical cancer is the third leading cause of death in Malaysia, and Human Papilloma Virus (HPV) is the principal aetiology that is responsible for its development. This study was aimed to determine the prevalence and distribution of HPV types among different age groups, ethnicity, and areas in Malaysia. Materials and Methods:A total of 764 women aged 20-74 years old within the cities of Johor Bahru, Kuala Lumpur, Ipoh, Penang, and Kota Kinabalu underwent both cervical cytological assessment and HPV DNA analysis. Cervical cytology glass slides were prepared using the liquid base technique (Path TEZT TM). HPV DNA was extracted using TANBead® Nucleic Acid Extraction Kit (Taiwan Advanced Nonotech Inc.), then the types were further identified using a DR.HPV Genotyping IVD kit. Results:The prevalence of HPV infection was 14.0% (107/764) with high-risk type at 10.7% (82/764) and low-risk type at 3.27% (25/764). The most common high-risk HPV types were HPV-52, 66, 33, 39, and 58 whereas low-risk HPV types were HPV-6, 40, and 81. The majority of HPV infections (80.37%) were detected in women with normal cytology results. The most prevalent HPV type among Chinese is 33 (n=6) followed by 16, 44, 58, 66 and 68 (n=5). Among Malays, HPV 16 and 51 were the two most prevalent types (n=2). The sensitivity of the HPV DNA test compared to cytology was 100% with a specificity of 88.37%.Conclusion:This study revealed that the most common high-risk HPV type among women living in urban areas in Malaysia is HPV 52, unfortunately which is not the type of infection the current HPV vaccine is covered for protection among females. These findings may contribute beneficial information to health care providers for the appropriate use of HPV vaccine in the prevention of cervical cancer in Malaysia.

Highlights

  • Cervical cancer is the fourth leading cause of mortality among women worldwide, with an approximate 311,000 deaths and 570,000 new cases in 2018 (Arbyn et al, 2020)

  • This study revealed that the most common high-risk Human Papilloma Virus (HPV) type among women living in urban areas in Malaysia is HPV 52, which is not the type of infection the current HPV vaccine is covered for protection among females

  • HPV 16 and 18 are the most common types that are responsible for the development of cervical cancer and pre-cancerous cervical lesions (Bray et al, 2018)

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Summary

Introduction

Cervical cancer is the fourth leading cause of mortality among women worldwide, with an approximate 311,000 deaths and 570,000 new cases in 2018 (Arbyn et al, 2020). The high-risk group is an oncogenic and persistent infection in the human system responsible for the development of cancer. Conclusion: This study revealed that the most common high-risk HPV type among women living in urban areas in Malaysia is HPV 52, which is not the type of infection the current HPV vaccine is covered for protection among females.

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