Abstract
BackgroundHuman papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain.MethodsThe CLEOPATRE Spain study enrolled 3 261 women aged 18–65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection.ResultsA lifetime number of two or more sexual partners, young age (18–25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01).ConclusionThis is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection.
Highlights
Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix
91.3% of the women were born in Spain, 77.2% lived in an urban area (≥10 000 inhabitants), 39.7% were single, 33.0% had a university/college education, 25.5% were students, 35.6% were current smokers, and 19.5% reported having had four or more lifetime sexual partners
When comparing the two methods, a Kappa value of 0.67 was found, which could be interpreted as being acceptable. This analysis of the CLEOPATRE Spain study has identified several socio-demographic, lifestyle, and medical factors associated with cervical HPV infection
Summary
Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate sociodemographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain. Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. It is well established that HPV is the necessary cause of cervical cancer and its precancerous lesions. Most sexually active women will be infected with HPV during their lifetime [3]. While the majority of HPV infections are cleared within 2 years, persistent infections and the presence of risk factors that promote persistence may lead to the development of precancerous and cancerous lesions in a small fraction of women. HPV genotypes are classified as high-risk (HR) or low-risk (LR) based on their association with cervical cancer, HPV 16 being the type most commonly identified in this cancer [4]
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