Abstract
BackgroundCervical cancer is the most common cancer among women in Nepal. The prevalence of human papillomavirus (HPV) 16 and or HPV 18 among women with cervical pre-cancer and cancer is higher than the incidence of HPV in the world population. The population-based epidemiological data of HPV in the general population in most parts of the country remains unknown. The objective of this study was to assess the prevalence and type distribution of HPV infection and association of abnormal cytology with high risk HPV infection among women in mid-western rural, Nepal.MethodsA population-based cross sectional study was conducted in Jumla, one of the most remote districts in Nepal. A total of 1050 cervical samples were collected from married and non- pregnant women aged 20–65 years during mobile Cervical Cancer Screening Clinics conducted from May 2016 to January 2017. The presence of HPV DNA was firstly confirmed by HPV consensus PCR using PGMY09/PGMY11 designed primers, then HPV positive samples were further genotyped by the membrane hybridization method to detect the 21 high-risk HPV (HR-HPV) and low-risk HPV types. The prevalence of HR-HPV among women with normal and abnormal cytology was calculated. Data were analyzed using SPSS software for Windows. P < 0.05 was considered statistically significant.ResultsA total of 998 women were eligible for this study with the mean age 32.6 ± 8.6 years, and the mean marital age was 16.7 ± 3.8 years. The overall prevalence of HPV infections was 19.7%. HR-HPV and low-risk HPV were 11.7 and 8.7% respectively. The six most common HR-HPV types were HPV16, 39, 58, 33, 51 and 18. HR-HPV infection among the women with abnormal and normal cytology was of 27.3 and 10.8% respectively.ConclusionsThere was a higher prevalence of HR-HPV infection among women living in Jumla than other parts of Nepal. This study provides preliminary information on overall HPV and type-specific HR-HPV prevalence, HR-HPV 16, 39, 58, 33, 51, and 18 are the most prevalent genotypes in this region. The data contribute to the epidemiological knowledge about HPV and type-specific HR-HPV genotypes prevalence in mid-Western Nepal.
Highlights
Cervical cancer is the most common cancer among women in Nepal
The potential risk of human papillomavirus (HPV) for cervical cancer is higher than Hepatitis B virus (HBV) is for liver cancer and even smoking is for lung cancer [2]
high risk (HR)-HPV was most prevalent in the younger age group from 20 to 29 years, and in the same way more common on those who marry before the age of 20 years
Summary
The prevalence of human papillomavirus (HPV) 16 and or HPV 18 among women with cervical pre-cancer and cancer is higher than the incidence of HPV in the world population. The prevalence of human papillomavirus (HPV) 16 and or HPV 18 among women with low grade squamous Intraepithelial Lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL) and cervical cancer is 25.8, 51.9 and 69.4% respectively [1]. Cervical cancer demonstrates a decreasing trend in more developed countries, but consistently remains the number one female cancer of incidence and mortality in Nepal. According to the Information Center on HPV and Cancer (ICO), Nepal reports a prevalence of HPV 16 and or HPV 18 among women with LSIL, HSIL, and cervical cancer are 30.2, 63.4, and 80.3% respectively. The prevalence of HPV infection in Nepal is higher than in the world population [3,4,5]
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