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Abstract
BackgroundCervical cancer ranks as the first most frequent cancer among women in Benin. The major cause of cervical cancer now recognized is persistent infection of Human Papillomavirus (HPV). In Benin there is a lack of screening programs for prevention of cervical cancer and little information exists regarding HPV genotype distribution.MethodsCervical cells from 725 women were examined for the presence of viral DNA by means of a polymerase chain reaction (PCR) multiplex-based assay with the amplification of a fragment of L1 region and of E6/E7 region of the HPV genome, and of abnormal cytology by Papanicolaou method. The association between HPV status and Pap test reports was evaluated. Socio-demographic and reproductive characteristics were also related.ResultsA total of 18 different HPV types were identified, with a prevalence of 33.2% overall, and 52% and 26.7% among women with and without cervical lesions, respectively. Multiple HPV infections were observed in 40.2% of HPV-infected women. In the HPV-testing group, the odds ratio for the detection of abnormal cytology was 2.98 (95% CI, 1.83-4.84) for HPV positive in comparison to HPV negative women. High risk types were involved in 88% of infections, most notably HPV-59, HPV-35, HPV-16, HPV-18, HPV-58 and HPV-45. In multiple infections of women with cytological abnormalities HPV-45 predominated.ConclusionsThis study provides the first estimates of the prevalence of HPV and type-specific distribution among women from Benin and demonstrates that the epidemiology of HPV infection in Benin is different from that of other world regions. Specific area vaccinations may be needed to prevent cervical cancer and the other HPV-related diseases.
Highlights
Cervical cancer ranks as the first most frequent cancer among women in Benin
Among the 354 women Human Papillomavirus (HPV) DNA was found in 26.7% of 258 women with negative Pap tests and in 52% of 96 abnormal Pap tests
Seventy-two Atypical squamous cells (ASC)-US, 7 Low-grade squamous intraepithelial lesion (LSIL), 4 High-grade squamous intraepithelial lesion (HSIL), 7 ASC cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 6 Atypical glandular cells (AGC) were found among the 96 women with abnormal Pap test
Summary
Cervical cancer ranks as the first most frequent cancer among women in Benin. The major cause of cervical cancer recognized is persistent infection of Human Papillomavirus (HPV). In Benin there is a lack of screening programs for prevention of cervical cancer and little information exists regarding HPV genotype distribution. More than 80% of these cases occur in developing In developing countries, such as Benin, there is a lack of effective screening programs for prevention of cervical cancer. In these countries, no clinically significant reduction in the incidence of cervical cancer has occurred during the past three decades [2,4]. The introduction of the Pap test into general screening programs in the United States has reduced the incidence of advanced forms of cervical cancer by 75% over the past few decades [5,6]
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