High Rates Of Human Papillomavirus Infection Research Articles

Abstract C058: Differential DNA methylation in HPV+ and HPV- penile tumors from Puerto Rican men

Abstract The incidence of penile squamous cell carcinoma (PSCC) in Puerto Rico is nearly three times higher when compared with other racial and ethnic groups in the United States. Mortality rate for PSCC is also significantly higher among Puerto Rican men when compared to the US population. Human papillomavirus (HPV) is a common virus, and its infection may increase the risk of developing PeCa. Despite the high incidence, the molecular mechanism of PSCC remains poorly understood. Our laboratory found that the prevalence of HPV in PSCC in Puerto Rican men is 49%. Due to the high rates of HPV infection and increased incidence of penile cancer in Puerto Rican men, there is a need to understand the pathogenesis of penile cancer. DNA Methylation is an epigenetic alteration that can be found in cancer cells, which can lead to changes in gene expression and cellular function. This study aims to analyze the DNA methylation patterns in HPV-positive and HPV-negative PSCC tissues from Puerto Rican men. DNA was extracted from twenty-four fresh PSCC tissue samples from Puerto Rican patients. HPV status and genotyping were determined using the DNA ELISA kit HPV SPF10 protocol. DNA was amplified and hybridized using PCR. We perform a DNA methylation assay using the Infinium Methylation EPIC v2.0 BeadChip Kit to identify and compare average DNA methylation levels (%) in the 9 HPV-positive and 15 HPV-negative penile cancer samples. Our results demonstrated 43 loci significantly different between HPV-positive and HPV-negative samples, with an adjusted p-value <0.1 (Benjamini-Hochberg method). Most of the hypermethylated loci were present in HPV-negative tumor samples. Additionally, we identified four methylated-differentially expressed genes: ANXA4, CACNA1C-AS1, UBXN2A, and DUOX1, which are found as uncharacterized proteins (open reading frames, ORFs) of the human genome with adjusted p-value <0.05. Studies have revealed that specific DNA methylation patterns could be linked with cancer development and progression. Identification of differentially methylated regions in HPV positive (HPV+) PSCC compared with HPV negative (HPV-) cases will provide much needed data to aid studies on early detection, prognosis, and development of therapeutic agents to reduce the morbidity and mortality from PeCa. Identification of differentially expressed genes and pathways in HPV positive (HPV+) PeCa compared with HPV negative (HPV-) cases will provide much needed data to aid studies on prevention, early detection, prognosis, and development of therapeutic agents to reduce the morbidity and mortality from PeCa. Citation Format: Yarelis M. Roque Reyes, María Sánchez-Vázquez, Josué Perez, Luis R. Llanos, Ingrid Montes, Jasmine Figueroa-Díaz, Carlos Rivera-Lopez, María Marcos, Antonio Puras, Magaly Martínez-Ferrer. Differential DNA methylation in HPV+ and HPV- penile tumors from Puerto Rican men [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C058.

Pathology of cervical epithelium in women with various forms of infertility

Failure to conceive in a couple, that does not prevent fertilization for 12 months or more, is defined as infertility. This diagnosis is special one both because of the social component and of the involvement of two persons in it, as well as because of polyetiological factors. Pathology of the cervical epithelium is a common problem among women of reproductive age. In patients with infertility, it has its own significance as a factor for fertility disorders. In addition, there is a possible influence of different methods of treatment of pathology of the cervical canal on the course of pregnancy that occurred after treatment.The objective: to study the prevalence of cervical pathology in patients with various types of infertility.Materials and methods. The results of liquid cytology and human papillomavirus (HPV) testing were analyzed in 416 women, who were divided into four groups: I group included 108 patients with infertility associated with anovulation, II group – 101 patients with infertility of tubal origin, III group – 102 women with a male infertility factor in marriage, IV group – 105 women who applied for a preventive examination.Results. The general frequency of early cervical lesions of severity various degrees was differed significantly in the groups of the examined persons – from the lowest 25.9% in the group of patients with infertility associated with anovulation, and 35.2% in the group of women who applied for a preventive examination, to 50.9 % among women with infertility of tubal origin and 52.4% – in the group with a male infertility factor.In the last two mentioned groups, the frequency of severe intraepithelial lesions (7.8% and 7.9%, respectively) was higher than in the other groups, where it was established at a level of no more than 1.5%. A higher rate of HPV infection was also established in the groups infertility of tubal origin – 68.6%, male infertility – 63.4%, while in the group of patients with anovulation infertility its prevalence was at the level of 35.1%, which does not exceed the rate of healthy women in control group – 25.7%.Conclusions. 1. Patients with infertility of tubal origin and male factor infertility have a higher frequency of early cervical changes (50.9% and 52.9%, respectively) than healthy women of reproductive age (35.2%). 2. In cases of tubal and male factor infertility, the frequency of HPV infection is higher than the rate of the cervical epithelium lesions detected by the cytological method (68.6% and 63.4%, respectively), which allows us to recommend the HPV test to include in the list of mandatory examinations during preparation for the program of assisted reproductive technologies.

Investigation of awareness of human papilloma virus infection among female health workers at Ondokuz Mayıs University

Less developed areas have the highest incidence rates of cervical cancer, which vary by geographic region. If the right lifestyle changes are made, all cervical cancer risk factors can be avoided. Furthermore, vaccines have been created to guard against a number of the high-risk strains of the human papillomavirus (HPV). Not all women are aware of cervical cancer or how to prevent it, even though it is preventable. Therefore, every woman must assess level of knowledge regarding HPV prevention and cervical cancer. We applied a validated questionnaire between January and June 2021 to the female health workers at Ondokuz Mayıs University Hospital to assess their knowledge of cervical cancer and HPV protection as well as their attitudes toward it. Our findings indicate that women's knowledge on this topic is lacking, especially regarding the most recent advancements in HPV testing and vaccination-based cervical cancer prevention. Only 99% of the women who responded to the survey were actually aware that HPV testing was available. Although the incidence of cervical cancer is low, this figure is subject to change, particularly in light of the economic crisis and rising immigration rates, which could lead to higher rates of HPV infection in the population if no action is taken. Although the HPV vaccine has been available for some time, the Turkish government does not recommend it as a routine vaccine as part of the National Immunization Program. Even among the highly educated workforce in the healthcare industry, there is a lack of understanding about HPV vaccine. Healthcare professionals should be fully informed about the HPV vaccine for their own benefit so that they can discuss it with their patients. This study aimed to remove vaccination barriers and assess healthcare professionals' current knowledge of cervical cancer and HPV vaccination in a tertiary hospital.

Detection of Human Papilloma Virus (HPV) Infection in Colorectal Cancer and Viral Genome Integration Status

Background: Colorectal cancer (CRC) is the third common cause of malignancy in Iran, and its incidence rate has been raised due to an increase in individual and environmental risk factors. Objectives: The present study aimed to define the role of human papillomavirus (HPV) infection in CRC, then by drawing a phylogenetic tree, we aimed to analysis the sequences of isolated HPVs, and finally determine the viral genome physical status for HPV-16. Methods: A nested-PCR (nPCR), direct sequencing, and INNO-LiPA HPV genotyping assay were carried out for HPV detection, and a quantitative real-time PCR assay (qRT-PCR) was conducted for the physical status of the viral genome. Results: Among 157 subsets, there were 66 cases and 91 controls. Moreover, 5.7% (9/157) were HPV positive by nPCR, among whom 9.1% (6/66) were cases and 3.3% (3/91) were control groups (P = 0.750). The qRT-PCR analysis showed three forms of integrated, episomal, and mixed forms in our three HPV-16 strains. A higher rate of HPV infection was detected in the CRC cases; however, it was not statistically significant. Conclusions: Although there were limited positive results, higher ages (> 65) were related to HPV involvement and CRC outcome. Furthermore, 9.1% of the CRC cases were infected with HPVs. The HPV-16 genome integration is observed in high-grade cancer cases with severe malignancy in CRC patients.

Knowledge of Human Papillomavirus and Cervical Cancer Among Low-Income Women in New Jersey.

Although much research has been conducted on knowledge and awareness of the connection between human papillomavirus (HPV) and cervical cancer risk among university students, few studies have examined these associations among low-income populations. We examined knowledge of HPV and cervical cancer risk among racially and ethnically diverse low-income women. We used a cross-sectional study design to recruit and interview 476 low-income women in New Jersey from November 1, 2013, through February 28, 2016. We used multivariate logistic regression to determine whether knowledge of HPV and its association with cervical cancer risk differed by race and ethnicity. Compared with non-Hispanic White women, Hispanic (odds ratio [OR] = 0.37; 95% CI, 0.18-0.77) and non-Hispanic Black (OR = 0.38; 95% CI, 0.19-0.77) women were significantly less likely to report having heard of HPV. Of women who had ever heard of HPV (n = 323), non-Hispanic Black women were significantly less likely (OR = 0.44; 95% CI, 0.21-0.89) than non-Hispanic White women to report knowing that HPV can be associated with cervical cancer. Given the higher rates of HPV infection among non-Hispanic Black and Hispanic women, these results suggest a need to improve education about risks of HPV among low-income populations. These messages need to include information on the connection between HPV and cervical cancer and must be provided in culturally and linguistically appropriate ways.

Clinicopathologic Analysis of Sinonasal Inverted Papilloma, with Focus on Human Papillomavirus Infection Status.

Sinonasal inverted papilloma (SNIP) can recur; however, the factors related to tumor recurrence remain unclear. This study aimed to analyze risk factors, including human papillomavirus (HPV) infection, as well as other factors associated with SNIP recurrence. Thirty-two patients who were diagnosed with SNIP and underwent surgery between 2010 and 2019 were enrolled: 24 men and 8 women, with a mean age of 59.2 years. The mean follow-up was 57.3 months. Demographics and information about history of smoking, diabetes mellitus (DM), hypertension, allergic rhinitis, alcohol consumption, tumor stage, surgical approach, and recurrence were reviewed retrospectively. Specimens were investigated using polymerase chain reaction to detect HPV DNA (high-risk subtypes: 16, 18, 31, 33, 35, 52b, and 58; low-risk subtypes: 6 and 11). Seven patients (21.9%) experienced recurrence. HPV DNA was detected in five (15.6%) patients (high-risk subtypes, n = 2; low-risk subtypes, n = 3). Patients with recurrence of SNIP had a higher proportion of young adults and displayed higher rates of HPV infection, DM, and advanced tumor stage than those without recurrence. HPV infection, young adulthood, DM, and advanced tumor stage could be associated with a high recurrence rate, which suggests that patients with these risk factors could require close follow-up after surgery.

Abstract PO-270: Evaluation of attitudes, beliefs and influences and their impact on HPV vaccination rates among minority health science students

Abstract Introduction: Human Papillomavirus (HPV) is the most common sexually transmitted disease. The contraction of HPV is associated with the development of several different types of cancers, including anal, cervical, and oropharyngeal cancers. These cancers have proven to impact Black and Hispanic women disproportionately across the United States, suffering from high rates of HPV infection and high incidence of cervical cancer. Despite knowledge of this risk, HPV vaccination rates remain low among minority women. Personal beliefs and access surrounding HPV vaccination may be contributors to these disparities. This survey aims to study the motivations behind the choice to receive HPV vaccination among health science students. Health science students are the target for this study as they are uniquely situated as the future providers of their communities. If the study is able to gauge how they feel about HPV vaccination, then the scientific community can target interventions to impact change beginning with the providers themselves. Females specifically were chosen as they are the primary targets of HPV vaccination. HPV vaccination rates among female health science students are a secondary result. Methods: A 37-item electronic survey was sent out to female health science students at the University of Florida which include the schools of Dentistry, Medicine, Nursing, Pharmacy, Public Health, and Veterinary Science. The online survey was then distributed in July of 2021 through Qualtrics. The survey evaluated previous HPV knowledge, motivations for or against HPV vaccination, and beliefs surrounding HPV vaccination. Results: The survey was delivered and distributed in July of 2021. In this study there are four different types of questions analyzed to gather information on previous HPV knowledge, attitudes, beliefs and external influences. Results will be categorized and compared based on race/ethnicity. By analyzing these groups there is an opportunity to understand how one's racial or ethnic background can affect their medical decisions in health science students and the recommendations they give to others. Results are pending. Conclusion: This being the first study of its kind warrants further investigation as health science students are trusted individuals of the medical community. If these students are against HPV vaccination, then medical schools could target interventions to teach students about racial disparities in HPV infection and vaccination recommendation. So, when given the opportunity as a provider these students can recommend vaccination to their patients. These results are indicative of knowledge gaps and attitudes within the younger generations of the medical community. Citation Format: Katya M Marcia, John M Allen. Evaluation of attitudes, beliefs and influences and their impact on HPV vaccination rates among minority health science students [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-270.

HPV-Related Cancers: A Growing Threat to U.S. Military Health and Readiness.

The incidence of human papillomavirus (HPV) related cancers is growing in the United States. Active duty service members (ADSM) have higher rates of HPV infection than civilians and are therefore at greater risk of developing HPV-related cancers. The purpose of this commentary is to examine the burden of HPV-related cancers in ADSM. The current HPV vaccination and cervical cancer screening uptake rates of U.S. ADSM are presented, including a literature review of military-focused studies on HPV vaccination and cervical cancer screenings. We provide directions for future research, interventions, and policy recommendations to improve HPV-related cancer prevention among ADSM.

The Prevalence and Genotype Distribution of Human Papillomaviruses Among Men in Henan Province of China

Background: This paper aimed to assess the prevalence of human papillomavirus (HPV) infection and the associations of sociodemographic and behavioral characteristics with HPV in unvaccinated men in Henan Province before the mass administration of the HPV vaccine through a baseline survey.Methods: Between June 2015 to June 2020, 3,690 men were tested for the HPV genotype at the Henan Provincial People's Hospital. The HPV genotype was detected by a polymerase chain reaction (PCR)-based hybridization gene chip assay.Results: The overall HPV infection rate was 29.97%; The most prevalent genotypes were HPV 6 (21.76%), 11 (12.68%), 16 (8.94%), 58 (5.37%), 18 (3.41%), 84 (3.25%), 61 (3.09%), and 81 (3.09%). Low-risk HPV (LR-HPV) infection (24.91%) and single infection (17.78%) were the most prevalent forms. Age-specific HPV distribution was presented as a bimodal curve; the youngest age group (≤ 25 years) had the highest HPV infection rate (36.03%), followed by the 36–40-year-old group (33.68%). Men with Junior high school or above were more likely to have Pure-LR HPV infection. Unmarried status and smoking increased single and LR-HPV infection. Multiple lifetime sex partners and not using a condom were more likely to cause LR-HPV infection.Conclusions: The data on the prevalence and HPV infection type distribution in men in Henan Province could serve as a valuable reference to guide nationwide screening. We provide a time-based estimate of the maximum impact of the HPV vaccine and critical reference measurements important for assessing the clinical benefits of HPV vaccination and the increase in non-vaccine HPV types.

Detection of human papillomavirus high-risk genotypes in rural women of Lucknow, North India.

Human papilloma virus (HPV) has been widely implicated in cervical carcinogenesis and 90% of carcinoma cervix cases are due to high-risk HPV infection. This study was done to find the high-risk HPV genotypes in the rural women of Lucknow, North India. HPV-DNA testing has been carried out in 130 cases of squamous intraepithelial lesions (SILs) of the cervix to find HPV status and type of high-risk HPV genotype infecting the rural women. These cases were collected from the rural cervical cancer screening program carried out in the villages of West Lucknow, North India. HPV status in 130 SIL cases revealed HPV positivity in only 17 cases (13.1%), whereas the remaining 113 cases were HPV negative (86.9%). HPV genotypes detected in the study were HPV-18, HPV-31, HPV-33, and HPV-35. HPV positivity was found highly associated with the young and sexually active group of women complaining of vaginal discharge. High HPV infection rate was also seen with multiparity and illiteracy as majority of women attending the camps were multiparous and illiterate. The present study revealed highly oncogenic HPV-18 alone or in combination with multiple infections of high-risk genotypes - 31, 33, and 35 - in the rural women of Lucknow, North India. Since HPV vaccine currently available in India is for HPV-16 and HPV-18 combined, efforts should be made to make region-specific vaccine according to their prevalence in that particular state of the country to provide effective HPV vaccination.

The prevalence, genotype distribution of human papillomavirus and cervical cytology in Wenzhou, China: a retrospective research of 7391 cases

Human papillomavirus (HPV) infection is the main pathogen of precancerous transformation and finally progress to cervical cancer. It associated with cervical squamous and glandular lesions. However, the genotype distribution of HPV and the relationship between HPV infection and cervical disease are still remind unclear. A total of 7391 abnormal cervical cytology cases with detailed histological reports and HPV genotypes were collected. The prevalence of HPV infection in squamous epithelial lesions and glandular epithelial lesions were statistically analyzed. Around 6958 cytological squamous epithelial lesions and 433 glandular epithelial lesions were enrolled. 79.72% of cytological squamous epithelial lesions and 26.56% of glandular epithelial lesions were HPV infected. The HPV infection rates in squamous cell carcinoma, cervical adenocarcinoma and endometrial adenocarcinoma were 66.67%, 54.17% and 19.72%, respectively. HVP16, 18 and 58 are the most common types in squamous and glandular epithelial lesions. Among the squamous epithelial lesions, women less than 25 years old had the highest HPV infection rate, and majority of multiple infections was found in women >55 years old. The total infection rate of HPV in glandular epithelial lesions was the highest in the 35 to 45 group. Multiple infections peaked in women around 55 years old. The prevalence of HPV infection is divergent in different types of cervical cancer. The HPV infections in cervical squamous epithelial lesions tended to be younger. HPV detection is one of the necessary tests for cervical disease screening and should be individualized in an age manner.

Human papillomavirus (HPV) types among Alaska native women attending a colposcopy clinic in Anchorage, Alaska, 2009\u20132011

BackgroundThe first HPV vaccines licensed targeted two HPV types responsible for most cervical cancers. A 9-valent vaccine (9vHPV), targeting 5 additional types, was introduced in 2016 and is currently the only HPV vaccine available in the United States. Previous studies demonstrated high rates of HPV infection in Alaska Native (AN) women. We sought to measure prevalence of high risk HPV types in AN women undergoing colposcopy and to determine those preventable by vaccination.MethodsFor this cross-sectional study, we recruited women who were undergoing colposcopy for clinical indications at Alaska Native Medical Center to obtain cervical brush biopsy samples. Specimens were shipped to Atlanta, Georgia for DNA extraction, HPV detection, and typing using L1 PCR with type-specific hybridization to detect 37 HPV types.ResultsFour hundred eighty eight specimens from 489 women were tested. At least one HPV type was found in 458 (94%) specimens. Of 458 participants who were HPV positive, 332 (72%) had two or more types. At least one type targeted by 9vHPV was detected in 95% of participants with CIN 3 (21/22), 82% with CIN 2 (37/45), and 65% with CIN 1 (119/184). (p < 0.001) HPV 16 or 18 were detected in 77% (17/22) with CIN 3, 53% (24/45) with CIN 2, and 36% (67/184) with CIN 1. (p < 0.001).ConclusionsA substantial proportion of AN women attending colposcopy clinic had evidence of HPV 16/18 infection, as well as other high risk types targeted by 9vHPV. At least one 9vHPV type was detected in 62% of the participants overall, and 95% of participants with CIN3. AN women are expected to benefit from vaccination against HPV 16/18, and will have greater benefit from 9vHPV. Information from this study could be used to develop public health strategies to increase vaccine uptake, or to track HPV genotype prevalence over time.

Prevalence and genotype distribution of human papillomavirus in Zhengzhou, China, in 2016.

In this study, the prevalence and genotype distribution of human papillomavirus (HPV) in 49,793 women aged 25-64 years were determined by fluorescent real-time polymerase chain reaction (PCR) assay. HPV was detected in 6,020 women, giving a prevalence of 12.09% (6020/49,793). Single and multiple infections accounted for 71.81% (4323/6020) and 28.19% (1697/6020) of total infections, respectively. The most commonly found genotypes were HPV52 (19.90%, 1198/6020) and HPV16 (19.17%, 1154/6020), followed by HPV58 (13.11%, 789/6020), HPV81 (10.10%, 608/6020) and HPV56 (9.00%, 542/6020). The prevalence of HPV increased with age and was highest in the 54- to 64-year-old age group. The genotypes covered by the nonavalent HPV vaccine accounted for 39.32% (2367/6020) and 22.81% (1373/6020) of the total monoinfections and polyinfections, respectively. This study indicates a high HPV infection rate in women in the city of Zhengzhou and a large percentage of women are infected with single or multiple high-risk HPV genotypes that cannot be prevented using the current nonavalent HPV vaccine. Vaccines incorporating more HPV genotypes and extended age coverage for the current nonavalent vaccine might be necessary to better prevent HPV-related cervical cancer.

Laryngeal squamous cell papilloma is highly associated with human papillomavirus.

To delineate the association between characteristics of adult-onset laryngeal squamous cell papilloma and human papillomavirus (HPV) infection. Clinical records and paraffin-embedded specimens of 77 papilloma patients who had been treated between 1998 and 2014 were collected. Of the 77 cases, 34 were identified in the larynx, 28 in the oral cavity and 15 in the oropharynx. Specimens were investigated by polymerase chain reaction (PCR) to detect HPV 6, 11, 16, 18, 31, 33, 35, 52b and 58, and immunohistochemical (IHC) staining for anti-p16INK4a antibody. In 21 cases (61.8%) with laryngeal squamous cell papilloma, various types of HPV were detected: 14 cases (41.2%) were positive of high-risk HPV, 18 (52.9%) were positive of low-risk HPV and 11 (32.4%) were positive of both high-risk HPV and low-risk HPV. Younger patients (<60 years) showed a higher rate of HPV infection than older patients. Among the 34 cases with laryngeal papilloma, no malignant transformation was observed during the study period. With IHC staining, positive expression of p16 was observed in 20 cases (58.8%). HPV infection and p16-expression were associated with the pathological finding of koilocytosis. Only four cases (14.3%) showed HPV-positivity in the oral cavity, and none of the 15 oropharyngeal cases were positive for HPV, and none of the oral cavity and oropharyngeal cases showed koilocytosis. Results of HPV-PCR and p16-IHC staining were significantly correlated each other. HPV infection is frequently associated with laryngeal squamous cell papilloma, and koilocytosis is a characteristic pathological finding. To the best of our knowledge, this is the first report which have described infections with multiple HPV types in laryngeal papilloma.

Prevalence of and Risk Factors for Anal Human Papillomavirus Infection in a Sample of Young, Predominantly Black Men Who Have Sex With Men, Houston, Texas.

Young men who have sex with men (MSM) are at increased risk for human papillomavirus (HPV)-associated disease as a result of HPV infection. Our objective was to characterize the prevalence of high-risk anal HPV infection and factors associated with prevalence in a group of young, primarily black MSM in Houston, Texas. MSM aged 18-29 years were recruited using a respondent-driven sampling method to study HIV and sexually transmitted disease transmission and risk. All engaged in peer-recruitment chains and self-collected anal exfoliated cells. Prevalence ratios assessed factors associated with high-risk HPV and HPV types in the 9-valent vaccine. Black race was reported by 87% of men. Slightly over one half (53%) were human immunodeficiency virus (HIV) positive. Approximately 75% of men had at least 1 high-risk HPV type, and 39% of HIV-positive men harbored HPV-16. Analysis that controlled for potential confounders revealed that only HIV infection was associated with high-risk HPV infection. Black MSM would benefit from increased HPV vaccination efforts, owing to high rates of HPV infection, increased HPV disease, and low vaccination series completion rates in this population.

Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population

ObjectivesCervical cancer is a largely preventable disease, and the strategic implementation of a cervical cancer prevention programme is partly dependent on the impact of human papillomavirus (HPV) infection interpreted within...

Prevalence of Human Papillomavirus Infection and Cervical Cancer Screening among Riverside Women of the Brazilian Amazon.

Purpose The aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Methods Cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. Results The mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026). Conclusions The infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.

Disparity in rates of HPV infection and cervical cancer in underserved US populations.

There is a higher rate of HPV infection and cervical cancer incidence and mortality in underserved US population who reside in Appalachian mountain region compared to Northern Plains. Social and behavioral factors such as smoking and alcohol consumption are for such a high incidence. However, by and large, the reasons for these discrepancies lie in the reluctance of the underserved population to adopt preventive measures such as prophylactic Human papilloma virus (HPV) vaccines and Pap smear screening that have significantly reduced the incidence and mortality rate of cervical cancer in Caucasian women. Thus, it is clear that drastic change in social behavior and implementation of preventive measures is required to effectively reduce the incidence and mortality from cervical cancer in this underserved population.

Analysis of HPV subtype infection in 4 037 healthy women in Haikou area

Objective To investigate the infection of 23 kinds of human papillomavirus (HPV) subtypes in female cervical epithelium samples and to analyze their relationships with age and results of cytologic test in Haikou area. Methods A total of 4 037 local healthy women were enrolled in this study from July 2013 to August 2016, 1 967 of whom received cervical cytology test. Cervical cell samples collected from those women were detected for HPV typing by using PCR-reverse dot blot hybridization. Results (1) The total positive rate of HPV in 4 037 samples was 22.15% (894 cases), and the detection rates of carcinogenic, possibly carcinogenic and non-carcinogenic HPV were 16.13%, 3.99% and 5.55% (651, 161 and 224 cases), respectively. The positive rates of 6 genotypes were high, which were HPV52, 53, 81, 51, 16 and 58 in turn. (2) The detection rates of carcinogenic, possibly carcinogenic HPV and some of the genotypes (HPV18, 52, 53, 66) increased with age (all P<0.05). (3) Multiple infection in HPV-positive women accounted for 24.38% (218/894), in which the infection rates of carcinogenic types declined with age and the numbers of HPV genotypes in carcinogenic infections were negatively correlated with age (both P<0.05). (4) Only 2.49% (49/1 967) of the samples were positive for cervical cytologic test, classified into the ≥ASC-US (atypical squamous cells of undetermined significance) group. The detection rates of eight kinds of carcinogenic and two kinds of possibly carcinogenic HPV in ≥ASC-US group were significantly higher than those in the negative (no intraepithelial lesion or malignant lesion, NILM) group (all P<0.05). Conclusion This study indicates that Haikou women have higher rates of HPV infection, especially the elderly group. HPV subtype infections present some regional characteristics and are mainly single type infection. Cervical cancer screening should be combined with tests for HPV and cytology analysis to improve its effectiveness. Key words: Human papillomavirus; PCR-reverse dot blot hybridization; Genotyping; Multiple infection; Liquid based cytology

Awareness of human papilloma virus and cervical cancer prevention among Greek female healthcare workers

The incidence rate of cervical cancer varies by geographic region, with less developed regions showing the highest rates. All risk factors for cervical cancer are actually preventable if appropriate lifestyle changes are adopted. In addition, vaccines protecting against the majority of human papilloma virus (HPV) high-risk types have been developed. Even though cervical cancer is preventable, not all women are aware of this or how it can be prevented. Thus, it is essential for every nation to assess the level of knowledge among women of cervical cancer and HPV prevention. In this work, we assessed the level of awareness and attitudes of Greek female healthcare workers on cervical cancer and HPV prevention through the delivery of a validated questionnaire between March and June 2012 in three hospitals in Greece. Our results show that there exist gaps in the knowledge of women on this topic, especially in terms of the newest information on cervical cancer prevention through HPV testing and vaccination. In fact, only 80% of surveyed women knew about the existence of HPV testing. We propose that more information needs to be transmitted to Greek women and men on HPV testing and vaccination. Even though the incidence of cervical cancer is not extremely high in Greece, this number can easily change, especially in the face of the economic crisis and the increasing rates of migration, which can result in higher rates of HPV infection in the population if no measures for HPV prevention are implemented.