Human papillomavirus infection in women with and without cervical cancer in Warsaw, Poland
Introduction
The incidence of cervical cancer in Eastern Europe is approximately three-fold higher than in Western European countries, with particularly elevated rates reported in Poland (14.4/100,000 women in Warsaw, 19.6/100,000 women in Cracow).1 The disparity between Eastern and Western Europe is also reflected in cervical cancer mortality rates.2 Population-based screening programmes in Poland are few and restricted to small areas, but at least in urban districts, opportunistic cytological screening is widespread.3
The establishment of genital infection with certain types of human papillomavirus (HPV) as the central cause of cervical cancer has prompted a shift in the planning of primary and secondary prevention towards HPV test-based screening4 and vaccination.5
One of the essential pieces of epidemiological data required to introduce and predict the impact of HPV test-based screening or vaccination in a given country is population-based data on age- and type-specific patterns of HPV prevalence, which is known to vary substantially across different populations.6, 7 In addition, corresponding information on women with cervical cancer is important to predict the theoretical fraction of cervical cancer preventable by current HPV16/18 vaccines.
Population-based studies on the prevalence of HPV in Eastern European countries remain limited.8, 9 Therefore, the International Agency for Research on Cancer (IARC), in collaboration with The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland, have carried out an HPV survey on a representative sample of women from Warsaw, and on a corresponding sample of locally-diagnosed cervical cancer cases.
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Ethical approval
All participants, whether from the general female population or those with cervical cancer, signed informed consent forms according to the recommendations of the IARC and the Maria Sklodowska-Curie Memorial Institute and Cancer Center ethical review committees, which both approved the study.
General female population
The survey of HPV infection in the general female population was carried out between March and May 2006 in Warsaw, Poland. A population-based cervical screening programme, including an active call of women
General female population
Of 897 women who provided cervical cell samples, 49 had inadequate HPV results (β-globin negative), four had inadequate cytology, and 10 had undergone hysterectomy, leaving 834 women with valid cytology and HPV results. Among them, 35 (4.2%) had abnormal cytological findings, including 10 (1.2%) women with atypical squamous cells of undetermined significance, 22 (2.6%) with low-grade squamous intraepithelial lesions and three (0.4%) with high-grade squamous intraepithelial lesions. Final
Discussion
A major finding of the present study, the first carried out in Poland, is the disclosure of a relatively important burden of HPV prevalence in the general female population, particularly in women below the age of 35 years. The age-standardised HPV prevalence (17.8%) in Warsaw was higher than in previous studies using the same HPV testing protocol in Italy and the Netherlands, but similar to that found in some parts of South America and India.6 In addition, the prevalence of high-risk HPV types
Conflict of interest statement
None declared.
Acknowledgement
Source of support: The Bill & Melinda Gates Foundation (grant number 35537). The study sponsors had no role in the study design, the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. The authors did not contract any writing assistance.
References (23)
- et al.
Cervical cancer mortality in young women in Europe: patterns and trends
Eur J Cancer
(2000) - et al.
Papillomavirus vaccines in perspective
Lancet
(2007) - et al.
Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis
Lancet
(2005) - et al.
The diagnostics and prevalence of genital human papillomavirus (HPV) infection in Hungary
Eur J Obstet Gynecol Reprod Biol
(2002) - et al.
Prevalence of human papillomavirus infection in women in Turin, Italy
Eur J Cancer
(2005) - Parkin DM, Whelan SL, Ferlay J, Thomas DB, Teppo L, editors. Cancer incidence in five continents, Vol. VIII. IARC...
- et al.
15 years of active cervical cancer screening done by the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw - results obtained to-date
Nowotwory Journal of Oncology
(2003) - et al.
Overview of the European and North American studies on HPV testing in primary cervical cancer screening
Int J Cancer
(2006) - et al.
Variations in the age-specific curves of human papillomavirus prevalence in women worldwide
Int J Cancer
(2006) - et al.
Sexual habits and human papillomavirus infection among females in three New Independent States of the former Soviet Union
Sex Transm Dis
(2003)
HPV DNA detection and typing in cervical scrapes by general primer GP5+/6+ PCR
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HPV RNA and DNA testing in Polish women screened for cervical cancer – A single oncological center study
2022, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Moreover, Bardin et al. reported the highest prevalence (24.2%) was observed among women aged 25–34 years, particularly unmarried (37.3%). At the age of 55–59, HPV prevalence decreased to 8.6% [25]. Therefore, a 12% higher prevalence of HPV DNA in the younger group of women with abnormal cytology results can be explained by the higher sexual activity in this study group.
Human papillomavirus infection in Macau women
2012, Public HealthCitation Excerpt :To the authors' knowledge, this is the first epidemiological study of HPV infection in Macau. It has been reported that the HPV-DNA positive rate is 11% in Hong Kong,8 10.4% in Korea,10 22.1% in Africa,11 22% in Singapore,14 26.8% in the USA,15 16.2% in Taiwan16 and 16.6% in Poland.17 The worldwide prevalence of HPV infection is 10.4%.18