Human papillomavirus genotypes detected in clinician-collected and self-collected specimens from women living in the Mississippi Delta

Philip E Castle, Julia C Gage, Edward E Partridge, Alfio Rausa, Patti E Gravitt, Isabel C Scarinci, Philip E Castle, Julia C Gage, Edward E Partridge, Alfio Rausa, Patti E Gravitt, Isabel C Scarinci

Abstract

Background: There are no data available on human papillomavirus (HPV) infections in women living in the Mississippi Delta, where cervical cancer incidence and mortality among African American women is among the highest in the United States. The aim of this analysis was to report the age-specific prevalence of HPV in this population.

Methods: We recruited 443 women, 26-65 years of age, from the general population of women living in the Mississippi Delta to participate; 252 women had been screened for cervical cancer within the last 3 years while 191 had not. Women underwent a pelvic exam and had clinician-collected Pap sample taken for the routine cervical cancer screening by cytology. Women were asked to collect a self-collected specimen at home and return it to the clinic. Both specimens were tested for HPV genotypes.

Results: Four hundred and six women (91.6%) had HPV genotyping results for the clinician-collected and self-collected specimens. The prevalence of carcinogenic HPV was 18.0% (95% CI: 14.4%-22.1%) for clinician-collected specimens and 26.8% (95% CI: 22.6%-31.4%) for self-collected specimens. The concordance for the detection of carcinogenic HPV between clinician-collected and self-collected specimens was only fair (kappa = 0.54). While the prevalence of carcinogenic HPV in either sample decreased sharply with increasing age (ptrend< 0.01), the prevalence of non-carcinogenic HPV did not, especially the prevalence of HPV genotypes in the alpha 3/4/15 phylogenetic group.

Conclusions: The prevalence of carcinogenic HPV in our sample of women living in the Mississippi Delta was greater than the prevalence reported in several other U.S. studies. The high carriage of HPV infection, along with lack of participation in cervical cancer screening by some women, may contribute to the high cervical cancer burden in the region.

Figures

Figure 1
Figure 1
The age group-specific prevalence of any (A), any carcinogenic (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) (B), any alpha 5/6/7/9/11 (HPV16, 18, 26, 31, 33, 35, 39, 45, 51-56, 58, 59, 64, 66, 67, 68, 69, 70, 73, 82, and 82v) (C), and alpha 3/4/15 (HPV 61, 62, 71, 72, 81, 83, 84, and 89) (D) human papillomavirus (HPV) types as detected in clinician-collected cervical specimens and self-collected cervicovaginal specimens. Age groups were 26-29 (white bars), 30-39 (light gray bars) , 40-49 (medium gray bars), and 50-65 (black bars) years old (y.o.)

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