Maucort-Boulch Delphine, Franceschi Silvia, Plummer Martyn
Hospices Civils de Lyon, Service de Biostatistique, France.
Cancer Epidemiol Biomarkers Prev. 2008 Mar;17(3):717-20. doi: 10.1158/1055-9965.EPI-07-2691.
Data from population-based human papillomavirus (HPV) surveys in regions of low, intermediate, and high cervical cancer incidence were used to study the ecologic correlation between high-risk HPV prevalence and cervical cancer incidence. All the surveys were conducted by the IARC according to a standardized protocol for the collection of female population samples and detection of HPV DNA using PCR assay in a central laboratory. Cervical cancer incidence data were extracted, when available, from a cancer registry covering the surrounding or nearby area of the prevalence survey. Thirteen areas were included in this analysis. The relation between high-risk HPV prevalence and cervical cancer incidence was investigated within 10-year age groups from age 25 to 65 years. A Poisson regression model was used to predict cervical cancer incidence from HPV prevalence, and the strength of the correlation was assessed using Spearman's rank correlation coefficient. The rank correlation was weakest in women ages 25 to 34 years and strongest in women ages 55 to 64 years. In addition, the prevalence of high-risk HPV was not able to predict cervical cancer incidence accurately in every country. Nevertheless, our data raise a concern about the cervical cancer burden in areas where reliable cervical cancer statistics do not exist but where the prevalence of high-risk HPV in women over age 45 is high.
来自宫颈癌低发、中发和高发地区基于人群的人乳头瘤病毒（HPV）调查的数据，被用于研究高危型HPV流行率与宫颈癌发病率之间的生态学关联。所有调查均由国际癌症研究机构（IARC）按照标准化方案进行，该方案用于收集女性人群样本，并在中央实验室采用聚合酶链反应（PCR）检测法检测HPV DNA。如有宫颈癌发病率数据，会从覆盖患病率调查周边或附近地区的癌症登记处提取。本分析纳入了13个地区。在25岁至65岁的10岁年龄组内，研究了高危型HPV流行率与宫颈癌发病率之间的关系。采用泊松回归模型根据HPV流行率预测宫颈癌发病率，并使用斯皮尔曼等级相关系数评估关联强度。等级相关性在25岁至34岁女性中最弱，在55岁至64岁女性中最强。此外，高危型HPV的流行率在每个国家都无法准确预测宫颈癌发病率。然而，我们的数据引发了人们对某些地区宫颈癌负担的担忧，这些地区缺乏可靠的宫颈癌统计数据，但45岁以上女性中高危型HPV的流行率较高。
