Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA.
Infect Agent Cancer. 2009 Feb 10;4 Suppl 1(Suppl 1):S9. doi: 10.1186/1750-9378-4-S1-S9.
Disparities in cervical cancer incidence and mortality rates exist among women of African ancestry (African-American, African-Caribbean and African). Persistent cervical infection with Human papillomavirus (HPV) is associated with cervical dysplasia and if untreated, could potentially progress to invasive cervical cancer. Very few studies have been conducted to examine the true prevalence of HPV infection in this population. Comparisons of cervical HPV infection and the type-specific distribution of HPV were performed between cancer-free Caribbean and US women.
The Caribbean population consisted of 212 women from Tobago and 99 women from Jamaica. The US population tested, consisted of 82 women from Pittsburgh. The majority of the US subjects was Caucasian, 74% (61/82) while 12% (10/82) and 13% (11/82) were African-American or other ethnic groups, respectively. The age-adjusted prevalence of any HPV infection among women from Tobago was 35%, while for Jamaica, it was 81% (p < 0.0001). The age-adjusted prevalence of HPV infection for Caribbean subjects was not statistically significantly different from the US (any HPV: 47% vs. 39%, p > 0.1; high-risk HPVs: 27% vs. 25%, p > 0.1); no difference was observed between US-Blacks and Jamaicans (any HPV: 92% vs. 81%, p > 0.1; high-risk HPV: 50% vs. 53%, p > 0.1). However, US-Whites had a lower age-adjusted prevalence of HPV infections compared to Jamaican subjects (any HPV: 29% vs. 81%, p < 0.0001; high-risk HPV: 20% vs. 53%, p < 0.001). Subjects from Jamaica, Tobago, and US-Blacks had a higher proportion of high-risk HPV infections (Tobago: 20%, Jamaica: 58%, US-Blacks: 40%) compared to US-Whites (15%). Similar observations were made for the presence of infections with multiple high-risk HPV types (Tobago: 12%, Jamaica: 43%, US-Blacks: 30%, US-Whites: 8%). Although we observed similar prevalence of HPV16 infections among Caribbean and US-White women, there was a distinct distribution of high-risk HPV types when comparisons were made between the ethnic groups.
The higher prevalence of cervical HPV infections and multiple high-risk infections in Caribbean and US-Black women may contribute to the high incidence and prevalence of cervical cancer in these populations. Evaluation of a larger sample size is currently ongoing to confirm the distinct distribution of HPV types between ethnic groups.
非裔美国女性（非裔美国人、非裔加勒比人和非裔）的宫颈癌发病率和死亡率存在差异。人乳头瘤病毒（HPV）持续感染与宫颈发育不良有关，如果不治疗，可能会发展为浸润性宫颈癌。很少有研究来检查这一人群中 HPV 感染的真实流行率。对无癌加勒比和美国妇女进行了宫颈 HPV 感染和 HPV 型别分布的比较。
加勒比人群包括来自多巴哥的 212 名女性和来自牙买加的 99 名女性。接受检测的美国人群由来自匹兹堡的 82 名女性组成。大多数美国受试者为白种人，占 74%（61/82），12%（10/82）和 13%（11/82）分别为非裔美国人和其他族裔。多巴哥妇女中 HPV 感染的年龄调整患病率为 35%，而牙买加为 81%（p<0.0001）。加勒比地区人群 HPV 感染的年龄调整患病率与美国无统计学差异（任何 HPV：47%比 39%，p>0.1；高危 HPV：27%比 25%，p>0.1）；美国黑人与牙买加人之间无差异（任何 HPV：92%比 81%，p>0.1；高危 HPV：50%比 53%，p>0.1）。然而，与牙买加人相比，美国白人 HPV 感染的年龄调整患病率较低（任何 HPV：29%比 81%，p<0.0001；高危 HPV：20%比 53%，p<0.001）。与美国白人相比，牙买加、多巴哥和美国黑人高危 HPV 感染的比例更高（多巴哥：20%，牙买加：58%，美国黑人：40%）（美国白人：15%）。同样的观察结果也见于多种高危 HPV 类型的感染（多巴哥：12%，牙买加：43%，美国黑人：30%，美国白人：8%）。尽管我们观察到加勒比和美国白人妇女的 HPV16 感染率相似，但在族裔群体之间比较时，高危 HPV 型别的分布明显不同。
加勒比和美国黑人妇女中宫颈 HPV 感染和多种高危感染的高流行率可能导致这些人群宫颈癌的发病率和患病率较高。目前正在评估更大的样本量，以确认族裔群体之间 HPV 类型的不同分布。
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