Kist Medical College, Lalitpur, Nepal.
Cancer Causes Control. 2010 Mar;21(3):323-30. doi: 10.1007/s10552-009-9467-z. Epub 2009 Nov 22.
Cervical cancer is the most common malignancy among Nepalese women. Rational prevention measures are informed by epidemiological data on human papillomavirus (HPV) prevalence.
Cervical specimens were obtained from 932 married women aged 15-59 years from the general population of Bharatpur, Nepal, as well as from 61 locally diagnosed invasive cervical cancers (ICC). HPV was detected using a GP5+/6+ PCR-based assay.
Among the general population, the overall prevalence of HPV was 8.6% (6.1% for high-risk types). Prevalence of abnormal Pap smears was 3.6%, including five high-grade squamous intraepithelial lesions. Residence in slum housing, lower education level, > or =3 sexual partners in a woman's lifetime, and husband's extramarital affairs were significantly associated with HPV positivity. HPV prevalence was relatively constant across all age groups. HPV16 was the most common type, both among the general population (1.9%) and among 54 women with HPV-positive ICC (68.5%). HPV18 (22.2%) and 45 (5.6%) were also common in ICC.
Nepal has an intermediate burden of HPV infection, lower than many areas in India and China. Approximately 80% of cervical cancer in Nepal is theoretically preventable by HPV16/18 vaccines. In the meantime, screen-and-treat approaches should be encouraged to overcome difficulties that were encountered to recall women with screening-positive findings.
宫颈癌是尼泊尔女性最常见的恶性肿瘤。合理的预防措施需要基于人乳头瘤病毒（HPV）流行率的流行病学数据。
从尼泊尔巴哈特布尔的普通人群中采集了 932 名年龄在 15-59 岁的已婚妇女以及 61 名本地诊断为浸润性宫颈癌（ICC）的宫颈标本。使用 GP5+/6+基于 PCR 的检测方法检测 HPV。
在普通人群中，HPV 的总流行率为 8.6%（高危型为 6.1%）。异常巴氏涂片的患病率为 3.6%，包括 5 例高级别鳞状上皮内病变。居住在贫民窟、教育程度较低、女性一生中的性伴侣数≥3 和丈夫的婚外情与 HPV 阳性显著相关。HPV 流行率在所有年龄组中相对稳定。HPV16 是最常见的类型，无论是在普通人群（1.9%）还是在 54 名 HPV 阳性 ICC 妇女中（68.5%）都是如此。HPV18（22.2%）和 45（5.6%）在 ICC 中也很常见。
尼泊尔 HPV 感染负担处于中等水平，低于印度和中国的许多地区。大约 80%的尼泊尔宫颈癌理论上可以通过 HPV16/18 疫苗预防。同时，应鼓励筛查和治疗方法，以克服召回筛查阳性发现的妇女所遇到的困难。
