Denver Public Health, Denver Health Medical Center, 301 W. Sixth Ave., MC0151, Denver, CO 80204, USA.
Public Health Rep. 2011 May-Jun;126(3):330-7. doi: 10.1177/003335491112600305.
OBJECTIVES; We described prevalence estimates of high-risk human papillomavirus (HR-HPV), HPV types 16 and 18, and abnormal Papanicolaou (Pap) smear tests among American Indian/Alaska Native (AI/AN) women compared with women of other races/ethnicities.
A total of 9,706 women presenting for cervical screening in a sentinel network of 26 clinics (sexually transmitted disease, family planning, and primary care) received Pap smears and HR-HPV type-specific testing. We compared characteristics of 291 women self-identified as AI/AN with other racial/ethnic minority groups.
In our population, AI/AN and non-Hispanic white (NHW) women had similar age- and clinic-adjusted prevalences of HR-HPV (29.1%, 95% confidence interval [CI] 23.9, 34.3 for AI/AN women vs. 25.8%, 95% CI 24.4, 27.2 for NHW women), HPV 16 and 18 (6.7%, 95% CI 3.9, 9.6 for AI/AN women vs. 8.8%, 95% CI 7.9, 9.7 for NHW women), and abnormal Pap smear test results (16%, 95% CI 11.7, 20.3 for AI/AN women vs. 14.9%, 95% CI 13.7, 16.0 for NHW women). AI/AN women had a higher prevalence of HR-HPV than Hispanic women, and a similar prevalence of HPV 16 and 18 as compared with Hispanic and African American women.
We could not demonstrate differences in the prevalence of HR-HPV, HPV 16 and 18, or abnormal Pap smear test results between AI/AN and NHW women. This finding should improve confidence in the benefit of HPV vaccine and Pap smear screening in the AI/AN population as an effective strategy to reduce rates of cervical cancer.
目的;我们描述了高危型人乳头瘤病毒(HR-HPV)、HPV 型 16 和 18 以及美国印第安人/阿拉斯加原住民(AI/AN)女性巴氏涂片检查异常的流行率,与其他种族/族裔的女性进行比较。
共有 9706 名女性在一个由 26 个诊所(性传播疾病、计划生育和初级保健)组成的监测网络中进行宫颈筛查,接受巴氏涂片检查和 HR-HPV 型特异性检测。我们比较了 291 名自我认定为 AI/AN 的女性与其他少数族裔群体的特征。
在我们的人群中,AI/AN 和非西班牙裔白人(NHW)女性的 HR-HPV(29.1%,95%置信区间[CI]23.9,34.3 为 AI/AN 女性,25.8%,95%CI24.4,27.2 为 NHW 女性)、HPV 16 和 18(6.7%,95%CI3.9,9.6 为 AI/AN 女性,8.8%,95%CI7.9,9.7 为 NHW 女性)和巴氏涂片检查异常结果(16%,95%CI11.7,20.3 为 AI/AN 女性,14.9%,95%CI13.7,16.0 为 NHW 女性)的年龄和诊所调整后的流行率相似。AI/AN 女性的 HR-HPV 流行率高于西班牙裔女性,HPV 16 和 18 的流行率与西班牙裔和非裔美国女性相似。
我们无法证明 AI/AN 和 NHW 女性之间 HR-HPV、HPV 16 和 18 或巴氏涂片检查异常结果的流行率存在差异。这一发现应该增强对 HPV 疫苗和巴氏涂片筛查在 AI/AN 人群中的有效性的信心,作为降低宫颈癌发病率的有效策略。