Department of Gynecologic Oncology, Chittaranjan National Cancer Institute, Kolkata, India.
Int J Cancer. 2013 Apr 1;132(7):1693-9. doi: 10.1002/ijc.27793. Epub 2012 Sep 14.
Population prevalence of human papillomavirus (HPV) and cervical intraepithelial neoplasias (CIN) is an important indicator to judge the disease burden in the community, to monitor the performance of cervical cancer screening program and to assess the impact of HPV vaccination program. India being a country without any cervical cancer screening program has no published data on the population prevalence of CIN and only a few large community-based studies to report the high-risk HPV prevalence. The objective of our study was to study HPV and CIN prevalence in a previously unscreened population. We pooled together the results of three research studies originally designed to assess the performance of visual inspection after acetic acid application and Hybrid Capture 2 (HC 2). Nearly 60% of the screened women had colposcopy irrespective of their screening test results. The diagnosis and grading of cervical neoplasias were based on histology. The age standardized prevalence of HPV by HC 2 test was 6.0%. Age-adjusted prevalence of CIN1 and CIN2 was 2.3% and 0.5%, respectively. The age-adjusted prevalence of CIN3 was 0.4% and that of invasive cancer was 0.2%. The prevalence of high-risk HPV was relatively low in the population we studied, which is reflected in the low prevalence of high-grade CIN. The prevalence of CIN3 remained constant across age groups due to absence of screening.
人群中人类乳头瘤病毒(HPV)和宫颈上皮内瘤变(CIN)的流行率是判断社区疾病负担、监测宫颈癌筛查计划效果以及评估 HPV 疫苗接种计划影响的重要指标。印度是一个没有宫颈癌筛查计划的国家,没有关于 CIN 人群流行率的发表数据,只有少数大型社区研究报告了高危型 HPV 的流行率。我们的研究目的是研究一个未经筛查的人群中 HPV 和 CIN 的流行率。我们将最初旨在评估醋酸视觉检查和 Hybrid Capture 2(HC 2)性能的三项研究的结果汇总在一起。近 60%的筛查妇女无论其筛查测试结果如何都接受了阴道镜检查。宫颈病变的诊断和分级基于组织学。HC 2 检测的 HPV 年龄标准化流行率为 6.0%。CIN1 和 CIN2 的年龄调整患病率分别为 2.3%和 0.5%。CIN3 的年龄调整患病率为 0.4%,浸润性癌的患病率为 0.2%。我们研究人群中的高危型 HPV 流行率相对较低,这反映在高级别 CIN 的低流行率上。由于缺乏筛查,CIN3 的患病率在各年龄组中保持不变。