Centre for Public Health Research, Massey University, PO Box 756, Wellington 6140, New Zealand.
Centre for Public Health Research, Massey University, PO Box 756, Wellington 6140, New Zealand ; London School of Hygiene & Tropical Medicine, London, UK.
Infect Agent Cancer. 2014 Apr 28;9:14. doi: 10.1186/1750-9378-9-14. eCollection 2014.
Cancer is among the leading contributors to morbidity and mortality in the Pacific, but the magnitude of the problem and the potential for prevention have not been comprehensively studied. Over the past decade, cervical cancer has been the most common cancer among women in Fiji with an age standardised cervical cancer incidence rate of 51 per 100,000. This rate is among the highest in the South Pacific region and in the world. This high cervical cancer incidence rate is likely linked to the low cervical screening rate, but it points also to the possibility of a high burden of human papillomavirus (HPV) infection.
We conducted a population-based survey in Fiji to provide information on human papillomavirus (HPV) prevalence, and the distribution of individual HPV types in a Fijian health-sub-district. We included 1,261 women aged between 16 and 64 years. A general primer GP5+/6+ mediatedpolymerase chain reaction (PCR) assay was used for HPV testing of 44 HPV types.
The crude HPV prevalence in 1,244 women with an adequate HPV sample was 24.0% (95% confidence interval (CI), 21.7-26.4%) and the corresponding age standardised prevalence was 25.5% (95% CI, 23.1-28.1%). The prevalence of high-risk HPV types was 13.6% (95% CI, 11.8-15.6%). Among 1,192 women with adequate cytological results, 13 (1.1%) showed cervical abnormalities, the majority of which were high-grade intraepithelial lesions or worse. HPV prevalence declined from 35.8% in women aged <25 years to 18.6% in those aged 55-64 years of age. After adjustment, the only variables significantly associated with HPV-positivity were age (ranging from odds ratio (OR) 0.57 (95% CI, 0.36-0.89) for 25-34 year-old-women to OR 0.43 (95% CI, 0.20-0.89) for 55-64 year-old-women) and 'husband's extramarital sexual relationships' (OR 1.69; 95% CI, 1.17-2.34).
These findings on HPV provide key information for future policy decisions on the most appropriate methods of cervical cancer prevention in Fiji and in the Pacific region.
癌症是太平洋地区发病率和死亡率的主要原因之一，但该问题的严重程度和预防潜力尚未得到全面研究。在过去十年中，宫颈癌一直是斐济女性中最常见的癌症，其宫颈癌发病率的年龄标准化率为每 10 万人 51 例。这一比率在南太平洋地区和世界范围内都属于最高水平。如此高的宫颈癌发病率可能与较低的宫颈癌筛查率有关，但也可能表明人乳头瘤病毒（HPV）感染负担较高。
我们在斐济进行了一项基于人群的调查，以提供 HPV 流行率以及斐济一个卫生分区中 HPV 各型别分布的信息。我们纳入了 1261 名年龄在 16 至 64 岁之间的女性。使用通用引物 GP5+/6+介导的聚合酶链反应（PCR）检测法对 44 种 HPV 型别进行 HPV 检测。
1244 名 HPV 样本充足的女性中，HPV 总感染率为 24.0%（95%置信区间（CI），21.7-26.4%），相应的年龄标准化感染率为 25.5%（95%CI，23.1-28.1%）。高危型 HPV 感染率为 13.6%（95%CI，11.8-15.6%）。在 1192 名具有充足细胞学结果的女性中，有 13 名（1.1%）出现宫颈异常，其中大多数为高级别上皮内瘤变或更严重的病变。HPV 感染率从 25 岁以下女性的 35.8%降至 55-64 岁女性的 18.6%。调整后，唯一与 HPV 阳性显著相关的变量是年龄（25-34 岁女性的比值比（OR）为 0.57（95%CI，0.36-0.89），55-64 岁女性的 OR 为 0.43（95%CI，0.20-0.89））和“丈夫的婚外性关系”（OR 1.69；95%CI，1.17-2.34）。
这些 HPV 发现为斐济和太平洋地区未来关于宫颈癌最适宜预防方法的政策决策提供了关键信息。
