Olusola Patti, Ousley Kia, Ndetan Harrison, Singh Karan P, Banerjee Hirendra Nath, Dasgupta Santanu
Department of Family Medicine, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, USA.
Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, USA.
Medicines (Basel). 2019 Sep 4;6(3):93. doi: 10.3390/medicines6030093.
Undergoing a timely Pap smear, high-risk human papilloma virus (HPV)- and colposcopy-based testing can reduce HPV-associated cervical cancer (CC) development in women. However, in rural areas, women and minorities without insurance do not undergo periodic assessment and remain at greater risk of HPV infection and CC. In this study, 173 women from rural East Texas with various ethnic backgrounds were examined thorough HPV/Pap-based testing and colposcopic assessment. Of the 113 informative cases, 77% (87/113) were positive for high-risk HPV infection and 23% of subjects (26/113) were negative. Associations between HPV positivity with young age ( = 0.002), and a low number of pregnancy ( = 0.004) and births ( = 0.005) were evident. Women with long-term use of contraceptives (OR 1.93, 95% CI, 0.80-4.69) were associated with increased risk of HPV infection. African-American women had a higher risk of abnormal Pap outcome compared to Caucasians (OR 5.31, 95% CI, 0.67-42.0). HPV seemed to be a predictor of abnormal Pap outcome (OR 1.77, 95% CI, 0.48-6.44) in these subjects. Unmarried/widowed/divorced women had an increased abnormal Pap test outcome compared to married women or women living with a partner ( = 0.01), with over 278% increased odds (OR 3.78 at 95% CI, 1.29-11.10). Insured women undergoing periodic checkups were detected early with high-risk HPV infection and abnormal Pap test/colposcopic outcome. Comprehensive and timely screening of uninsured women and minorities in rural East Texas are warranted, which could potentially prevent the onset of HPV-associated CC.
及时进行巴氏涂片检查、基于高危人乳头瘤病毒（HPV）和阴道镜的检测，可以降低女性患HPV相关宫颈癌（CC）的风险。然而，在农村地区，没有保险的女性和少数族裔不进行定期评估，感染HPV和患CC的风险更高。在本研究中，对173名来自东德克萨斯农村、具有不同种族背景的女性进行了基于HPV/巴氏涂片的检测和阴道镜评估。在113例有效病例中，77%（87/113）高危HPV感染呈阳性，23%的受试者（26/113）呈阴性。HPV阳性与年轻（P = 0.002）、怀孕次数少（P = 0.004）和生育次数少（P = 0.005）之间的关联明显。长期使用避孕药的女性（OR 1.93，95% CI，0.80 - 4.69）感染HPV的风险增加。与白种人相比，非裔美国女性巴氏涂片结果异常的风险更高（OR 5.31，95% CI，0.67 - 42.0）。在这些受试者中，HPV似乎是巴氏涂片结果异常的一个预测因素（OR 1.77，95% CI，0.48 - 6.44）。与已婚女性或与伴侣同居的女性相比，未婚/丧偶/离婚女性巴氏涂片检查结果异常的情况增加（P = 0.01），几率增加超过278%（95% CI下OR为3.78，1.29 - 11.10）。接受定期检查的参保女性高危HPV感染以及巴氏涂片检查/阴道镜检查结果异常被早期发现。对东德克萨斯农村地区未参保女性和少数族裔进行全面及时的筛查是必要的，这有可能预防HPV相关CC的发生。
