National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America; University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Department of Cell and Molecular Biology, Jackson, MS, United States of America.
University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
Prev Med. 2021 Dec;153:106740. doi: 10.1016/j.ypmed.2021.106740. Epub 2021 Jul 20.
Cervical cancer rates in Mississippi are disproportionately high, particularly among Black individuals; yet, research in this population is lacking. We designed a statewide, racially diverse cohort of individuals undergoing cervical screening in Mississippi. Here, we report the baseline findings from this study. We included individuals aged 21 years and older undergoing cervical screening with cytology or cytology-human papillomavirus (HPV) co-testing at the Mississippi State Health Department (MSDH) and the University of Mississippi Medical Center (UMMC) (December 2017-May 2020). We collected discarded cytology specimens for future biomarker testing. Demographics and clinical results were abstracted from electronic medical records and evaluated using descriptive statistics and chi-square tests. A total of 24,796 individuals were included, with a median age of 34.8 years. The distribution of race in our cohort was 60.2% Black, 26.4% White, 7.5% other, and 5.9% missing. Approximately 15% had abnormal cytology and, among those who underwent co-testing at MSDH (n = 6,377), HPV positivity was 17.4% and did not vary significantly by race. Among HPV positives, Black individuals were significantly less likely to be HPV16/18 positive and more likely to be positive for other high-risk 12 HPV types compared to White individuals (20.5% vs. 27.9%, and 79.5% and 72.1%, respectively, p = 0.011). Our statewide cohort represents one of the largest racially diverse studies of cervical screening in the U.S. We show a high burden of abnormal cytology and HPV positivity, with significant racial differences in HPV genotype prevalence. Future studies will evaluate cervical precancer risk, HPV genotyping, and novel biomarkers in this population.
密西西比州的宫颈癌发病率极高，尤其是在黑人中；然而，针对这一人群的研究却很缺乏。我们设计了一个全州范围内、种族多样化的密西西比州接受宫颈筛查的个体队列。在这里，我们报告了这项研究的基线结果。我们纳入了年龄在 21 岁及以上，在密西西比州立卫生部（MSDH）和密西西比大学医学中心（UMMC）接受宫颈筛查的个体，筛查方法包括细胞学检查或细胞学-人乳头瘤病毒（HPV）联合检测（2017 年 12 月至 2020 年 5 月）。我们收集了废弃的细胞学标本，用于未来的生物标志物检测。我们从电子病历中提取人口统计学和临床结果，并使用描述性统计和卡方检验进行评估。共纳入 24796 例个体，中位年龄为 34.8 岁。我们队列的种族分布为 60.2%为黑人，26.4%为白人，7.5%为其他，5.9%为缺失。约 15%的个体细胞学检查异常，在 MSDH 接受联合检测的个体中（n=6377），HPV 阳性率为 17.4%，且与种族无显著差异。在 HPV 阳性个体中，与白人相比，黑人个体 HPV16/18 阳性的可能性显著降低，而其他高危型 12 种 HPV 阳性的可能性更高（20.5%比 27.9%，79.5%比 72.1%，p=0.011）。我们的全州队列是美国最大的种族多样化的宫颈筛查研究之一。我们显示了异常细胞学和 HPV 阳性率负担沉重，且 HPV 基因型流行率存在显著的种族差异。未来的研究将在该人群中评估宫颈癌前病变风险、HPV 基因分型和新型生物标志物。
