BACKGROUND: Detailed epidemiologic studies of cervical type-specific human papillomavirus (HPV) infection in large populations are scarce. METHODS: We recruited a population-based cohort in Guanacaste, Costa Rica. Participants were interviewed, screened for cervical neoplasia, and tested for >40 HPV types by use of MY09/11 L1 consensus primer polymerase chain reaction. We estimated the risk factors for infection and the associations between type-specific HPV infections and cervical intraepithelial neoplasia (CIN) and cancer in 8514 sexually active women who had not undergone a hysterectomy. RESULTS: The overall HPV prevalence was 26.5%. The most common type was HPV-16 (3.6% of the population). HPV prevalence showed a U-shaped age-specific curve. Sexual behaviors were the main determinants of oncogenic and nononcogenic infections; age at first sexual intercourse was not independently associated with infection. Barrier contraceptive use was somewhat protective against infection. Oncogenic infections were strongly associated with risk of all grades of CIN and of cancer. Types 16, 18, and 58 were the most common in women diagnosed with CIN3 and cancer. Except for those that included HPV-16, multiple-type infections were associated with an increased risk (compared with that for single-type infections) of all grades of CIN and of cancer. CONCLUSIONS: We confirmed the bimodal age pattern of HPV infection in Guanacaste and the sexually transmitted nature of both oncogenic and nononcogenic HPV types.
BACKGROUND: Detailed epidemiologic studies of cervical type-specific human papillomavirus (HPV) infection in large populations are scarce. METHODS: We recruited a population-based cohort in Guanacaste, Costa Rica. Participants were interviewed, screened for cervical neoplasia, and tested for >40 HPV types by use of MY09/11 L1 consensus primer polymerase chain reaction. We estimated the risk factors for infection and the associations between type-specific HPV infections and cervical intraepithelial neoplasia (CIN) and cancer in 8514 sexually active women who had not undergone a hysterectomy. RESULTS: The overall HPV prevalence was 26.5%. The most common type was HPV-16 (3.6% of the population). HPV prevalence showed a U-shaped age-specific curve. Sexual behaviors were the main determinants of oncogenic and nononcogenic infections; age at first sexual intercourse was not independently associated with infection. Barrier contraceptive use was somewhat protective against infection. Oncogenic infections were strongly associated with risk of all grades of CIN and of cancer. Types 16, 18, and 58 were the most common in women diagnosed with CIN3 and cancer. Except for those that included HPV-16, multiple-type infections were associated with an increased risk (compared with that for single-type infections) of all grades of CIN and of cancer. CONCLUSIONS: We confirmed the bimodal age pattern of HPV infection in Guanacaste and the sexually transmitted nature of both oncogenic and nononcogenic HPV types.
Authors: Julia C Gage; Kayode O Ajenifuja; Nicolas A Wentzensen; Akinfolarin C Adepiti; Claire Eklund; Mary Reilly; Martha Hutchinson; Sholom Wacholder; Joe Harford; Amr S Soliman; Robert D Burk; Mark Schiffman Journal: Int J Cancer Date: 2011-08-05 Impact factor: 7.396
Authors: Troy J Kemp; Allan Hildesheim; Alfonso García-Piñeres; Marcus C Williams; Gene M Shearer; Ana Cecilia Rodriguez; Mark Schiffman; Robert Burk; Enrique Freer; Jose Bonilla; Rolando Herrero; Ligia A Pinto Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-07-20 Impact factor: 4.254
Authors: Mark Schiffman; Nicolas Wentzensen; Sholom Wacholder; Walter Kinney; Julia C Gage; Philip E Castle Journal: J Natl Cancer Inst Date: 2011-01-31 Impact factor: 13.506
Authors: Ana Cecilia Rodríguez; Alfonso J García-Piñeres; Allan Hildesheim; Rolando Herrero; Matthew Trivett; Marcus Williams; Ivannia Atmella; Margarita Ramírez; Maricela Villegas; Mark Schiffman; Robert Burk; Enrique Freer; José Bonilla; Concepción Bratti; Ligia A Pinto Journal: Int J Cancer Date: 2011-02-01 Impact factor: 7.396
Authors: Philip E Castle; Ana C Rodríguez; Robert D Burk; Rolando Herrero; Allan Hildesheim; Diane Solomon; Mark E Sherman; Jose Jeronimo; Mario Alfaro; Jorge Morales; Diego Guillén; Martha L Hutchinson; Sholom Wacholder; Mark Schiffman Journal: Int J Cancer Date: 2009-10-01 Impact factor: 7.396
Authors: Philip E Castle; Patti E Gravitt; Diane Solomon; Cosette M Wheeler; Mark Schiffman Journal: J Clin Microbiol Date: 2007-11-07 Impact factor: 5.948
Authors: Long Fu Xi; Laura A Koutsky; Philip E Castle; Zoe R Edelstein; Craig Meyers; Jesse Ho; Mark Schiffman Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-12 Impact factor: 4.254