title: Oncogenic human papillomavirus (HPV) infection and uterine cervical cancer: a screening strategy in the perspective of rural India.
abstract: The predominance of cervical cancer in India can mostly be attributed to the lack of early screening. The objective of the present study has been, therefore, to determine a cost-effective oncogenic human papillomavirus (HPV)-based cervical cancer screening plan for rural Indian women. The results showed that in normal women, highest prevalence of HPV 16/18 infection was in the age group < or =23 years and lowest in > or =44 years with an insignificant change in between. HPV 16/18 infection was significantly associated with cervical erosion at age < or =23 years, but not with cytology or visual inspection with acetic acid testing at any age. The low-grade cytological lesions, however, increased only with increase in age. Fourteen per cent of the cervical malignancy was also found to be present in the age group 24-33 years with an 87% HPV infection. Here we proposed a cost-effective screening scheme in which HPV testing must be performed in women (a) < or =23 years with cervical erosion and (b) 24-43 years, as an adjunct to Pap smears (both HPV and cytology were prevalent in this group). For women > or =44 years, HPV testing might not be useful, since abnormal cytology was more prominent over the viral infection. We infer that by not performing HPV test in the group < or =23 years, approximately 76% of the high-risk HPV-infected individuals potentially "at risk" for developing cervical cancer might be missed.
authors.affiliation: Biochemistry Unit, Indian Statistical Institute, 203 B. T. Road, Calcutta 700 035, India. chandra@isical.ac.in
authors.forename: C
authors.initials: C
authors.lastname: Duttagupta
authors.forename: S
authors.initials: S
authors.lastname: Sengupta
authors.forename: M
authors.initials: M
authors.lastname: Roy
authors.forename: D
authors.initials: D
authors.lastname: Sengupta
authors.forename: S
authors.initials: S
authors.lastname: Chakraborty
authors.forename: P
authors.initials: P
authors.lastname: Bhattacharya
authors.forename: S
authors.initials: S
authors.lastname: Roy
authors.forename: S
authors.initials: S
authors.lastname: Ghosh
mesh_terms: D019342:Acetic Acid / Q000191:economics; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000191:economics / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000191:economics / Q000473:pathology; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D007202:Indicators and Reagents / Q000191:economics; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000191:economics / Q000473:pathology; D015995:Prevalence; D012423:Rural Health; D012720:Severity of Illness Index; D013223:Statistics as Topic; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000191:economics / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000473:pathology; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000473:pathology; D016387:Women's Health
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid