title: A population-based study of vaginal human papillomavirus infection in hysterectomized women.
abstract: We compared point prevalences and determinants of human papillomavirus (HPV) DNA detection by testing enrollment vaginal specimens from hysterectomized women (n=569) and enrollment cervical specimens from nonhysterectomized women (n=6098) >or=30 years old, using MY09/MY11 L1 consensus-primer polymerase chain reaction. The subjects were participating in a population-based cohort study (n=10,049) in Guanacaste, Costa Rica, that was initiated in 1993. Non-cancer-associated HPV types, especially types 61, 71, and 72, were detected more frequently in the vaginal specimens from hysterectomized women (23.7% [95% confidence interval [CI], 20.3%-27.4%]) than in the cervical specimens from nonhysterectomized women (16.7% [95% CI, 15.7%-17.6%]) (P=.0001). There was no difference between the prevalences of cancer-associated HPV types in hysterectomized women and those in nonhysterectomized women; in both groups, the prevalence of HPV DNA was greater in women with multiple lifetime sex partners. We infer from our data that the cervical transformation zone may not be needed for cancer-associated HPV infection but may be uniquely susceptible to HPV-induced carcinogenesis; we also infer that specific phylogenetic groups of HPV (i.e., A3/A4/A15) may have a predilection for vaginal epithelium.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-7234, USA. castlep@mail.nih.gov
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
authors.forename: Mark
authors.initials: M
authors.lastname: Schiffman
authors.forename: M Concepcion
authors.initials: MC
authors.lastname: Bratti
authors.forename: Allan
authors.initials: A
authors.lastname: Hildesheim
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: Martha L
authors.initials: ML
authors.lastname: Hutchinson
authors.forename: Ana Cecilia
authors.initials: AC
authors.lastname: Rodriguez
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: Hortense
authors.initials: H
authors.lastname: Kendall
authors.forename: Raphael P
authors.initials: RP
authors.lastname: Viscidi
authors.forename: Jose
authors.initials: J
authors.lastname: Jeronimo
authors.forename: John E
authors.initials: JE
authors.lastname: Schussler
authors.forename: Robert D
authors.initials: RD
authors.lastname: Burk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D002584:Cervix Uteri / Q000821:virology; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology; D014621:Vagina / Q000821:virology; D014623:Vaginal Diseases / Q000453:epidemiology / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral