title: Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study.
abstract: In this cross-sectional population-based study we determine human papillomavirus (HPV) prevalence in South Wales to provide comprehensive baseline data for future assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. Liquid-based cytology samples from women attending routine cervical screening were collected (n=10 000: mean age 38 years, 93% cytology negative, and 64.8% from the 50% least deprived LSOA according to social deprivation score (SDS)). High-Risk (HR) and Low-Risk HPV screening was performed using HPV PCR-EIA with genotyping of HR positives and data correlated with age, SDS and cytology. Overall HPV prevalence was 13.5% (9.3% age standardised) and the most frequent HR types were HPV 16, 31, 18 and 58. In HR HPV-positive cases 42.4% had a single HR type and they were predominant in women with severe cytological abnormalities. Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status. HPV prevalence increased significantly with degree of dyskaryosis from 7% in cytology negative samples to 80% in samples with severe cytological abnormalities (P-value <0.0001). Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18). The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population.
authors.affiliation: Department of Obstetrics & Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. hibbittssj@cf.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Hibbitts
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: N
authors.initials: N
authors.lastname: Powell
authors.forename: N
authors.initials: N
authors.lastname: Dallimore
authors.forename: J
authors.initials: J
authors.lastname: McRea
authors.forename: H
authors.initials: H
authors.lastname: Beer
authors.forename: A
authors.initials: A
authors.lastname: Tristram
authors.forename: H
authors.initials: H
authors.lastname: Fielder
authors.forename: A N
authors.initials: AN
authors.lastname: Fiander
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D052162:Human papillomavirus 16; D052161:Human papillomavirus 18; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014852:Wales