title: Distribution of human papillomavirus types, cervical cancer screening history, and risk factors for infection in Manitoba.
abstract: OBJECTIVE
  We conducted a study to investigate the prevalence of human papillomavirus (HPV) infections in an opportunistic sample of women in Manitoba, Canada. We inquired about risk factors associated with HPV infections and linked the HPV typing results with the cervical cancer screening history of the participants.
  
  
  METHODS
  The study population included 592 women attending Papanicolaou (Pap) test clinics. After signing a consent form, participants were given a self-administered questionnaire on risk factors and received a conventional Pap test. Residual cells from the Pap tests were collected and sent for HPV typing.
  
  
  RESULTS
  The mean age of the population was 43 years. A total of 115 participants (19.4%) had an HPV infection, 89 of whom had a normal Pap test. Of those who were HPV-positive, 61 (10.3%) had high-risk (Group 1) HPV. HPV-16 was the most prevalent type (15/115: 13.0% of infections). The most consistent risk factors for HPV infection were young age, Aboriginal ethnicity, higher lifetime number of sexual partners and higher number of sexual partners in the previous year.
  
  
  CONCLUSIONS
  The prevalence of HPV types in Manitoba is consistent with the distributions reported in other jurisdictions. These data provide baseline information on type-specific HPV prevalence in an unvaccinated population and can be useful in evaluating the effectiveness of the HPV immunization program. An added benefit is in the validation of a proof of concept which links a population-based Pap registry to laboratory test results and a risk behaviour survey to assess early and late outcomes of HPV infection. This methodology could be applied to other jurisdictions across Canada where such capacities exist.
authors.affiliation: Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada. alain.demers@phac-aspc.gc.ca
authors.forename: A A
authors.initials: AA
authors.lastname: Demers
authors.forename: B
authors.initials: B
authors.lastname: Shearer
authors.forename: A
authors.initials: A
authors.lastname: Severini
authors.forename: R
authors.initials: R
authors.lastname: Lotocki
authors.forename: E V
authors.initials: EV
authors.lastname: Kliewer
authors.forename: S
authors.initials: S
authors.lastname: Stopera
authors.forename: T
authors.initials: T
authors.lastname: Wong
authors.forename: G
authors.initials: G
authors.lastname: Jayaraman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D052685:Alphapapillomavirus; D016001:Confidence Intervals; D055088:Early Detection of Cancer; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D004930:Inuit / Q000706:statistics & numerical data; D016015:Logistic Models; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology*; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*