title: Prevalence of human papillomavirus in women attending cervical screening in the UK and Ireland: new data from northern Ireland and a systematic review and meta-analysis.
abstract: There is substantial international variation in human papillomavirus (HPV) prevalence; this study details the first report from Northern Ireland and additionally provides a systematic review and meta-analysis pooling the prevalence of high-risk (HR-HPV) subtypes among women with normal cytology in the UK and Ireland. Between February and December 2009, routine liquid based cytology (LBC) samples were collected for HPV detection (Roche Cobas® 4800 [PCR]) among unselected women attending for cervical cytology testing. Four electronic databases, including MEDLINE, were then searched from their inception till April 2011. A random effects meta-analysis was used to calculate a pooled HR-HPV prevalence and associated 95% confidence intervals (CI). 5,712 women, mean age 39 years (±SD 11.9 years; range 20-64 years), were included in the analysis, of which 5,068 (88.7%), 417 (7.3%) and 72 (1.3%) had normal, low, and high-grade cytological findings, respectively. Crude HR-HPV prevalence was 13.2% (95% CI, 12.7-13.7) among women with normal cytology and increased with cytological grade. In meta-analysis the pooled HR-HPV prevalence among those with normal cytology was 0.12 (95% CIs, 0.10-0.14; 21 studies) with the highest prevalence in younger women. HPV 16 and HPV 18 specific estimates were 0.03 (95% CI, 0.02-0.05) and 0.01 (95% CI, 0.01-0.02), respectively. The findings of this Northern Ireland study and meta-analysis verify the prevalent nature of HPV infection among younger women. Reporting of the type-specific prevalence of HPV infection is relevant for evaluating the impact of future HPV immunization initiatives, particularly against HR-HPV types other than HPV 16 and 18.
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, QUB, Belfast, Northern Ireland, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Anderson
authors.forename: Michael
authors.initials: M
authors.lastname: O'Rorke
authors.forename: Jackie
authors.initials: J
authors.lastname: Jamison
authors.forename: Robbie
authors.initials: R
authors.lastname: Wilson
authors.forename: Anna
authors.initials: A
authors.lastname: Gavin
mesh_terms: D000328:Adult; D003584:Cytological Techniques / Q000379:methods; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D015995:Prevalence; D006113:United Kingdom / Q000453:epidemiology; D014773:Virology / Q000379:methods; D055815:Young Adult