title: Risk factors for human papillomavirus infection in Shanghai suburbs: a population-based study with 10,000 women.
abstract: BACKGROUND
  High risk human papillomavirus (HPV) infection is the major cause of cervical cancer. Several epidemiological studies have performed HPV screening in Chinese women, but no report was for Shanghai suburb women.
  
  
  OBJECTIVE
  To understand the prevalence of HPV infection and risk factors in Shanghai suburbs.
  
  
  METHODS
  Between March 2011 and May 2011, 10,000 female volunteers lived in Fengxian District of Shanghai were recruited for the detection of 21 HPV types using PCR and fast flow hybridization of gene chip array. For the 508 HPV-positive patients, we performed the liquid-based ThinPrep cytology test (TCT) and histological examination for the diagnosis of local cervical lesions. The questionnaire surveyed demographic and behavioral indicators for the evaluation of risk factors of HPV infection.
  
  
  RESULTS
  We found that the HPV-positive rate was 12.6%. The five top HPV types were as follows (in descending order): HPV52, 16, 58, 18 and 33. Moreover, HPV-positive rates were higher in women with older age, lower educational level, younger age of the first sexual intercourse, multiple sexual partners, no usage of condom for contraception, multiple deliveries, vaginal delivery, menopause, vaginal inflammation, cervical erosion and no regular cervical cytological examination. We also found that an HPV genotyping in combination with TCT and histological examination could improve early diagnosis for local cervical lesions.
  
  
  CONCLUSIONS
  HPV infection was associated with age, sexual behavior and chronic inflammation of the cervix and vagina. We recommend popularizing HPV genotyping in women with high risk factors for the early diagnosis and prevention of cervical cancer.
authors.affiliation: Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, PR China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.forename: Ting-Yan
authors.initials: TY
authors.lastname: Shi
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ren
authors.forename: Huan
authors.initials: H
authors.lastname: Lu
authors.forename: Zhen-Hong
authors.initials: ZH
authors.lastname: Wei
authors.forename: Wen-Jing
authors.initials: WJ
authors.lastname: Hou
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Congjian
authors.initials: C
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D046228:Microarray Analysis; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D020411:Oligonucleotide Array Sequence Analysis; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D013383:Suburban Population; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ASC-US; CIN; Cervical cancer; FCHS; Fengxian Central Hospital, Shanghai; HPV; HPV types; HR; HSIL; LR; LSIL; Risk factor; TCT; ThinPrep cytology test; atypical squamous cells of unknown significance; cervical intraepithelial neoplasia; high-grade squamous intraepithelial lesion; high-risk; human papilloma virus; low-grade squamous intraepithelial neoplasia; low-risk