title: Population-based prevalence of cervical infection with human papillomavirus genotypes 16 and 18 and other high risk types in Tlaxcala, Mexico.
abstract: Cervical cancer remains an important cause of cancer mortality for Mexican women. HPV 16/18 typing may help to improve cervical cancer screening. Here we present the prevalence of high-risk human papillomavirus (hrHPV) including HPV16 and HPV18 from the FRIDA (Forwarding Research for Improved Detection and Access) population.
  
  
  
  Beginning in 2013, we recruited 30,829 women aged 30-64 in Tlaxcala, Mexico. Cervical samples were collected and tested for 14 hrHPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68). We used logistic regression to estimate odds ratios with 95 % confidence intervals for hrHPV infections according to putative risk factors.
  
  
  
  Prevalence of infection with any of the 14 hrHPV types was 11.0 %. The age-specific prevalence of all hrHPV formed a U-shaped curve with a higher prevalence for women aged 30-39 and 50-64 than women aged 40-49. Across all age groups, 2.0 % of women were positive for HPV16 and/or HPV18 (HPV16/18), respectively. HPV16/18 prevalence also showed a U-shaped curve with increased prevalence estimates for women aged both 30-39 and 60-64. Both prevalence curves had a significant quadratic age coefficient. Infections with hrHPV were positively associated with an increased number of lifetime sexual partners, a history of sexually transmitted disease, being unmarried, use of hormonal contraception, having a history of smoking and reported condom use in the multivariate model.
  
  
  
  The FRIDA population has a bimodal distribution of both hrHPV and HPV16/18 positivity with higher prevalences at ages 30-39 and 60-64. These findings will help to evaluate triage algorithms based on HPV genotyping.
  
  
  
  The trial is registered with ClinicalTrials.gov, number NCT02510027 .
authors: UC Berkeley-UCSF Joint Medical Program, Berkeley, CA, USA.|Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.
authors: Samantha E
authors: SE
authors: Rudolph
authors: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK.
authors: Attila
authors: A
authors: Lorincz
authors: Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA.
authors: Cosette M
authors: CM
authors: Wheeler
authors: Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA.
authors: Patti
authors: P
authors: Gravitt
authors: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad 655, Colonia Sta. María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
authors: Eduardo
authors: E
authors: Lazcano-Ponce
authors: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad 655, Colonia Sta. María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico. leticia.torres@insp.mx.
authors: Leticia
authors: L
authors: Torres-Ibarra
authors: CONACYT, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors: Leith
authors: L
authors: León-Maldonado
authors: Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.|Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad 655, Colonia Sta. María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
authors: Paula
authors: P
authors: Ramírez
authors: Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.|Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad 655, Colonia Sta. María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
authors: Berenice
authors: B
authors: Rivera
authors: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad 655, Colonia Sta. María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
authors: Rubí
authors: R
authors: Hernández
authors: Division of Cancer Epidemiology, McGill University, Montreal, Canada.
authors: Eduardo L
authors: EL
authors: Franco
authors: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK.
authors: Jack
authors: J
authors: Cuzick
authors: Departamento de Enseñanza, Capacitación e Investigación, Secretaría de Salud de Tlaxcala, Tlaxcala, Tlaxcala, Mexico.|Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala, Tlaxcala, Tlaxcala, Mexico.
authors: Pablo
authors: P
authors: Méndez-Hernández
authors: Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.
authors: Jorge
authors: J
authors: Salmerón
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016015:Logistic Models; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology; D016387:Women's Health
keywords: HPV16/18; Human papillomavirus DNA testing; Mexico; Prevalence; Risk factors