The application value of low-risk human papillomavirus testing in cervical cancer prevention and treatment in low- and middle-resource areas

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2024-10-23 DOI:10.1016/j.puhe.2024.10.020

Zhongliang Ma , Xueying Xiang , Yuyang Chai , Jing Wang , Cailing Ma

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引用次数: 0

Abstract

Objectives

To assess the application value of low-risk human papillomavirus (lrHPV) detection in the prevention and treatment of cervical cancer in low- and middle-resource areas (LMRAs).

Study design

A retrospective cross-sectional study.

Methods

Cervical HPV typing results were collected from 2019 to 2023, utilizing fluorescence PCR technology. An adjusted logistic regression model was used to assess the relative risk (OR) and 95 % confidence interval (CI) for co-infection with lrHPV and high-risk HPV (hrHPV).

Results

Out of 113,883 women included in the study, the overall lrHPV positivity rate was 1.9 %. In total, 47.7 % (1033/2167) of lrHPV positive women also had hrHPV co-infections. Multivariate analysis identified 12 hrHPV subtypes (T-hrHPV) significantly associated with co-infection risk, including HPV16, 31, 33, 39, 51, 52, 53, 56, 59, 66, 68, and 73. The risk of T-hrHPV infection was 3.77 times higher (95 % CI: 3.44-4.12) for women with a single lrHPV infection and 9.71 times higher (95 % CI: 4.72-19.99) for those with two lrHPV infections. Women screened in the gynecological outpatient clinic faced a T-hrHPV infection risk 2.64 times higher (95 % CI: 2.54-2.74) than those in the general health check department.

Conclusions

lrHPV positivity significantly increases the risk of T-hrHPV co-infection, particularly under multiple infections, highlighting the importance of comprehensive HPV screening in LMRAs. The notable differences in T-hrHPV infection risks across various screening settings highlight their critical role in cervical cancer prevention and offer new insights into optimizing vaccination strategies to enhance effective prevention and treatment in LMRAs.

查看原文本刊更多论文

低风险人类乳头瘤病毒检测在中低端资源地区宫颈癌防治中的应用价值。

目的：评估低危人乳头瘤病毒（lrHPV）检测在中低端资源地区宫颈癌防治中的应用价值：研究设计：一项回顾性横断面研究：研究设计：回顾性横断面研究：利用荧光 PCR 技术收集了 2019 年至 2023 年的宫颈 HPV 分型结果。采用调整后的逻辑回归模型评估lrHPV和高危HPV（hrHPV）合并感染的相对风险（OR）和95%置信区间（CI）：在纳入研究的 113 883 名妇女中，lrHPV 阳性率为 1.9%。在 lrHPV 阳性的妇女中，47.7%（1033/2167）的人同时感染了 hrHPV。多变量分析发现，12 种 hrHPV 亚型（T-hrHPV）与合并感染风险显著相关，包括 HPV16、31、33、39、51、52、53、56、59、66、68 和 73。单次感染 lrHPV 的妇女感染 T-hrHPV 的风险是前者的 3.77 倍（95 % CI：3.44-4.12），而两次感染 lrHPV 的妇女感染 T-hrHPV 的风险是前者的 9.71 倍（95 % CI：4.72-19.99）。结论：lrHPV 阳性会显著增加 T-hrHPV 合并感染的风险，尤其是在多重感染的情况下，这凸显了在 LMRAs 进行全面 HPV 筛查的重要性。不同筛查环境下T-hrHPV感染风险的显著差异凸显了其在宫颈癌预防中的关键作用，并为优化疫苗接种策略提供了新的视角，以提高低密度地区的有效预防和治疗。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.