Background
Methods
Population
HPV testing and liquid based cytology (LBC)
Statistical analyses
Results
General female population
HPV type | Normal (N = 2136) | ASCUS/ASC-H/LSIL (n = 210) | HSIL (n = 45) | Total (n = 2508) a
| ||||
---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | |
Negative | 1510 | 70.7 | 56 | 26.7 | 2 | 4.4 | 1651 | 65.8 |
Positive | 626 | 29.3 | 154 | 73.3 | 43 | 95.6 | 857 | 34.2 |
Multiple | 250 | 11.7 | 85 | 40.5 | 23 | 51.1 | 377 | 15.0 |
High-risk | ||||||||
16 | 88 | 4.1 | 23 | 11.0 | 13 | 28.9 | 131 | 5.2 |
18 | 31 | 1.5 | 13 | 6.2 | 6 | 13.3 | 52 | 2.1 |
31 | 35 | 1.6 | 12 | 5.7 | 4 | 8.9 | 54 | 2.2 |
33 | 29 | 1.4 | 4 | 1.9 | 3 | 6.7 | 36 | 1.4 |
35 | 48 | 2.2 | 20 | 9.5 | 4 | 8.9 | 75 | 3.0 |
39 | 22 | 1.0 | 10 | 4.8 | 2 | 4.4 | 37 | 1.5 |
45 | 36 | 1.7 | 12 | 5.7 | 4 | 8.9 | 55 | 2.2 |
51 | 29 | 1.4 | 14 | 6.7 | 2 | 4.4 | 47 | 1.9 |
52 | 50 | 2.3 | 20 | 9.5 | 3 | 6.7 | 76 | 3.0 |
56 | 38 | 1.8 | 13 | 6.2 | 4 | 8.9 | 59 | 2.4 |
58 | 38 | 1.8 | 17 | 8.1 | 9 | 20.0 | 68 | 2.7 |
59 | 28 | 1.3 | 6 | 2.9 | 0 | 0.0 | 36 | 1.4 |
68 | 11 | 0.5 | 2 | 1.0 | 2 | 4.4 | 16 | 0.6 |
Any | 378 | 17.7 | 113 | 53.8 | 40 | 88.9 | 557 | 22.2 |
Possibly high-risk | ||||||||
26 | 9 | 0.4 | 4 | 1.9 | 3 | 6.7 | 16 | 0.6 |
30 | 11 | 0.5 | 6 | 2.9 | 1 | 2.2 | 18 | 0.7 |
34 | 0 | 0.0 | 1 | 0.5 | 0 | 0.0 | 1 | 0.0 |
53 | 13 | 0.6 | 11 | 5.2 | 2 | 4.4 | 26 | 1.0 |
66 | 39 | 1.8 | 18 | 8.6 | 1 | 2.2 | 63 | 2.5 |
67 | 53 | 2.5 | 8 | 3.8 | 5 | 11.1 | 68 | 2.7 |
69 | 11 | 0.5 | 5 | 2.4 | 0 | 0.0 | 17 | 0.7 |
70 | 30 | 1.4 | 8 | 3.8 | 0 | 0.0 | 38 | 1.5 |
73 | 13 | 0.6 | 2 | 1.0 | 1 | 2.2 | 19 | 0.8 |
82 | 11 | 0.5 | 6 | 2.9 | 0 | 0.0 | 18 | 0.7 |
85 | 4 | 0.2 | 1 | 0.5 | 1 | 2.2 | 6 | 0.2 |
Any | 167 | 7.8 | 60 | 28.6 | 10 | 22.2 | 248 | 9.9 |
Low risk | ||||||||
6 | 28 | 1.3 | 10 | 4.8 | 0 | 0.0 | 40 | 1.6 |
11 | 15 | 0.7 | 4 | 1.9 | 0 | 0.0 | 20 | 0.8 |
Any | 282 | 13.2 | 59 | 28.1 | 10 | 22.2 | 368 | 14.7 |
Characteristic | N women a
| HPV-positive (%) | Adjusted b PR | 95 % CI | Adjusted c PR | 95 % CI |
---|---|---|---|---|---|---|
Age-group (years) | ||||||
≤ 24 | 1179 | 500 (42.4) | 1 | - | 1 | - |
25–34 | 519 | 170 (32.8) | 0.77 | 0.67–0.89 | 0.71 | 0.62–0.82 |
35–44 | 406 | 101 (24.9) | 0.59 | 0.49–0.70 | 0.52 | 0.44–0.63 |
≥ 45 | 404 | 86 (21.3) | 0.50 | 0.41–0.61 | 0.45 | 0.37–0.55 |
Chi
2
(1) for trend
|
p <0.001
|
p <0.001
| ||||
Education (Years) | ||||||
Non-literate 0–5 | 325 | 122 (37.5) | 1 | - | 1 | - |
Literate 0–5 | 640 | 226 (35.3) | 0.86 | 0.73–1.03 | 0.97 | 0.82–1.14 |
Literate 6–10 | 1123 | 383 (34.1) | 0.88 | 0.75–1.03 | 1.00 | 0.86–1.17 |
Literate ≥11 | 420 | 126 (30.0) | 0.85 | 0.70–1.04 | 0.99 | 0.82–1.20 |
Chi
2
(1) for trend
|
p =0.199
|
p =0.849
| ||||
Occupation | ||||||
Housewife | 964 | 366 (38.0) | 1 | - | 1 | - |
Shopkeeper/salesman | 391 | 154 (39.4) | 1.13 | 0.98–1.31 | 1.03 | 0.90–1.18 |
Manual worker | 400 | 132 (33.0) | 0.90 | 0.77–1.06 | 0.92 | 0.79–1.08 |
Teacher/health worker/Student/Clerical staff | 188 | 56 (29.8) | 0.93 | 0.73–1.17 | 0.92 | 0.73–1.15 |
Farmer | 532 | 134 (25.2) | 0.72 | 0.61–0.85 | 0.78 | 0.66–0.92 |
Tobacco use | ||||||
Never | 2276 | 766 (33.7) | 1 | - | 1 | - |
Ever | 230 | 91 (39.6) | 1.45 | 1.23–1.71 | 1.13 | 0.96–1.32 |
Marital status | ||||||
Married or cohabiting | 1734 | 533 (30.7) | 1 | - | 1 | - |
Single | 444 | 212 (47.8) | 1.35 | 1.20–1.53 | 1.16 | 1.02–1.30 |
Separated/widowed | 330 | 112 (33.9) | 1.38 | 1.17–1.63 | 1.16 | 0.98–1.37 |
Lifetime sexual partnersd
| ||||||
1 | 1131 | 294 (26.0) | 1 | - | 1 | - |
2 | 701 | 263 (37.5) | 1.45 | 1.26–1.65 | 1.37 | 1.20–1.56 |
3 | 281 | 128 (45.6) | } 1.84e
| 1.62–2.10 | 1.53e
| 1.33–1.77 |
≥ 4 | 248 | 116 (46.8) | ||||
Chi
2
(1) for trend
|
p <0.001
|
p <0.001
| ||||
Sexual activity in the last year | ||||||
Yes | 2189 | 766 (35.0) | 1 | - | 1 | - |
No | 299 | 84 (28.1) | 1.07 | 0.87–1.30 | 0.93 | 0.77–1.14 |
History of receiving cash for sexd
| ||||||
Never | 2333 | 769 (33.0) | 1 | - | 1 | - |
Ever | 154 | 85 (55.2) | 1.59 | 1.37–1.84 | 1.14 | 0.98–1.33 |
Evidence of anogenital warts | ||||||
No | 2395 | 814 (34.0) | 1 | - | 1 | - |
Yes | 113 | 43 (38.1) | 1.35 | 1.07–1.72 | 1.09 | 0.88–1.35 |
HIV status | ||||||
Negative | 1414 | 450 (31.8) | 1 | - | 1 | - |
Unknown | 604 | 166 (27.5) | 1.01 | 0.87–1.18 | 1.02 | 0.87–1.18 |
Positive | 490 | 241 (49.2) | 1.84 | 1.65–2.06 | 1.54 | 1.36–1.75 |
Number of pregnancies | ||||||
Nulliparous | 237 | 101 (42.6) | 1.15 | 0.97–1.36 | 0.99 | 0.85–1.15 |
1 | 804 | 327 (40.7) | 1 | - | 1 | - |
2-3 | 840 | 285 (33.9) | 0.94 | 0.83–1.08 | 0.85 | 0.75–0.97 |
≥ 4 | 616 | 141 (22.9) | 0.85 | 0.67–1.06 | 0.78 | 0.63–0.97 |
Chi
2
(1) for trend
|
p =0.010
|
p =0.006
| ||||
Contraceptive use in the last year | ||||||
No | 1146 | 422 (36.8) | 1 | - | 1 | - |
Yes | 1359 | 432 (31.8) | 0.80 | 0.72–0.89 | 0.82 | 0.74–0.91 |
Hormonal | 1005 | 339 (33.7) | 0.82 | 0.73–0.92 | 0.84 | 0.75–0.96 |
Intra Uterine Device | 185 | 54 (29.2) | 0.79 | 0.62–1.00 | 0.79 | 0.62–1.00 |
Condom | 72 | 25 (34.7) | 0.92 | 0.67–1.27 | 0.86 | 0.64–1.16 |
Other/two or more of above | 97 | 14 (14.4) | 0.48 | 0.29–0.78 | 0.45 | 0.26–0.78 |
Cytology | HIV negative | HIV positive | Total | |||
---|---|---|---|---|---|---|
N | HPV16/18-pos n (%) | N | HPV16/18-pos n (%) | N | HPV16/18-pos n (%) | |
Normal | 1749 | 91 (5.2) | 387 | 26 (6.7) | 2136 | 117 (5.5) |
ASCUS/ASC-H/LSIL | 146 | 26 (17.8) | 64 | 8 (12.5) | 210 | 34 (16.2) |
HSIL | 27 | 11 (40.7) | 18 | 7 (38.9) | 45 | 18 (40.0) |
p-value for heterogeneity by HIV statusa = 0.33 |