Background
Materials and methods
Study population and enrollment
Sample collection and preparation
HPV genotyping
PCR amplification
Hybridization to the oligonucleotide probe
Colorimetric determination
Statistical analysis
Results
Demographic characteristics of 5906 Thai women
Demographics
|
Total (N =5906)
|
Chulabhorn hospital (N = 4487)
|
Bangkhayaeng district (N = 1419)
|
p-value
|
---|---|---|---|---|
Age | ||||
Mean (years) | 44.8 | 44.8 | 44.8 | 0.9861
|
Median (years) | 45.0 | 45.0 | 45.0 | |
Range (years) | 20-70 | 20-70 | 20-70 | |
20-30 years (%) | 634 (10.7) | 481 (10.7) | 153 (10.8) | |
31-70 years (%) | 5272 (89.3) | 4006 (89.3) | 1266 (89.2) | |
Parity†
| <0.0012,* | |||
Nulliparous | 1867 (31.7) | 1658 (36.9) | 209 (14.9) | |
Multiparous | 4019 (68.3) | 2829 (63.1) | 1190 (85.1) | |
Menopause†
| 0.7142
| |||
Pre-menopause | 4012 (68.2) | 3064 (68.3) | 948 (67.8) | |
Post-menopause | 1874 (31.8) | 1423 (31.7) | 451 (32.2) | |
Marital status | <0.0012,* | |||
Single | 1448 (24.5) | 1319 (29.4) | 129 (9.1) | |
Married | 3619 (61.3) | 2530 (56.4) | 1089 (76.7) | |
Divorced | 839 (14.2) | 638 (14.2) | 201 (14.2) | |
Number of life-time sex partner(s) | ||||
0 (virgin) | - | 430 (9.6) | - | |
1 | - | 2827 (63.0) | - | |
1+ | - | 1230 (27.4) | - | |
Contraception use†
| <0.0012,* | |||
Yes | 3002 (51.0) | 2002 (44.6) | 1000 (71.5) | |
No | 2884 (49.0) | 2485 (55.4) | 399 (28.5) | |
Education†
| <0.0012,* | |||
No education | 56 (1.0) | 27 (0.6) | 29 (2.1) | |
Primary education | 1319 (22.4) | 678 (15.1) | 641 (45.8) | |
High school | 1025 (17.4) | 651 (14.5) | 374 (26.7) | |
Vocation school | 820 (13.9) | 650 (14.5) | 170 (12.2) | |
Bachelor degree | 2162 (36.7) | 1991 (44.4) | 171 (12.2) | |
Postgraduate | 504 (8.6) | 490 (10.9) | 14 (1.0) |
HPV prevalence and genotypic distribution
Total
|
Chulabhorn hospital
|
Bangkhayaeng district
|
p-value
| |
---|---|---|---|---|
Period (year)
| 2011-2012 | 2013 | ||
Total
| 5906 | 4487 | 1419 | |
HPV
| 0.178 | |||
Negative
| 5016 (84.9) | 3795 (84.6) | 1221 (86.0) | |
Positive
| 890 (15.1) | 692 (15.4) | 198 (14.0) | |
High risk HPV
†
| 376 (6.4) | 292 (6.5) | 84 (5.9) | 0.429 |
Probable HR HPV
†
| 204 (3.5) | 156 (3.5) | 48 (3.4) | 0.866 |
Low risk HPV
†
| 495 (8.4) | 394 (8.8) | 101 (7.1) | 0.049 |
Age-specific prevalence of HPV infection and abnormal Pap smear
HPV Type
|
Age range (year)
|
Normal cytology
|
Abnormal cytology
| |||||
---|---|---|---|---|---|---|---|---|
20-30
|
31-40
|
41-50
|
51-60
|
61-70
|
Total
| |||
N
| 634 | 1479 | 1936 | 1368 | 489 | 5906 | 5614 (95.1) | 292 (4.9) |
Pap smear results
| ||||||||
Normal
| 592 (93.4) | 1403 (94.9) | 1835 (94.8) | 1312 (95.9) | 472 (96.5) | 5614 (95.1) | - | - |
Abnormal
| 42 (6.6) | 76 (5.1) | 101 (5.2) | 56 (4.1) | 17 (3.5) | 292 (4.9) | - | - |
HPV results
| ||||||||
HPV negative
| 477 (75.2) | 1221 (82.6) | 1666 (86.1) | 1217 (89.0) | 435 (89.0) | 5016 (84.9) | 4866 (86.7) | 150 (51.4) |
HPV positive
| 157 (24.8) | 258 (17.4) | 270 (13.9) | 151 (11.0) | 54 (11.0) | 890 (15.1) | 748 (13.3) | 142 (48.6) |
High risk HPV
| 84 (13.2) | 126 (8.5) | 101 (5.2) | 50 (3.7) | 15 (3.1) | 376 (6.4) | 285 (5.1) | 91 (31.2) |
Probable HR
| 43 (6.8) | 64 (4.3) | 61 (3.2) | 26 (1.9) | 10 (2.0) | 204 (3.5) | 169 (3.0) | 35 (12.0) |
Low risk HPV
| 76 (12.0) | 124 (8.4) | 157 (8.1) | 103 (7.5) | 35 (7.2) | 495 (8.4) | 431 (7.7) | 64 (21.9) |
HPV infection frequency and abnormal cervical cytology
Discussion
Study/year
|
Site/N
|
HPV Test
|
HR-HPV*
|
16
|
18
|
31
|
33
|
35
|
39
|
45
|
51
|
52
|
56
|
58
|
59
|
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N (%)
| |||||||||||||||
Ralston Howe E (15) | USA | PCR | 13444 | 4507 | 881 | 1757 | 524 | 479 | 306 | 734 | 26 | 2009 | 437 | 865 | 919 |
2009 | 73371 | (18.3) | (33.5) | (6.6) | (13.1) | (3.9) | (3.6) | (2.3) | (5.5) | (0.2) | (14.9) | (3.3) | (6.4) | (6.8) | |
Dickson EL (16) ** | USA | PCR | 11.9% | 4.1% | 0.7% | 1.9% | 0.4% | 0.3% | 0.5% | - | 2.1% | - | 1.1% | 0.8% | |
2013 | 309471 | (100) | (34.5) | (5.9) | (16.0) | (3.4) | (2.5) | - | (4.2) | (17.6) | (9.2) | (6.7) | |||
Agarossi A (17) | Italy | HC2 followed by PCR | 1403 | 415 | 150 | 211 | 61 | 67 | 111 | 68 | 132 | 67 | 142 | 120 | 45 |
2009 | 9946 | (14.1) | (29.6) | (10.7) | (15.0) | (4.3) | (4.8) | (7.9) | (4.8) | (9.4) | (4.8) | (10.1) | (8.6) | (3.2) | |
Anderson L (18) ** | Ireland | Cobas4800 test followed by Linear array | 16.6% | 3.2% | 1.2% | 1.8% | 1.2% | 0.5% | 1.2% | 1.0% | 1.6% | 1.5% | 1.0% | 0.8% | 1.6% |
2012 | 5712 | (100) | (19.3) | (7.2) | (10.8) | (7.2) | (3.0) | (7.2) | (6.0) | (9.6) | (9.0) | (6.0) | (4.8) | (9.6) | |
Ucakar V (19) | Slovenia | HC2/Real Time PCR followed by Linear array | 502 | 155 | 46 | 114 | 32 | 9 | 50 | 42 | 81 | 78 | 31 | 29 | 29 |
2012 | 4431 | (11.3) | (30.9) | (9.2) | (22.7) | (6.4) | (1.8) | (10.0) | (8.4) | (16.1) | (15.5) | (6.2) | (5.8) | (5.8) | |
INOUE M (23) | Japan | HC2 followed by HPVDNAChip (Biomedlab Co., South Korea) | 632 | 167 | 73 | 50 | 17 | 7 | 43 | 20 | 98 | 189 | 100 | 131 | 39 |
2006 | 8156 | (7.7) | (22.7) | (9.9) | (6.8) | (2.3) | (1.0) | (5.9) | (2.7) | (13.3) | (25.7) | (13.6) | (17.8) | (5.3) | |
Li H (24) | China | HPV GenoArray (Hybribio, Hong Kong) | 755 | 233 | 64 | 26 | 30 | 3 | 44 | 9 | 20 | 163 | 27 | 119 | 17 |
2013 | 3640 | (20.7) | (30.9) | (8.5) | (3.4) | (4.0) | (0.4) | (5.8) | (1.2) | (2.6) | (21.5) | (3.6) | (15.8) | (2.3) | |
Zhoa FH (31) | China | SPF PCR-DEIA-LiPA (LaboBiomedial Product, Rijswijk, the Netherlands) | 924 | 222 | 74 | 59 | 65 | 31 | 81 | 33 | 102 | 243 | 69 | 90 | 22 |
2014 | 6035 | (15.3) | (3.7) | (1.2) | (1.0) | (1.1) | (0.5) | (1.3) | (0.5) | (1.7) | (4.0) | (1.1) | (1.5) | (0.4) | |
This study | Thailand | Linear array (Roche, USA) | 376 | 80 | 35 | 18 | 13 | 7 | 33 | 11 | 55 | 94 | 19 | 47 | 18 |
2015 | 5906 | ||||||||||||||
(6.4) | (21.2) | (9.3) | (4.8) | (3.5) | (1.9) | (8.8) | (2.9) | (14.6) | (25.0) | (5.1) | (12.5) | (4.8) |