Prevalence of human papillomavirus and cervical intraepithelial neoplasia in China: A pooled analysis of 17 population‐based studies

International Journal of Cancer - Tập 131 Số 12 - Trang 2929-2938 - 2012
Fanghui Zhao1, Adam K. Lewkowitz1,2, Shangying Hu1, Feng Chen1, Long‐Yu Li3, Qing‐Ming Zhang4, Rui‐Fang Wu5, Changqing Li6, Lihui Wei7, Aidi Xu8, Wen‐Hua Zhang1, Qin‐Jing Pan1, Qian Zhang1, Jerome L. Belinson9, John W. Sellors10,11, Jennifer S. Smith12, You‐Lin Qiao1,13, Silvia Franceschi14
1Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2Department of Medical Education, Mount Sinai School of Medicine, New York, NY, USA
3Department of Obstetrics and Gynecology, Jiangxi Provincial Women and Children Hospital, Nanchang, Jiangxi Province, China
4Department of Gynecological Oncology, Gansu Provincial Cancer Hospital, Lanzhou, Gansu Province, China
5Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
6Xinmi City Women and Children Hospital, Henan Province, China
7Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, China
8Hongkou District Health Bureau, Shanghai, China
9Preventive Oncology International Inc. & Department of Obstetrics and Gynecology, the Cleveland Clinic, Cleveland, OH, USA
10McMaster University, Hamilton, ON, Canada
11PATH, Seattle, WA 9810, USA
12Department of Epidemiology, University of North Carolina, Chapel Hill, NC USA
13Tel.: +86-10-8778-8489,
14Section of Infections, International Agency for Research on Cancer, Lyon, France

Tóm tắt

AbstractHigh‐risk (HR) human papillomavirus (HPV) prevalence has been shown to correlate well with cervical cancer incidence rates. Our study aimed to estimate the prevalence of HR‐HPV and cervical intraepithelial neoplasia (CIN) in China and indirectly informs on the cervical cancer burden in the country. A total of 30,207 women from 17 population‐based studies throughout China were included. All women received HPV DNA testing (HC2, Qiagen, Gaithersburg, MD), visual inspection with acetic acid and liquid‐based cytology. Women positive for any test received colposcopy‐directed or four‐quadrant biopsies. A total of 29,579 women had HR‐HPV testing results, of whom 28,761 had biopsy confirmed (9,019, 31.4%) or assumed (19,742, 68.6%) final diagnosis. Overall crude HR‐HPV prevalence was 17.7%. HR‐HPV prevalence was similar in rural and urban areas but showed dips in different age groups: at age 25–29 (11.3%) in rural and at age 35–39 (11.3%) in urban women. In rural and urban women, age‐standardized CIN2 prevalence was 1.5% [95% confidence interval (CI): 1.4–1.6%] and 0.7% (95% CI: 0.7–0.8%) and CIN3+ prevalence was 1.2% (95% CI: 1.2–1.3%) and 0.6% (95% CI: 0.5–0.7%), respectively. Prevalence of CIN3+ as a percentage of either all women or HR‐HPV‐positive women steadily increased with age, peaking in 45‐ to 49‐year‐old women. High prevalence of HR‐HPV and CIN3+ was detected in both rural and urban China. The steady rise of CIN3+ up to the age group of 45–49 is attributable to lack of lesion removal through screening. Our findings document the inadequacy of current screening in China while indirectly raising the possibility that the cervical cancer burden in China is underreported.

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International Journal of Cancer

Tập 131 Số 12

2929-2938

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