Population-Based Study of Human Papillomavirus Infection and Cervical Neoplasia in Rural Costa Rica

摘要: Background: Human papillomavirus (HPV) is the main cause of cervical neoplasia. Because few population-based studies have investigated prevalence type-specific infection in relation to disease, we studied a high-risk population, estimating HPV and risk associated with various types. Methods: We screened 9175 women Guanacaste, Costa Rica, obtain referent standard final diagnosis, tested 3024 for more than 40 types polymerase chain reaction-based system. Results: Among normal cytology, infections peaked first younger 25 years, they again at age 55 years or older predominantly non-cancer-associated uncharacterized Low-grade squamous intraepithelial lesions (LSILs) (n = 189) decreased consistently age. The high-grade (HSILs) 128) around 30 65 older. Seventy-three percent LSILs were positive, HPV16 being predominant type (16% positive subjects). was found 89% HSILs 88% cancers, strongly (51% 53% Virtually all cancers had cancer-associated types, high odds ratios (ORs) attributable fractions 80%. Risk particularly (OR 320, 95% confidence interval [CI] 97-1000; OR cancer 710, CI 110-4500). Conclusions: confirm early decline but note increased after menopause, which could be related second peak HSILs, an observation that warrants further investigation. At least 80% HPVs involved carcinogenesis this population been characterized. Polyvalent vaccines including may able prevent most cases disease region.