Epidemiologic profile of type-specific human papillomavirus infection and cervical neoplasia in Guanacaste, Costa Rica

Rolando Herrero, Philip E. Castle, Mark Schiffman, M. Concepción Bratti, Allan Hildesheim, Jorge Morales, Mario Alfaro, Mark E. Sherman, Sholom Wacholder, Sabrina Chen, Ana C. Rodriguez, Robert D. Burk

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285 Citations (Scopus)

Abstract

Background. Detailed epidemiologic studies of cervical type-specific human papillomavirus (HPV) infection in large populations are scarce. Methods. We recruited a population-based cohort in Guanacaste, Costa Rica. Participants were interviewed, screened for cervical neoplasia, and tested for >40 HPV types by use of MY09/11 L1 consensus primer polymerase chain reaction. We estimated the risk factors for infection and the associations between type-specific HPV infections and cervical intraepithelial neoplasia (CIN) and cancer in 8514 sexually active women who had not undergone a hysterectomy. Results. The overall HPV prevalence was 26.5%. The most common type was HPV-16 (3.6% of the population). HPV prevalence showed a U-shaped age-specific curve. Sexual behaviors were the main determinants of oncogenic and nononcogenic infections; age at first sexual intercourse was not independently associated with infection. Barrier contraceptive use was somewhat protective against infection. Oncogenic infections were strongly associated with risk of all grades of CIN and of cancer. Types 16, 18, and 58 were the most common in women diagnosed with CIN3 and cancer. Except for those that included HPV-16, multiple-type infections were associated with an increased risk (compared with that for single-type infections) of all grades of CIN and of cancer. Conclusions. We confirmed the bimodal age pattern of HPV infection in Guanacaste and the sexually transmitted nature of both oncogenic and nononcogenic HPV types.

Original languageEnglish (US)
Pages (from-to)1796-1807
Number of pages12
JournalJournal of Infectious Diseases
Volume191
Issue number11
DOIs
StatePublished - Jun 1 2005

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Costa Rica
Papillomavirus Infections
Cervical Intraepithelial Neoplasia
Infection
Neoplasms
Human papillomavirus 16
Coitus
Population
Contraceptive Agents
Hysterectomy
Sexual Behavior
Epidemiologic Studies
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Epidemiologic profile of type-specific human papillomavirus infection and cervical neoplasia in Guanacaste, Costa Rica. / Herrero, Rolando; Castle, Philip E.; Schiffman, Mark; Bratti, M. Concepción; Hildesheim, Allan; Morales, Jorge; Alfaro, Mario; Sherman, Mark E.; Wacholder, Sholom; Chen, Sabrina; Rodriguez, Ana C.; Burk, Robert D.

In: Journal of Infectious Diseases, Vol. 191, No. 11, 01.06.2005, p. 1796-1807.

Research output: Contribution to journalArticle

Herrero, R, Castle, PE, Schiffman, M, Bratti, MC, Hildesheim, A, Morales, J, Alfaro, M, Sherman, ME, Wacholder, S, Chen, S, Rodriguez, AC & Burk, RD 2005, 'Epidemiologic profile of type-specific human papillomavirus infection and cervical neoplasia in Guanacaste, Costa Rica', Journal of Infectious Diseases, vol. 191, no. 11, pp. 1796-1807. https://doi.org/10.1086/428850
Herrero, Rolando ; Castle, Philip E. ; Schiffman, Mark ; Bratti, M. Concepción ; Hildesheim, Allan ; Morales, Jorge ; Alfaro, Mario ; Sherman, Mark E. ; Wacholder, Sholom ; Chen, Sabrina ; Rodriguez, Ana C. ; Burk, Robert D. / Epidemiologic profile of type-specific human papillomavirus infection and cervical neoplasia in Guanacaste, Costa Rica. In: Journal of Infectious Diseases. 2005 ; Vol. 191, No. 11. pp. 1796-1807.
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AU - Bratti, M. Concepción

AU - Hildesheim, Allan

AU - Morales, Jorge

AU - Alfaro, Mario

AU - Sherman, Mark E.

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N2 - Background. Detailed epidemiologic studies of cervical type-specific human papillomavirus (HPV) infection in large populations are scarce. Methods. We recruited a population-based cohort in Guanacaste, Costa Rica. Participants were interviewed, screened for cervical neoplasia, and tested for >40 HPV types by use of MY09/11 L1 consensus primer polymerase chain reaction. We estimated the risk factors for infection and the associations between type-specific HPV infections and cervical intraepithelial neoplasia (CIN) and cancer in 8514 sexually active women who had not undergone a hysterectomy. Results. The overall HPV prevalence was 26.5%. The most common type was HPV-16 (3.6% of the population). HPV prevalence showed a U-shaped age-specific curve. Sexual behaviors were the main determinants of oncogenic and nononcogenic infections; age at first sexual intercourse was not independently associated with infection. Barrier contraceptive use was somewhat protective against infection. Oncogenic infections were strongly associated with risk of all grades of CIN and of cancer. Types 16, 18, and 58 were the most common in women diagnosed with CIN3 and cancer. Except for those that included HPV-16, multiple-type infections were associated with an increased risk (compared with that for single-type infections) of all grades of CIN and of cancer. Conclusions. We confirmed the bimodal age pattern of HPV infection in Guanacaste and the sexually transmitted nature of both oncogenic and nononcogenic HPV types.

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