TY - JOUR
T1 - Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain
T2 - the CLEOPATRE study
AU - Roura, Esther
AU - Iftner, Thomas
AU - Vidart, José Antonio
AU - Kjaer, Susanne Krüger
AU - Bosch, F Xavier
AU - Muñoz, Nubia
AU - Palacios, Santiago
AU - Rodriguez, Maria San Martin
AU - Morillo, Carmen
AU - Serradell, Laurence
AU - Torcel-Pagnon, Laurence
AU - Cortes, Javier
AU - Castellsagué, Xavier
AU - CLEOPATRE Spain Study Group
PY - 2012/6/26
Y1 - 2012/6/26
N2 - BACKGROUND: Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain.METHODS: The CLEOPATRE Spain study enrolled 3 261 women aged 18-65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection.RESULTS: A lifetime number of two or more sexual partners, young age (18-25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01).CONCLUSION: This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection.
AB - BACKGROUND: Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain.METHODS: The CLEOPATRE Spain study enrolled 3 261 women aged 18-65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection.RESULTS: A lifetime number of two or more sexual partners, young age (18-25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01).CONCLUSION: This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection.
KW - Adolescent
KW - Adult
KW - Aged
KW - Cross-Sectional Studies
KW - Decision Support Techniques
KW - Early Detection of Cancer
KW - Female
KW - Genotype
KW - Humans
KW - Middle Aged
KW - Papillomaviridae/classification
KW - Papillomavirus Infections/diagnosis
KW - Risk Factors
KW - Sexual Behavior/statistics & numerical data
KW - Spain/epidemiology
KW - Uterine Cervical Neoplasms/diagnosis
KW - Young Adult
U2 - 10.1186/1471-2334-12-145
DO - 10.1186/1471-2334-12-145
M3 - Journal article
C2 - 22734435
SN - 1471-2334
VL - 12
SP - 145
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
ER -