Prevalence of Genital Human Papillomavirus Infections in a Mass-Screened Finnish Female Population Aged 20

Abstract

The results of the nationwide, population-based cervical cancer screening programme (organized by the Finnish Cancer Society since early 1960s) were analysed to establish the prevalence figures (and their changes) for genital human papillomavirus (HPV) infections in an unselected Finnish female population (aged between 20 and 65 years) screened in Kuopio Province between 1981 and 1989. During the study period 82,393 women were invited on a regular basis for the mass-screening, and also 4131 women in a risk group. Of these, a total of 63,115 and 3249 women attended, resulting in the attendance rates of 76.6% and 78.6%, respectively. As a result of the screening, a total of 509 (0.80%) of the 63,115 smears were diagnosed as having the cytological changes consistent with HPV infection in the mass screening. The corresponding figures in the risk group screening were 58/3249 (1.78%). There was a sharply increasing trend in the prevalence of genital HPV infections from 1981 through 1987, from 0.04% to 1.76% (ie a 44-fold increase in 7 years) which, surprisingly, then declined to 1.43% in 1988 and 1.04% in 1989. Based on a random sample of 2084 routine (non-mass-screening) Pap smears (out of 28,861) collected from the files of our laboratory, the prevalence of HPV infections was stratified by age groups. The highest prevalence (6.1%) was observed in women aged between 20 and 29 years, followed by 2.2% in those aged 30–39 years. Using the figures of the relative risk (RR) of HPV infections by age, an estimation was made to assess the prevalence of clinical HPV infections in the Finnish female population in general. With the annual number of female births (approximately 30,000), it was estimated that some 18,000 women aged between 20 and 29 years will harbour a clinically manifest genital HPV infection. It is noteworthy that the above established figures do not include any data of the subclinical and latent HPV infections, not detectable by the Pap smear. Beyond any doubt, genital HPV infections are the most frequent STD in Finland.

Keywords

Mass-screening cervical precancer HPV infection Pap smears epidemiology

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References

zur Hausen

Human papillomaviruses and their possible role in squamous cell carcinomas. Curr Top Microbiol Immunol 1977; 78: 1–30

Koss

. Cytologic and histologic manifestations of human papillomavirus infection of the female genital tract and their clinical significance. Cancer 1987; 60: 1942–51

Syrjänen

. Human papillomavirus (HPV) infections of the female genital tract and their associations with intraepithelial neoplasia and squamous cell carcinoma. Pathol Annu 1986; 21: 53–89

Mitchell

Drake

Medley

Prospective evaluation of risks of cervical cancer after cytological evidence of Human papillomavirus infection. Lancet 1986; i: 573–5

Syrjänen

. Papillomaviruses and cancer. In: Syrjänen

Gissmann

Koss

, eds. Papillomaviruses and human disease. Heidelberg: Springer Verlag, 1987:468–503

Syrjänen

Väyrynen

Castren

. Sexual behaviour of the females with human papillomavirus (HPV) lesions in the uterine cervix. Br J Vener Dis 1984; 60: 243–8

Oriel

. Genital warts. Sex Transm Dis 1981; 8: 326–9

Kadish

Burk

Kress

Carderin

Romney

. Human papillomavirus of different types in precancerous lesions of the uterine cervix: Histologic, immunocytochemical and ultrastructural studies. Hum Pathol 1986; 17: 384–92

Mauney

Eide

Sotham

Rates of condyloma and dysplasia in Papanicolaou smears with and without endocervical cells. Diagn Cytopathol 1990; 6: 18–21

10.

Lörincz

Schiffman

Jaffurs

Marlow

Quinn

Temple

. Temporal associations of human papillomavirus infection with cervical cytologic abnormalities. Am J Obstet Gynecol 1990; 162: 645–51

11.

Douglas

Werness

. Genital human papillomavirus infections. Sex Transm Dis 1989; 9: 421–44

12.

Meisels

Morin

Human papillomavirus and cancer of the uterine cervix. Gynecol Oncol 1981; 12: 111–23

13.

Chuang

T-Y

Perry

Kurland

Ilstrup

. Condyloma acuminatum in Rochester, Minn, 1950–1978. I. Epidemiology and clinical features. Arch Dermatol 1984; 120: 469–75

14.

Syrjänen

Hakama

Saarikoski

. Prevalence, incidence and estimated life-time risk of cervical human papillomavirus infections in a nonselected Finnish female population. Sex Transm Dis 1990; 17: 15–19

15.

Drake

Mitchell

Medley

Human papillomavirus infection of the cervix in Victoria, 1982–1985. Med J Austr 1987; 147: 57–9

16.

Hakama

Efficacy of screening for cervical cancer. Bandbury Rep 1986; 21: 45–54

17.

Hakama

Trends in the incidence of cervical cancer in the Nordic countries. In: Magnus

, ed. Trends in cancer incidence. Causes and practical implications. Washington: Hemisphere Publishing 1982:279–92

18.

Läärä

Day

Hakama

Trends in mortality from cervical cancer in the Nordic countries: Association with organized screening programmes. Lancet 1987; i: 1247–9

19.

Koss

Durfee

. Unusual patterns of squamous epithelium of the uterine cervix: Cytologic and pathologic study of koilocytotic atypia. Ann NY Acad Sci 1956; 63: 1245–61

20.

Meisels

Fortin

Roy

Condylomatous lesions of cervix and vagina. I. Cytologic patterns. Acta Cytol 1976; 20: 505–9

21.

Purola

Savia

Cytology of gynecologic condyloma accuminatum. Acta Cytol 1977; 21: 26–31

22.

Syrjänen

Heinonen

Kauraniemi

Cytological evidence of the association of condylomatous lesions with the dysplastic and neoplastic changes in uterine cervix. Acta Cytol 1981; 25: 17–22

23.

Meisels

Morin

Problems in cytological screening from condylomatous lesions of the cervix. Clin Obstet Gynaecol 1985; 12: 53–66

24.

Meisels

The story of a cell. Acta Cytol 1983; 27: 584–96

25.

Syrjänen

Mäntyjärvi

Väyrynen

. Cervical smears in assessment of the natural history of human papillomavirus infections in prospectively followed women. Acta Cytol 1987; 31: 855–65

26.

Cohen

A coefficient of agreement for nominal scales. Educ Psychol Meas 1960; 20: 37–46

27.

McNicol

Guijon

Paraskevas

Heywood

Gray

Brunham

. Effect of the menstrual cycle on detection and typing of human papillomavirus in uterine cervical cells. Am J Obstet Gynecol 1990; 162: 1037–41

28.

Syrjänen

. Epidemiology of human papillomavirus (HPV) infections and their associations with genital squamous cell cancer. APMIS 1989; 97: 957–70

29.

Syrjänen

Concept of the existence of human papillomavirus (HPV) DNA in histologically normal squamous epithelium of the genital tract should be reevaluated. Acta Obstet Gynecol Scand 1989; 68: 613–17

30.

Syrjänen

Väyrynen

Mäntyjärvi

Parkkinen

Syrjänen

Castren

Natural history of HPV infections in uterine cervix as determined by prospective follow-up. In: Howley

Broker

, eds. Papilloma viruses: molecular and clinical aspects. UCLA Symposia on Molecular and Cellular Biology, new series 32. New York: Alan R Liss 1985:31–45

31.

Syrjänen

Väyrynen

Saarikoski

. Natural history of cervical human papillomavirus (HPV) infections based on prospective follow-up. Br J Obstet Gynaecol 1985; 92: 1086–92

32.

Syrjänen

Mäntyjärvi

Saarikoski

. Factors associated with clinical progression of cervical human papillomavirus (HPV) infections during a long-term prospective follow-up. Br J Obstet Gynaecol 1988; 95: 1096–102

33.

Syrjänen

de Villiers

E-M

Väyrynen

. Cervical papillomavirus infection progressing to invasive cancer in less than three years. Lancet 1985; i: 510–11

34.

Kataja

Syrjänen

. Prospective follow-up of genital HPV infections: Survival analysis of the HPV typing data. Eur J Epidemiol 1990; 6: 9–14

35.

Syrjänen

Mäntyjärvi

. Prospective follow-up of genital HPV infections: Life-table analysis of histopathological, cytological and colposcopic data. Eur J Epidemiol 1989; 5: 1–7

Prevalence of Genital Human Papillomavirus Infections in a Mass-Screened Finnish Female Population Aged 20–65 Years

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