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Open Access Research article

Human papillomavirus genotypes detected in clinician-collected and self-collected specimens from women living in the Mississippi Delta

Philip E Castle1*, Julia C Gage2, Edward E Partridge3, Alfio Rausa4, Patti E Gravitt5 and Isabel C Scarinci3

Author affiliations

1 Global Cancer Imitative, Chestertown, MD, USA

2 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD, USA

3 University of Alabama at Birmingham, Birmingham, AL, USA

4 Mississippi State Department of Health, Jackson, MS, USA

5 Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA

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Citation and License

BMC Infectious Diseases 2013, 13:5  doi:10.1186/1471-2334-13-5

Published: 7 January 2013

Abstract

Background

There are no data available on human papillomavirus (HPV) infections in women living in the Mississippi Delta, where cervical cancer incidence and mortality among African American women is among the highest in the United States. The aim of this analysis was to report the age-specific prevalence of HPV in this population.

Methods

We recruited 443 women, 26–65 years of age, from the general population of women living in the Mississippi Delta to participate; 252 women had been screened for cervical cancer within the last 3 years while 191 had not. Women underwent a pelvic exam and had clinician-collected Pap sample taken for the routine cervical cancer screening by cytology. Women were asked to collect a self-collected specimen at home and return it to the clinic. Both specimens were tested for HPV genotypes.

Results

Four hundred and six women (91.6%) had HPV genotyping results for the clinician-collected and self-collected specimens. The prevalence of carcinogenic HPV was 18.0% (95% CI: 14.4%-22.1%) for clinician-collected specimens and 26.8% (95% CI: 22.6%-31.4%) for self-collected specimens. The concordance for the detection of carcinogenic HPV between clinician-collected and self-collected specimens was only fair (kappa = 0.54). While the prevalence of carcinogenic HPV in either sample decreased sharply with increasing age (ptrend< 0.01), the prevalence of non-carcinogenic HPV did not, especially the prevalence of HPV genotypes in the alpha 3/4/15 phylogenetic group.

Conclusions

The prevalence of carcinogenic HPV in our sample of women living in the Mississippi Delta was greater than the prevalence reported in several other U.S. studies. The high carriage of HPV infection, along with lack of participation in cervical cancer screening by some women, may contribute to the high cervical cancer burden in the region.

Keywords:
Human papillomavirus (HPV); Self-collection; Pap; Cervical intraepithelial neoplasia; Cervix