High-risk Human Papillomavirus Infection In Urban And Rural Areas In China And Epidemiological Study Of Risk Factors

Objective: To investigate the prevalence of high-risk human papillomavirus (HR-HPV) types infection and analyze the risk factors of HR-HPV in urban and rural areas of China. To provide the evidence on the prevention of HR-HPV infection and cervical cancer in China.Methods: We conducted a cross sectional study using cluster sampling method to screen cervical cancer in the four regions of China including Shanxi Xiangyuan, Henan Xinmi, Shanghai and Beijing. Questionnaire included basic information, medical history, smoking, drinking, menstrual, marriage and pregnancy history, sexual behavior and health habits, contraception and cancer family history. The collected cervical cells samples were tested for high-risk HPV types, HPV DNA≥1.0pg/ml was defined as positive reference value. Visual FoxPro 6.0 was used for data entry and management. Chi-square test and unconditional Logistic regression model were used for date analysis by SPSS15.0 software.Results: The number of valid questionnaires were 3332.The overall infection rate of HR-HPV was 13.8%, with 13.5% in urban (248/1763) and 14.1% in rural (212/1569). The infection rate of HR-HPV increased with the severity of lesions (100% in CIN2+). One peak is showed in age curve owing to the infection rate in 41～46 group(18.5%). There were no statistical significant for the infection rate in education years and number of years having sex activity. Multivariate Logistic regression analysis showed that: the risk factors of HR-HPV infection in urban were extramarital sexual activity in husband 1.66 (1.14 ~ 2.42), STD1.65 (1.17 ~ 2.31), number of abortions 1.63 (1.06 to 2.51), smoking 1.43 (1.06 ~ 1.93), history of cytology 0.62 (0.45 ~ 0.86), a protective factor. But risk factors in rural areas were: age at first sexual intercourse 3.01 (1.05 ~ 8.64), number of sexual partners in the past 5 years 2.16 (1.40 ~ 3.34), extramarital sexual activity in husband 1.69 (1.21 ~ 2.37),alcohol 1.41 (1.05 ~ 1.90) and number of years having sex activity 1.39(1.06~1.84)Conclusion There was no statistical significant for the rate of HR-HPV infection in urban and rural areas.The infection rate of HR-HPV increased with the severity of lesions. The prevalence of HR-HPV in different age groups showed the one peak. In urban and rural areas, risk factors for HR-HPV are difference. This suggests that when making cervical cancer prevention and control measures in China, policy makers should consider the local conditions.