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Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet

BACKGROUND: Cervical cancer has become a worldwide concern owing to its high incidence and mortality rates. To date, high-altitude areas of Tibet have not benefited from any large-scale cervical cancer screening programs. Therefore, we initiated a screening program to investigate the prevalence of h...

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Autores principales: Wang, Qimin, He, Yingying, Long, Fang, Li, Chaoran, Shen, Zhuowei, Guo, Dongxing, Zhaxi, Duoji, Bumu, Lamu, Hua, Zhengyu, Sun, Zhigang, Jiang, Nan, Han, Xu, Li, Jing, Yan, Keqing, Bai, Siqi, Tao, Muhan, Xu, Xiaoguang, Xiao, Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452642/
https://www.ncbi.nlm.nih.gov/pubmed/36091127
http://dx.doi.org/10.3389/fonc.2022.841547
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author Wang, Qimin
He, Yingying
Long, Fang
Li, Chaoran
Shen, Zhuowei
Guo, Dongxing
Zhaxi, Duoji
Bumu, Lamu
Hua, Zhengyu
Sun, Zhigang
Jiang, Nan
Han, Xu
Li, Jing
Yan, Keqing
Bai, Siqi
Tao, Muhan
Xu, Xiaoguang
Xiao, Zhen
author_facet Wang, Qimin
He, Yingying
Long, Fang
Li, Chaoran
Shen, Zhuowei
Guo, Dongxing
Zhaxi, Duoji
Bumu, Lamu
Hua, Zhengyu
Sun, Zhigang
Jiang, Nan
Han, Xu
Li, Jing
Yan, Keqing
Bai, Siqi
Tao, Muhan
Xu, Xiaoguang
Xiao, Zhen
author_sort Wang, Qimin
collection PubMed
description BACKGROUND: Cervical cancer has become a worldwide concern owing to its high incidence and mortality rates. To date, high-altitude areas of Tibet have not benefited from any large-scale cervical cancer screening programs. Therefore, we initiated a screening program to investigate the prevalence of human papilloma virus (HPV) and HPV genotype distribution to reveal cervical cancer and its precursor which lead to morbidity among women in the city of Nagqu in northern Tib3et. METHODS: A total of 25,173 women were recruited to undergo HPV genotype tests between June and December 2019. Women infected with HPV 16 and/or 18 underwent colposcopy and histological examination. Women with other high-risk HPV type (hr-HPV) underwent cytological tests to determine whether to conduct further colposcopy and histological examination for diagnosis. HPV prevalence was calculated in the total population and further stratified according to various parameters, such as age group, area location (altitude level), and single or mixed infection status. The HPV genotype distribution was also investigated accordingly. Cervical lesions revealed by further colposcopic findings were also analyzed; high-grade and malignant lesion morbidities were calculated in total and in each county. Most data were collected and analyzed using descriptive and consistency check statistical methods, and a risk factor investigation for HPV infection was performed using logistic regression models. RESULTS: The total HPV infection rate among women in Nagqu was 13.42%. Of the 25,173 women in the study, 999 (3.97%) were HPV 16/18 positive, 2,379 (9.45%) were other hr-HPV-positive, and 21,795 (86.58%) were HPV-negative. The five most common HPV genotypes, accounting for more than 60% of all HPV infections in Nagqu people, were HPV 16, 58, 31, 18, and 52. Tibetan women younger than 20 years and older than 60 years were the two age groups with the highest rates of HPV infection, 26.7% and 19.8%, respectively. Among the HPV-positive women, 2,656 (78.33%) were infected with a single strain and 732 (21.67%) were infected with multiple strains (more than two genotypes). HPV prevalence increased in high-altitude areas (positive rate highest in Nyima with an altitude of 5,000 m, 23.9%) and decreased in relatively low-altitude areas (positive rate lowest in Lhari with an altitude of 4,000 m, 6.6%). Multiple analyses showed that age, parity, age at first delivery, and altitude of residence were independent factors facilitating HPV infection in Tibetan women. High-grade and malignant cervical lesions revealed by histological findings were different among living locations, with the highest rates in Xainza, Baingoin, and Nyainrong, these being 2.019%, 1.820%, and 1.116%, respectively, among women in these areas. CONCLUSION: Our survey provides an overall perspective on HPV genotype infection and cervical lesions in women in northern Tibet. The data not only provide useful information for the treatment of cervical lesions but also has great value in terms of the primary and secondary prevention measures that can be taken for women living in these regions. CLINICAL TRIAL REGISTRATION: www.chictr.org.cn, indentifier ChiCTR2000035061.
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spelling pubmed-94526422022-09-09 Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet Wang, Qimin He, Yingying Long, Fang Li, Chaoran Shen, Zhuowei Guo, Dongxing Zhaxi, Duoji Bumu, Lamu Hua, Zhengyu Sun, Zhigang Jiang, Nan Han, Xu Li, Jing Yan, Keqing Bai, Siqi Tao, Muhan Xu, Xiaoguang Xiao, Zhen Front Oncol Oncology BACKGROUND: Cervical cancer has become a worldwide concern owing to its high incidence and mortality rates. To date, high-altitude areas of Tibet have not benefited from any large-scale cervical cancer screening programs. Therefore, we initiated a screening program to investigate the prevalence of human papilloma virus (HPV) and HPV genotype distribution to reveal cervical cancer and its precursor which lead to morbidity among women in the city of Nagqu in northern Tib3et. METHODS: A total of 25,173 women were recruited to undergo HPV genotype tests between June and December 2019. Women infected with HPV 16 and/or 18 underwent colposcopy and histological examination. Women with other high-risk HPV type (hr-HPV) underwent cytological tests to determine whether to conduct further colposcopy and histological examination for diagnosis. HPV prevalence was calculated in the total population and further stratified according to various parameters, such as age group, area location (altitude level), and single or mixed infection status. The HPV genotype distribution was also investigated accordingly. Cervical lesions revealed by further colposcopic findings were also analyzed; high-grade and malignant lesion morbidities were calculated in total and in each county. Most data were collected and analyzed using descriptive and consistency check statistical methods, and a risk factor investigation for HPV infection was performed using logistic regression models. RESULTS: The total HPV infection rate among women in Nagqu was 13.42%. Of the 25,173 women in the study, 999 (3.97%) were HPV 16/18 positive, 2,379 (9.45%) were other hr-HPV-positive, and 21,795 (86.58%) were HPV-negative. The five most common HPV genotypes, accounting for more than 60% of all HPV infections in Nagqu people, were HPV 16, 58, 31, 18, and 52. Tibetan women younger than 20 years and older than 60 years were the two age groups with the highest rates of HPV infection, 26.7% and 19.8%, respectively. Among the HPV-positive women, 2,656 (78.33%) were infected with a single strain and 732 (21.67%) were infected with multiple strains (more than two genotypes). HPV prevalence increased in high-altitude areas (positive rate highest in Nyima with an altitude of 5,000 m, 23.9%) and decreased in relatively low-altitude areas (positive rate lowest in Lhari with an altitude of 4,000 m, 6.6%). Multiple analyses showed that age, parity, age at first delivery, and altitude of residence were independent factors facilitating HPV infection in Tibetan women. High-grade and malignant cervical lesions revealed by histological findings were different among living locations, with the highest rates in Xainza, Baingoin, and Nyainrong, these being 2.019%, 1.820%, and 1.116%, respectively, among women in these areas. CONCLUSION: Our survey provides an overall perspective on HPV genotype infection and cervical lesions in women in northern Tibet. The data not only provide useful information for the treatment of cervical lesions but also has great value in terms of the primary and secondary prevention measures that can be taken for women living in these regions. CLINICAL TRIAL REGISTRATION: www.chictr.org.cn, indentifier ChiCTR2000035061. Frontiers Media S.A. 2022-08-25 /pmc/articles/PMC9452642/ /pubmed/36091127 http://dx.doi.org/10.3389/fonc.2022.841547 Text en Copyright © 2022 Wang, He, Long, Li, Shen, Guo, Zhaxi, Bumu, Hua, Sun, Jiang, Han, Li, Yan, Bai, Tao, Xu and Xiao https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Wang, Qimin
He, Yingying
Long, Fang
Li, Chaoran
Shen, Zhuowei
Guo, Dongxing
Zhaxi, Duoji
Bumu, Lamu
Hua, Zhengyu
Sun, Zhigang
Jiang, Nan
Han, Xu
Li, Jing
Yan, Keqing
Bai, Siqi
Tao, Muhan
Xu, Xiaoguang
Xiao, Zhen
Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet
title Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet
title_full Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet
title_fullStr Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet
title_full_unstemmed Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet
title_short Cervical cancer screening in high-altitude areas in China: A large cross-section study of 25,173 women in northern Tibet
title_sort cervical cancer screening in high-altitude areas in china: a large cross-section study of 25,173 women in northern tibet
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452642/
https://www.ncbi.nlm.nih.gov/pubmed/36091127
http://dx.doi.org/10.3389/fonc.2022.841547
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