Research articles
Zhihua LIU MD, Qing LI BM, Weihong LI BM,
The aim of this paper was to investigate the prevalence of human papilloma virus (HPV) infection in women under 30 years old with cervical intraepithelial neoplasia (CIN) or cervical cancer, in order to provide a basis for cervical cancer prevention and treatment. We recruited 2052 female cases from the education system in Futian District, Shenzhen city, from April 2006 to April 2008, with age ranging from 22 to 60 years old. Second-generation hybrid capture test was done for detection of female genital tract HPV and cervical colposcopy for screening CIN or cervical cancer. The prevalence of HPV and cervical precancerous lesions or cervical cancer was evaluated in different age groups of women. The HPV positive rate was 247/2052 (12.00%), and 35/2052 (1.71%) of the cases were≥CIN I by pathological diagnosis. In the 22―29-year-old age group, there were 291 cases, including 39HPV-positive cases (13.40%) and one case of pathological diagnosis≥CIN I (0.34%), and there were 1761 cases in the 30―60-year-old age group, including 208 HPV-positive cases (11.81%) and 34 cases of pathological diagnosis≥CIN I (1.93%). The HPV-positive rate of 22―29-year-old age group was higher than that of 30―60-year-old age group, but the difference was not significant (χ2 = 0.5967, P = 0.4398); the CIN and cervical cancer detection rate of the former group was lower than that of the latter one, and the difference was not significant either (χ2 = 3.7519, P = 0.0527). The cases in 30―60-year-old age group were divided into five age sub-groups, and the HPV-positive rate of the 22―29-year-old age group was compared with the remaining groups, and it was found that the HPV-positive rate of the former group (13.40%) was lower than that of the 40―44-year-old age group (14.70%) but higher than that of the other four groups. Moreover, the difference in the HPV-positive rate between the 22―29-year-old age group and the 50―60-year-old age group (6.06%) was significant (χ2 = 5.545, P = 0.018), but the difference between the 22― 29-year-old age group and each of the other four groups was not significant (P>0.05). In addition, the CIN and cervical cancer detection rate of the 22―29-year-old age group (0.34%) was lower than that of the remaining five groups, and the difference between the 22―29-year-old age group and the 35―39-year-old age group (2.26%), and between 22―29-year-old age group and 40―44-year-old age group (2.30%) was significant (χ2 = 4.446, P = 0.0035; χ2 = 4.525, P = 0.0363, respectively), but the difference between the 22―29-year-old age group and each of other three groups was not significant (P>0.05). Furthermore, 80.00% (28/35) cases of pathological diagnosis≥CIN I and 90.91% (10/11) lesions of pathological diagnosis≥CIN II occurred at 35―49 years of age. For many young women below the age of 30 who were infected with high-risk HPV were one-off infections, so it was not appropriate to recommend HPV detection as cervical precancerous lesions or cancer screening program for women less than 30 years old. The prevention and treatment of cervical cancer should be focused on those women more than 35 years of age.