Factors associated with high-risk human papillomavirus infection and high-grade cervical neoplasia: A population-based study in Paraguay

• Published in: PloS one 2019-06, Vol.14 (6), p.e0218016
• Main Authors: Kasamatsu, Elena, Rodríguez Riveros, María Isabel, Soilan, Ana María, Ortega, Marina, Mongelós, Pamela, Páez, Malvina, Castro, Amalia, Cristaldo, Carmen, Báez, Fátima Romina, Centurión, Claudia Carolina, Vester, Jaime, Barrios, Hernán, Villalba, Griselda, Amarilla, María Luisa, Giménez, Graciela, Caubere, Elodie, Hernández, María de la Luz, Baena, Armando, Almonte, Maribel, Herrero, Rolando, Mendoza, Laura Patricia
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biology and Life Sciences; Biopsy; Cancer; Cellular biology; Cervical cancer; Cervix; Cervix dysplasia; Collaboration; Colposcopy; Complications and side effects; Feasibility studies; Female; Geography; Health policy; Health risk assessment; Health risks; Human papillomavirus; Humans; Infection; Infections; Lesions; Medical research; Medical screening; Medicine and Health Sciences; Middle Aged; Mortality; Neoplasm Grading; Odds Ratio; Pap test; Papillomavirus; Papillomavirus infections; Papillomavirus Infections - epidemiology; Papillomavirus Infections - pathology; Paraguay - epidemiology; Patient outcomes; People and places; Population; Population studies; Population-based studies; Pregnancy; Prevalence; Public health; Risk analysis; Risk Factors; Sexual behavior; Sexual partners; Social Sciences; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Women; Women's associations; Women's health; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0218016

Cervical cancer (CC) is one of the leading causes of cancer mortality among women from Paraguay, with high incidence and mortality rates (31.2 and 16 per 100 000 women, respectively). Although the risk factors associated with high-risk human papillomavirus (hrHPV) infection and preneoplastic cervical lesions are widely studied, population-based characteristics of particular settings may influence the feasibility of HPV-based CC screening implementation. This study aimed to explore factors associated with hrHPV infection and high-grade cervical neoplasia in hrHPV-positive (hrHPV+) women from Paraguay. A total of 5677 women aged 30-64 years from the Central Department of Paraguay were screened with HPV test (Hybrid Capture 2) and Pap smear. Sociodemographic and risk factor interviews were conducted. hrHPV+ women were referred to colposcopy and women with an abnormal colposcopy had a biopsy taken. The outcomes recorded were the hrHPV status and the presence of high-grade cervical intraepithelial neoplasia or worse (CIN2+) among hrHPV+ women. Associations were investigated using multivariate logistic regressions. hrHPV prevalence was 13.8% (95%CI 13.0-14.8). This value decreased with the age of women (p-trend