Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Human papillomavirus prevalence to age 60 years among Australian women prevaccination

Julia M. L. Brotherton A B I , John R. Condon C , Peter B. McIntyre D , Sepehr N. Tabrizi E F G H , Michael Malloy A B , Suzanne M. Garland E F G H and on behalf of the WHINURS study group
+ Author Affiliations
- Author Affiliations

A National HPV Vaccination Program Register, PO Box 310, East Melbourne, Vic. 8002, Australia.

B School of Population and Global Health, Level 4, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.

C Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia.

D National Centre for Immunisation Research and Surveillance, University of Sydney and The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.

E Regional World Health Organisation Human Papillomavirus Laboratory Network, Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Locked Bag 300, Grattan Street and Flemington Road, Parkville, Vic. 3052, Australia.

F Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women’s Hospital, Locked Bag 300, Grattan Street and Flemington Road, Parkville, Vic. 3052, Australia.

G Department of Microbiology, Royal Children’s Hospital, 50 Flemington Road, Parkville, Vic. 3052, Australia.

H Murdoch Childrens Research Institute, The Royal Children’s Hospital, Flemington Road, Parkville, Vic. 3052, Australia.

I Corresponding author. Email: jbrother@vcs.org.au

Sexual Health 12(4) 353-359 https://doi.org/10.1071/SH15035
Submitted: 4 March 2015  Accepted: 15 April 2015   Published: 1 June 2015

Abstract

Background: The prevalence of human papillomavirus (HPV) at the cervix varies with age, peaking following sexual debut and declining thereafter in most populations. In some populations, a second peak is observed. Here we describe the prevalence of HPV at the cervix among Australian women before the commencement of the HPV vaccination program. Methods: Women aged 15 to 60 years attending health services for cervical screening between 2005 and 2008 were invited to participate. Liquid based cervical specimens were tested for 37 types of HPV using linear array. The percentage and 95% confidence interval of women with any type of HPV, any of 13 high risk HPV types, and with vaccine-preventable HPV types (types 6, 11, 16 and 18) were estimated in 5-year age bands. Results: Among 1929 women aged 15–60 years, HPV prevalence peaked at 64% at age 15–20 years, then declined gradually to 12% at age 41–45 years, whereafter it rose to 19% in women 51–55 years then returned to 14% in 56–60 year olds. Prevalence curves were similar for high-risk HPV types and vaccine-targeted HPV types 6, 11, 16 and 18 and when results were restricted to women with only normal cytology. Conclusions: The shape of the prevalence curve we observed is similar to those from other Western populations. Variation in prevalence curves is likely due to differences in sexual behaviour between populations and over time, reactivation of HPV during perimenopause, and possibly the presence of cervical screening programs. These data are the first such data from the Oceania region.


References

[1]  Bosch FX, Tsu V, Vorsters A, Van Damme P, Kane MA. Reframing cervical cancer prevention. Expanding the field towards prevention of human papillomavirus infections and related diseases. Vaccine 2012; 30 F1–11.
Reframing cervical cancer prevention. Expanding the field towards prevention of human papillomavirus infections and related diseases.Crossref | GoogleScholarGoogle Scholar | 23199951PubMed |

[2]  Schiller JT, Castellsague X, Garland SM. A review of clinical trials of human papillomavirus prophylactic vaccines. Vaccine 2012; 30 F123–38.
A review of clinical trials of human papillomavirus prophylactic vaccines.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xhsl2ju73L&md5=197ef6f488705ba587be403bd1c6a6dfCAS | 23199956PubMed |

[3]  Drolet M, Benard E, Boily M, Ali H, Baandrup L, Bauer H, Beddows S, Brisson J, Brotherton JML, Cummings T, Donovan B, Fairley CK, Flagg EW, Johnson AM, Kahn JA, Kavanagh K, Kjaer SK, Kliewer EV, Lemieux-Melloki P, Markowitz L, Mboup A, Mesher D, Niccolai L. Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis 2015;
Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 25744474PubMed |

[4]  Bruni L, Diaz M, Castellsague X, Ferrer E, Bosch FX, de Sanjose S. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis 2010; 202 1789–99.
Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings.Crossref | GoogleScholarGoogle Scholar | 21067372PubMed |

[5]  Smith JS, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of infection with human papillomavirus in females: a global review. J Adolesc Health 2008; 43 S5–25.
Age-specific prevalence of infection with human papillomavirus in females: a global review.Crossref | GoogleScholarGoogle Scholar | 18809145PubMed |

[6]  de Sanjose S, Diaz M, Castellsague X, Clifford G, Bruni L, Munoz N, Bosch FX. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis 2007; 7 453–9.
Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 17597569PubMed |

[7]  Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, Tortolero-Luna G, Kjaer SK, Munoz N. Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine 2008; 26 K1–16.
Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia.Crossref | GoogleScholarGoogle Scholar | 18847553PubMed |

[8]  Franceschi S, Herrero R, Clifford GM, Snijders PJ, Arslan A, Anh PT, Bosch FX, Ferreccio C, Hieu NT, Lazcano-Ponce E, Matos E, Molano M, Qiao Y-L, Rajkuma R, Ronco G, de Sanjose S, Shin H-R, Sukvirach S, Thomas JO, Meijer CJLM, Munoz N. Variations in the age-specific curves of human papillomavirus prevalence in women worldwide. Int J Cancer 2006; 119 2677–84.
Variations in the age-specific curves of human papillomavirus prevalence in women worldwide.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD28XhtFygur7F&md5=8f47e671ce8a5bb4c262119c6e6c9b33CAS | 16991121PubMed |

[9]  Gravitt PE, Rositch AF, Silver MI, Marks MA, Chang K, Burke AE, Viscidi RP. A cohort effect of the sexual revolution may be masking an increase in human papillomavirus detection at menopause in the United States. J Infect Dis 2013; 207 272–80.
A cohort effect of the sexual revolution may be masking an increase in human papillomavirus detection at menopause in the United States.Crossref | GoogleScholarGoogle Scholar | 23242540PubMed |

[10]  Rositch AF, Burke AE, Viscidi RP, Silver MI, Chang K, Gravitt PE. Contributions of recent and past sexual partnerships on incident human papillomavirus detection: acquisition and reactivation in older women. Cancer Res 2012; 72 6183–90.
Contributions of recent and past sexual partnerships on incident human papillomavirus detection: acquisition and reactivation in older women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhslGlu73E&md5=3347bd09eca473eb2245aee9c947fca5CAS | 23019223PubMed |

[11]  Gravitt PE. The known unknowns of HPV natural history. J Clin Invest 2011; 121 4593–9.
The known unknowns of HPV natural history.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhs1ShsLrN&md5=d4b58c2db9eb19ac48f630ffc3d0343eCAS | 22133884PubMed |

[12]  Guan P, Howell-Jones R, Li N, Bruni L, de Sanjose S, Franceschi S, Clifford GM. Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int J Cancer 2012; 131 2349–59.
Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XktFWrtbo%3D&md5=9c422e65ce967fdfb5f6ca150ef6f448CAS | 22323075PubMed |

[13]  Garland SM, Brotherton JM, Condon JR, McIntyre PB, Stevens MP, Smith DW, Tabrizi SN. Human papillomavirus prevalence among indigenous and non-indigenous Australian women prior to a national HPV vaccination program. BMC Med 2011; 9 104
Human papillomavirus prevalence among indigenous and non-indigenous Australian women prior to a national HPV vaccination program.Crossref | GoogleScholarGoogle Scholar | 21910918PubMed |

[14]  Tabrizi SN, Brotherton JML, Stevens MP, Condon JR, McIntyre PB, Smith D, Garland SM,, on behalf of the WHINURS group. HPV genotype prevalence in Australian women undergoing routine cervical screening by cytology status prior to implementation of an HPV vaccination program. J Clin Virol 2014; 60 250–6.
HPV genotype prevalence in Australian women undergoing routine cervical screening by cytology status prior to implementation of an HPV vaccination program.Crossref | GoogleScholarGoogle Scholar | 24854516PubMed |

[15]  Kjaer SK, Breugelmans G, Munk C, Junge J, Watson M, Iftner T. Population-based prevalence, type- and age-specific distribution of HPV in women before introduction of an HPV-vaccination program in Denmark. Int J Cancer 2008; 123 1864–70.
Population-based prevalence, type- and age-specific distribution of HPV in women before introduction of an HPV-vaccination program in Denmark.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXhtFKhu7fK&md5=a1fdab55f0a2413ac0688df44c313854CAS | 18661520PubMed |

[16]  Kavanagh K, Sinka K, Cuschieri K, Love J, Potts A, Pollock KG, Cubie H, Donaghy M, Robertson C. Estimation of HPV prevalence in young women in Scotland; monitoring of future vaccine impact. BMC Infect Dis 2013; 13 519
Estimation of HPV prevalence in young women in Scotland; monitoring of future vaccine impact.Crossref | GoogleScholarGoogle Scholar | 24188790PubMed |

[17]  Althoff KN, Paul P, Burke AE, Viscidi R, Sangaramoorthy M, Gravitt PE. Correlates of cervicovaginal human papillomavirus detection in perimenopausal women. J Womens Health 2009; 18 1341–6.
Correlates of cervicovaginal human papillomavirus detection in perimenopausal women.Crossref | GoogleScholarGoogle Scholar |

[18]  Brogaard KA, Munk C, Iftner T, Frederiksen K, Kjaer SK. Detection of oncogenic genital human papillomavirus (HPV) among HPV negative older and younger women after 7 years of follow-up. J Med Virol 2014; 86 975–82.
Detection of oncogenic genital human papillomavirus (HPV) among HPV negative older and younger women after 7 years of follow-up.Crossref | GoogleScholarGoogle Scholar | 24610211PubMed |

[19]  Berecki-Gisolf J, Begum N, Dobson AJ. Symptoms reported by women in midlife: menopausal transition or aging? Menopause 2009; 16 1021–9.
Symptoms reported by women in midlife: menopausal transition or aging?Crossref | GoogleScholarGoogle Scholar | 19546824PubMed |

[20]  Gonzalez P, Hildesheim A, Rodriguez AC, Schiffman M, Porras C, Wacholder S, Pineres AG, Pinto LA, Burk RD, Herrero R. Behavioral/lifestyle and immunologic factors associated with HPV infection among women older than 45 years. Cancer Epidemiol Biomarkers Prev 2010; 19 3044–54.
Behavioral/lifestyle and immunologic factors associated with HPV infection among women older than 45 years.Crossref | GoogleScholarGoogle Scholar | 20952561PubMed |

[21]  Kjaer SK, Munk C, Junge J, Iftner T. Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer: what is the potential for prevention? Cancer Causes Control 2014; 25 179–89.
Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer: what is the potential for prevention?Crossref | GoogleScholarGoogle Scholar | 24242002PubMed |