Article
Global HPV prevalence in older women with unknown cytology
Globale HPV-Prävalenz bei älteren Frauen mit unbekannter Zytologie
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Authors
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Linnea Schumann
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Marguerite Batta
- Technische Universität München, Munich, Germany
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Vanesa Osmani
- TUM School of Medicine and Health, Technische Universität München, München, Germany
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Aiswarya Puzhakkara
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Lucy Hörner
- TUM School of Medicine and Health, Technische Universität München, München, Germany
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Sophia Rank
- TUM School of Medicine and Health, Technische Universität München, München, Germany
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Stefanie J. Klug
- TUM School of Medicine and Health, Technische Universität München, München, Germany
| Published: | September 6, 2024 |
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Outline
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Background/objectives: According to the World Health Organization (WHO), in 2020, cervical cancer was the fourth most common cancer among women worldwide, with most new cases and deaths occurring in low- and middle-income countries (LMIC). It is estimated that around half of cervical cancer cases worldwide occur in women over 50 years of age. Therefore, this systematic literature review and meta-analysis aimed to provide a global estimate of overall and high-risk HPV (hrHPV) prevalence among this previously underrepresented population.
Methods: A systematic literature search was conducted in Medline via PubMed, Web of Science, and Scopus. Publication years included were between January 1990 and May 2022, and the eligible study designs were observational studies and randomized-controlled trials (RCTs). HPV pooled prevalence was calculated using random-effects models with a restricted maximum likelihood estimator (REML). We conducted subgroup analyses considering the continent of study conduct, recruitment mode, and HPV test used. The HPV prevalence was also calculated by 5-year age group and HPV genotype. A modified Newcastle-Ottawa Scale was used to assess the quality of the included studies. The statistical analyses were conducted in R version 4.2.2.
Results: 145 eligible studies were identified, of which 110 provided sufficient data for the meta-analysis. The global overall HPV prevalence was 13.7% (95% CI 12.1-16.5), whereas the pooled hrHPV prevalence was 12.2% (95% CI 10.5%-14%). The highest overall and hrHPV prevalence was found among older women in Asia. The analysis by 5-year age group showed a slightly decreasing HPV prevalence with increasing age. Study populations recruited from clinical settings resulted in higher HPV prevalence. PCR tests other than GP5/6, GP5/6+, MY09/11, or PGMY09/11 gave a higher HPV prevalence. The most common hrHPV genotype in women above 50 years of age was HPV16.
Conclusion: The study detected a substantial global HPV prevalence among older women. These results offer valuable and novel insights since no similar large-scale meta-analyses have been conducted in older women. Additionally, due to the limited number of studies reporting on hrHPV genotypes in older women, further research is needed to understand the regional distribution of different HPV types
The authors declare that they have no competing interests.
The authors declare that an ethics committee vote is not required.
The contribution has already been published: International Papillomavirus Society Congress (IPVC) 2023 [1]
References
- 1.
- Schumann L, Osmani V, Hörner L, Rank S, Klug SJ. Global HPV prevalence among women 50 years and older with unknown cytology. In: International Papillomavirus Society Congress (IPVC) 2023, Washington DC, USA.
