Lifestyle and socio-demographic factors associated with high-risk HPV infection in UK women

Abstract

The world age-standardised prevalence of high-risk HPV (hrHPV) infection among 5038 UK women aged 20-59 years, with a low-grade smear during 1999-2002, assessed for eligibility for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) was 34.2%. High-risk HPV prevalence decreased with increasing age, from 61% at ages 20-24 years to 14-15% in those over 50 years. The age-standardised prevalence was 15.1, 30.7 and 52.7%, respectively, in women with a current normal, borderline nuclear abnormalities (BNA) and mild smear. In overall multivariate analyses, tertiary education, previous pregnancy and childbirth were associated with reduced hrHPV infection risk. Risk of infection was increased in non-white women, women not married/cohabiting, hormonal contraceptives users and current smokers. In stratified analyses, current smear status and age remained associated with hrHPV infection. Data of this type are relevant to the debate on human papillomavirus (HPV) testing in screening and development of HPV vaccination programmes.

Figure 1

hr HPV positivity (%) by smear status and age. BNA, smear showing BNA; mild, smear showing mild dyskaryosis; worse than mild, smear showing moderate or severe dyskaryosis; single BNA, women with a current BNA smear and no other BNA smear in previous 3 years; single mild, women with a current mild smear and no BNA smear in previous 3 years. Adjusted OR: adjusted for age (in women aged 30 years or over – 30–34, 35–59, 40–44, 45–49, 50–54 and 55–59 years; in women aged less than 30 years – 20–24 and 25–29 years).