1. Among women with high-grade cervical lesions, black and Hispanic women were less likely to have human papillomavirus (HPV) types 16/18 than white women.
2. Women residing in poor areas were less likely to have HPV 16/18-positive lesions than women in wealthier areas.
Evidence Rating Level: 2 (Good)
Study Rundown: Among women with high-grade cervical lesions, women who were black, Hispanic, or resided in a poor area were less likely to have HPV 16/18-positive lesions. These results suggest that current HPV vaccination would not decrease the risk of high-grade cervical lesions in these populations. Strengths of this study were inclusion of individual and geographically based demographic data and case identification through a mandatory statewide surveillance program. However, only 45% of cases were eligible for inclusion, primarily due to lack of DNA testing (HPV typing) of high-grade lesions, which could limit generalizability. Additional investigations might examine HPV types in high-grade lesions in black and Hispanic women to inform vaccine development research.
In-Depth [retrospective cohort study]: This study examined the prevalence of HPV 16/18 in high-grade cervical lesions among 832 Connecticut women (ages 18-39) who had never received HPV vaccines. Eligible cases were reported between 2008 and 2010 and received HPV DNA testing. Data on race/ethnicity, health insurance status, age, type of lesion, and area of residence were obtained from medical records and patient interviews.
Among women with high-grade lesions, black and Hispanic women were less likely than white women to have HPV 16/18 (both p=0.01). Additionally, women residing in areas with ≥20% poverty were less likely to have HPV 16/18 than women in areas with <20% poverty (p=0.007). Younger age and higher grade lesions were associated with higher prevalence of HPV 16/18-positive lesions, though insurance status was not.
By Caroline Huang and Leah Hawkins
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