Introduction/Background In Japan, the incidence of cervical cancer and high grade cervical intraepithelial neoplasia (CIN) has been markedly increasing in young women. However, Japan has several problems about cervical cancer prevention, such as suspension of proactive recommendation of human papillomavirus (HPV) vaccination, low cervical cancer screening coverage and insufficient sex education. In this study, we aimed to investigate the correlation between sexual behavior and HPV infection and histological abnormalities of cervix in young women for a comprehensive approach to cervical cancer prevention in Japan.
Methodology We recruited women aged 20–30, 35–36, 40–41 years attending for public cervical cancer screening at Niigata city from April 2014 to March 2016 under informed consent. Residual Pap smear specimens were collected for HPV testing. The histological diagnosis for cervical abnormalities was examined using the database of the Niigata city health center. Abnormal histology was defined as CIN2 or worse. Sexual behavior was gathered from a questionnaire.
Results The study enrolled a total of 3968 participants and included 3231 in the analysis. Seventy-two percent of women become sexually active as a teenager. There was a correlation between lower age at first intercourse and multiple numbers of sex partners (p<0.01). In the multivariate analysis, HPV infections were associated with number of sex partners. Especially, women who had 6 or more sex partners were extremely high risk of HPV16/18 infection (aOR=74.9), however, logistic regression analysis revealed that number of sex partners was no longer a significant factor for abnormal histology. There were strong correlations between high-risk HPV infection (HPV16/18: aOR=113.8, HPV16/18/31/33/45/52/58: aOR=93.6) and abnormal histology.
Conclusion We recognized that sexual activity was closely correlate with HPV infection, and the highest-risk HPV types of abnormal histology were preventable by vaccination regardless of the sexual activity.
Disclosure Nothing to disclose
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