Cervical cancer screening results among women in Mississippi suggests that Black women have a higher prevalence of infection with human papillomavirus (HPV) high-risk types at younger ages than do White women. These study results were reported in the journal Cancer Medicine.1
Within the US, Mississippi has a high incidence of cervical cancer and a high mortality rate from cervical cancer.
This study was based on data from participants in cervical screening as part of the STRIDES (Studying Risk to Improve Disparities in cervical cancer in Mississippi) Study. Participants were between the ages of 21 and 65 years, and had undergone cervical cancer screening at the University of Mississippi Medical Center or Mississippi State Department of Health between May and November of 2018.
The researchers investigated age-specific prevalence of high-risk HPV infection with respect to race. Results were also compared with nationwide data from the National Health and Nutrition Examination Survey (NHANES; 2013 to 2016). Overall HPV infection prevalence and rates of types 16 and 18, and a set of 12 other HPV types (HR12) were outcomes of interest. HR12 included the 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 HPV genotypes.
For this study, 6871 participants, of whom 61.0% were Black, and 26.2% were White, underwent cervical cancer screening. Black participants were mean age 35.7 years, and White participants were mean age 36.7 years.
The overall prevalence of HPV infection was 25.6%. Prevalence was 28.0% and 22.4% among Black and White participants, respectively. Rates by HPV types were 3.0% for HPV16 and 1.7% for HPV18, without differences by race. The HR12 HPV types were pooled for prevalence estimates, with rates of 24.9% across the overall population, 27.5% among Black participants, and 21.3% among White participants.
By age groups, prevalence of HPV infection was 50.2% among Black participants aged 21 to 24 years and 30.2% among those aged 30 to 34 years. These rates were significantly higher than the HPV infection rates among White participants (32.1% and 20.7%, respectively; P <.0001 for each comparison). A similar pattern was suggested in the NHANES data for women aged 21 to 24 years only, which showed HPV infection rates of 49.5% in Black women, compared with 33.65% in White women.
The researchers found that cervical cancer screening may show an earlier age of onset of HPV infection, with HR12 types in particular, among Black women compared with White women. “These findings may have implications for natural history modeling, risk estimation, and recommendations for HPV-based screening,” the researchers concluded.
Clarke MA, Risley C, Stewart MW, et al. Age-specific prevalence of human papillomavirus and abnormal cytology at baseline in a diverse statewide prospective cohort of individuals undergoing cervical cancer screening in Mississippi. Cancer Med. November 3, 2021. doi:10.1002/cam4.4340