High-risk human papillomavirus (HPV) infection and cervical cancer prevention in Britain: Evidence of differential uptake of interventions from a probability survey

Clare Tanton*, Katherine Soldan, Simon Beddows, Catherine H. Mercer, Jo Waller, Nigel Field, Soazig Clifton, Andrew J. Copas, Kavita Panwar, Precious Manyenga, Filomeno Da Silva, Kaye Wellings, Catherine Ison, Anne M. Johnson, Pam Sonnenberg

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)

Abstract

Background: The third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) provides an opportunity to explore high-risk human papillomavirus (HR-HPV) and uptake of cervical screening and HPV vaccination in the general population. Methods: Natsal-3, a probability sample survey of men and women ages 16 to 74, resident in Britain, interviewed 8,869 women in 2010 to 2012. We explored risk factors for HR-HPV (in urine from 2,569 sexually experienced women ages 16 to 44), nonattendance for cervical screening in the past 5 years, and noncompletion of HPV catch-up vaccination. Results: HR-HPV was associated with increasing numbers of lifetime partners, younger age, increasing area-level deprivation, and smoking. Screening nonattendance was associated with younger and older age, increasing area-level deprivation (ageadjusted OR 1.91, 95% confidence interval, 1.48-2.47 for living in most vs. least deprived two quintiles), Asian/Asian British ethnicity (1.96, 1.32-2.90), smoking (1.97, 1.57-2.47), and reporting no partner in the past 5 years (2.45, 1.67-3.61 vs. 1 partner) butnotwithHR-HPV(1.35,0.79-2.31). Loweruptakeof HPV catch-up vaccination was associated with increasing arealevel deprivation, non-white ethnicity, smoking, and increasing lifetime partners. Conclusions: Socioeconomic markers and smoking were associated with HR-HPV positivity, nonattendance for cervical screening, and noncompletion of catch-up HPV vaccination. Impact: The cervical screening program needs to engage those missing HPV catch-up vaccination to avoid a potential widening of cervical cancer disparities in these cohorts. As some screening nonattenders are at low risk for HR-HPV, tailored approaches may be appropriate to increase screening among higher-risk women.

Original languageEnglish
Pages (from-to)842-853
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume24
Issue number5
DOIs
Publication statusPublished - 1 May 2015

Bibliographical note

Funding Information:
The study was supported by grants (to A.M. Johnson) from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health. N. Field is supported by a National Institute for Health Research Academic Clinical Lectureship.

Funding Information:
The study was supported by grants (to A.M. Johnson) from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health. N. Field is supported by a National Institute for Health Research Academic Clinical Lectureship. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Publisher Copyright:
© 2015 AACR.

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