Population-based type-specific prevalence of high-risk human papillomavirus infection in middle-aged Swedish Women

Human papillomavirus (HPV) DNA testing can be used to identify women at risk of the development of cervical cancer. The cost‐effectiveness of HPV screening is dependent on the type‐specific HPV prevalence in the general population. The present study describes the prevalence and spectrum of high‐risk HPV types found in a large real‐life population‐based HPV screening trial undertaken entirely within the cervical screening program offered to middle‐aged Swedish women. Cervical brush samples from 6,123 women aged 32–38 years were analyzed using a general HPV primer (GP5+/6+) polymerase chain reaction‐enzyme immunoassay (PCR‐EIA) combined with reverse dot‐blot hybridization for confirmation and HPV typing by a single assay. In this study, 6.8% (95% CI 6.2–7.5) (417/6,123) were confirmed as high‐risk HPV positive. Infections with 13 different high‐risk HPV types were detected, of which HPV 16 was the most prevalent type (2.1%; 128/6,123), followed by HPV 31 (1.1%; 67/6,123). Any one of the HPV types 18, 33, 35, 39, 45, 51, 52, 56, 58, 59, or 66 was detected in 3.6% (223/6,123) of the women. Infection with two, three, and five types simultaneously was identified in 32, 5, and 1 women, respectively. The combination of PCR‐EIA as a screening test and reverse dot‐blot hybridization as a confirmatory test, was found to be readily applicable to a real‐life population‐based cervical screening. The type‐specific HPV prevalence found support in previous modeling studies suggesting that HPV screening may be a favorable cervical screening strategy. J. Med. Virol. 66:535–541, 2002. © 2002 Wiley‐Liss, Inc.