Human Papillomavirus prevalence in Senegalese women in relation with age

Background: Senegal has high cervical cancer incidence rates of 34.7 per 100,000 women-years, disproportionately affecting women at different ages. Data on age-specific HPV prevalence, which potentially could have implications on cervical cancer screening and prevention, for Senegal are scant. Therefore, this study primarily sought to determine the age-specific HPV prevalence, overall and by HPV type, as well as the risk factors for HPV positivity in older women, among women in Senegal. Methods: This cross-sectional study included women aged 15-84 years undergoing screening in outpatient clinics in Dakar, Senegal, between 2002-2010. The sociodemographic and reproductive data, sexual behavior, and HPV genotype results were analyzed using R software. The Chi-square test was used to compare HPV prevalence across age groups and demographic and reproductive characteristics. Logistic regression was used to calculate odds ratios (OR) and to determine predictors for HPV. Results: A total of 2,031 women (mean age 43.7 years) were included. Overall HPV prevalence was 28.9% among the study population. HPV prevalence showed a bimodal age distribution among women differing by 5 years, with the first peak at the 25-29 ages (34.0%) and the second peak among >55 years old women (47.6%). The bivariate association of HPV with a priory selected risk factors showed a significant association with the age groups, relationship status, lifetime number of sex partners and contraception use. The most common high risk HPV types (hrHPV) were nonavalent vaccine-types HPV 16 (2.6%), HPV 58 (3.3%), HPV 52 (2.6%), HPV 33 (2.2%) and HPV 31 (2.0%). Women aged 55-84 had a higher prevalence of any HPV (37.0%) and multiple HPV infections (13.5%) and a lower prevalence of hrHPV infections (9.0%) than younger women. Conclusions: Recognizing the increased HPV prevalence among older, for whom periodic cervical screening may not be feasible, is essential in terms of its influence on the cervical screening programs. Revising the age of women for the cervical screening programs and screening intervals may help prevent women at older ages with persistent hrHPV infections from developing cervical cancer.