Oncogenic Human Papillomavirus Infection and Cervical Lesions in Aboriginal Women of Nunavut, Canada

Article excerpt

Healey, S.M., Aronson, K.J., Mao, Y. et al. (2001). Oncogenic human papillomavirus infection and cervical lesions in aboriginal women of Nunavut, Canada. Sexually Transmitted Diseases, 28, 694-700.

Rates of cervical cancer are higher in the Northwest Territories (of which Nunavut was a part until 1999) than in the other provinces and territories in Canada and these rates are also higher among the aboriginal people in the territories. It is well known that infection with specific oncogenic types of human papillomavirus (HPV), a sexually transmitted infection, is a strong independent risk factor for the development of cervical cancer and its precursors. Prior research has indicated that HPV testing identifies more than 90% of high-grade squamous intraepithelial lesions (SIL) and, therefore, HPV testing may be a useful tool for detecting cervical cancer and its precursors. The accuracy and cost effectiveness of HPV testing may make it a particularly effective part of cancer prevention strategies in remote area's where treatments such as colposcopy may be difficult to obtain. With respect to HPV-based cancer prevention screening, Healy and colleagues note that "Before embarking on a full-scale screening study, it was appropriate to determine the age-specific prevalence of HPV oncogenic risk types in Nunavut" (p. 695).

The authors conducted a cross-sectional study of women in 19 communities in the Baffin and Keewatin regions of Nunavut who had received a routine Pap test between May 1, 1999 and December 31, 1999. The study included a sociodemographic questionnaire, and testing for the presence of SIL through liquid-based Thin-Prep cytology and HPV DNA testing for 13 oncogenic HPV types. …