Human papillomavirus infection and the association with abnormal Pap findings in Yukon, Canada.

OBJECTIVE: Certain types of the human papillomavirus (HPV) are highly associated with cervical cancer or dysplasia, but its prevalence is largely unknown in northern Canada where there is significant aboriginal representation and unique barriers to accessing care. This study determined the prevalence of HPV infection and its association with cervical cancer precursor lesions in Yukon, Canada. MATERIALS AND METHODS: This was a cross-sectional study of 1,542 women attending routine Pap smear screening in 14 communities in Yukon, from February 2009 to June 2010. Type-specific HPV infection was detected by an in-house Luminex assay. Cervical Pap cytology was evaluated by pathologists blinded to HPV test results. RESULTS: The overall HPV prevalence rate in Yukon women was higher than those reported in some Canadian provinces and other countries. Human papillomavirus infection prevalence rates were 24.5% for any type, 18.4% for high-risk types, 6.2% for HPV types 16 or 18, 6.7% for HPV α-7 species, and 10.6% for HPV α-9 species. Human papillomavirus infection was strongly associated with single marital status or having 2 or more sexual partners in the past year. Human papillomavirus infection (overall, high-risk types, HPV-16/18, α-7, or α-9 species) was strongly associated with Pap cytological abnormalities (adjusted odds ratios ranged from 8.4 to 44.2). CONCLUSIONS: As in other areas of northern Canada, HPV prevalence for high-risk types and α-7 species is high among women in the Yukon. Sexual behavioral factors strongly influence HPV prevalence rates. The findings may have implications for HPV vaccination and health promotion programs in northern regions.