Risk factors for Human Papillomavirus Exposure and Co-factors for Cervical Cancer in Latin America and the Caribbean
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García, Patricia J.
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The incidence of cervical cancer in Latin America and the Caribbean (LAC) is among the highest in the world. Because there are major demographic shifts happening in LAC countries (population growth, urbanization and ageing) cervical cancer incidence and mortality will likely continue to be a significant public health problem. Overall human papillomavirus (HPV) prevalence in the LAC general population has been found to be 2-fold higher than the average worldwide prevalence. The large HPV and cancer burden may be explained by the highly prevalent HPV variants of HPV types -16 and 18, which have an increased oncogenic potential. Given the major mode of transmission of genital HPV is sexual, certain, patterns of sexual behaviour (early age at first sexual intercourse, number of sexual partners and sexual behaviour of the partner) are associated with an increased risk of HPV genital acquisition. Although HPV infection is necessary for carcinogenesis, certain co-factors (high parity, long term use of oral contraceptives, smoking and co-infection with the human immunodeficiency virus (HIV)) help in the progression from infection to cancer. Many studies that have contributed to this evidence have been carried out in LAC and are reviewed and summarised in this article. Since HPV vaccines will likely take years to implement, and many more years to show impact on disease, cervical cancer screening programmes remain as the key intervention to control disease in LAC in the years to come. © 2008 Elsevier Ltd. All rights reserved.
Antiretrovirus agent , Oral contraceptive agent , Virus dna , Wart virus vaccine , Acquired immune deficiency syndrome , Article , Cancer incidence , Cancer mortality , Cancer prevention , Cancer risk , Cancer screening , Caribbean islands , Chlamydia trachomatis , Cigarette smoking , Comorbidity , Disease association , Disease course , Herpes simplex virus 2 , Human , Human immunodeficiency virus infection , Human papillomavirus type 16 , Human papillomavirus type 18 , Nonhuman , Oral contraception , Parity , Polymerase chain reaction , Priority journal , Risk assessment , Risk factor , Sexual behavior , Sexual transmission , South and central america , Uterine cervix cancer , Virus infection , Virus transmission , Wart virus , Caribbean , Cervical cancer , Hpv , Hpv variants , Latin america , Male sexual behaviour , Risk factors , Sexual behaviour