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Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium

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Abstract
Background: Although female sex workers (FSWs) are a well-known high-risk group for Human Papillomavirus (HPV) infections, few tailored intervention programmes for HPV have been established worldwide. The lack of reliable data on the prevalence of HPV and related cervical lesions hampers the establishment of evidence-based intervention programmes. The objectives of this study were to describe the prevalence of high-risk Human Papillomavirus (hrHPV) infections and abnormal pap smears in FSWs compared to a control group in Antwerp, Belgium. Methods: HPV genotyping and cytology data were analysed from routine Pap smear tests that were collected from both FSWs and the general population (1334 samples for each group) between June 2006 and June 2010. Within the laboratory database, all FSWs were matched 1: 1 for age and testing date to determine the ORs of hrHPV genotypes, DNA and cytology outcome. Results: The prevalence of hrHPV DNA in FSWs was 41.7 % compared to 19.8 % in the age-matched controls with an overall OR of 2.8 (95 % CI: 2.3-3.4). Significant differences were observed in all age groups, and the most significant differences were observed in the cohort under 21 years of age (prevalence of 64.4 % in FSWs versus 14. 8 % in controls; OR 10.3 (95 % CI: 5.0-21.2). Significantly more cervical lesions were observed in FSWs, particularly in the 17- to 21-year old age group (OR for LSIL or HSIL: 10.3 (95 % CI: 3.2-33.8). In both groups, HPV 16 was the most prevalent at 12.1 and 6.6 % in the FSW and control groups, respectively. HPV 18 was the 8th and 7th most frequent genotype at 5.0 and 2.5 % in the FSW and control groups, respectively. Conclusions: FSWs have a significantly higher prevalence of hrHPV and more abnormal Pap smears than does the general population in Antwerp, Belgium. The hrHPV prevalence in FSWs is similar to that reported in the literature. The need for tailored intervention programmes should be investigated further.
Keywords
CERVICAL-CANCER, INFECTION, WORLDWIDE, WOMEN, AGE, METAANALYSIS, HISTORY, PCR, Human papilloma virus, Female sex workers, Epidemiology, Cervical, cancer, Prevention

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MLA
Vorsters, Alex et al. “Prevalence of High-risk Human Papillomavirus and Abnormal Pap Smears in Female Sex Workers Compared to the General Population in Antwerp, Belgium.” BMC PUBLIC HEALTH 16 (2016): n. pag. Print.
APA
Vorsters, A., Cornelissen, T., Leuridan, E., Bogers, J., Vanden Broeck, D., Benoy, I., Goossens, H., et al. (2016). Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium. BMC PUBLIC HEALTH, 16.
Chicago author-date
Vorsters, Alex, Tine Cornelissen, Elke Leuridan, Johannes Bogers, Davy Vanden Broeck, Ina Benoy, Herman Goossens, Niel Hens, and Pierre Van Damme. 2016. “Prevalence of High-risk Human Papillomavirus and Abnormal Pap Smears in Female Sex Workers Compared to the General Population in Antwerp, Belgium.” Bmc Public Health 16.
Chicago author-date (all authors)
Vorsters, Alex, Tine Cornelissen, Elke Leuridan, Johannes Bogers, Davy Vanden Broeck, Ina Benoy, Herman Goossens, Niel Hens, and Pierre Van Damme. 2016. “Prevalence of High-risk Human Papillomavirus and Abnormal Pap Smears in Female Sex Workers Compared to the General Population in Antwerp, Belgium.” Bmc Public Health 16.
Vancouver
1.
Vorsters A, Cornelissen T, Leuridan E, Bogers J, Vanden Broeck D, Benoy I, et al. Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium. BMC PUBLIC HEALTH. 2016;16.
IEEE
[1]
A. Vorsters et al., “Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium,” BMC PUBLIC HEALTH, vol. 16, 2016.
@article{8500639,
  abstract     = {Background: Although female sex workers (FSWs) are a well-known high-risk group for Human Papillomavirus (HPV) infections, few tailored intervention programmes for HPV have been established worldwide. The lack of reliable data on the prevalence of HPV and related cervical lesions hampers the establishment of evidence-based intervention programmes. 
The objectives of this study were to describe the prevalence of high-risk Human Papillomavirus (hrHPV) infections and abnormal pap smears in FSWs compared to a control group in Antwerp, Belgium. 
Methods: HPV genotyping and cytology data were analysed from routine Pap smear tests that were collected from both FSWs and the general population (1334 samples for each group) between June 2006 and June 2010. Within the laboratory database, all FSWs were matched 1: 1 for age and testing date to determine the ORs of hrHPV genotypes, DNA and cytology outcome. 
Results: The prevalence of hrHPV DNA in FSWs was 41.7 % compared to 19.8 % in the age-matched controls with an overall OR of 2.8 (95 % CI: 2.3-3.4). Significant differences were observed in all age groups, and the most significant differences were observed in the cohort under 21 years of age (prevalence of 64.4 % in FSWs versus 14. 8 % in controls; OR 10.3 (95 % CI: 5.0-21.2). Significantly more cervical lesions were observed in FSWs, particularly in the 17- to 21-year old age group (OR for LSIL or HSIL: 10.3 (95 % CI: 3.2-33.8). In both groups, HPV 16 was the most prevalent at 12.1 and 6.6 % in the FSW and control groups, respectively. HPV 18 was the 8th and 7th most frequent genotype at 5.0 and 2.5 % in the FSW and control groups, respectively. 
Conclusions: FSWs have a significantly higher prevalence of hrHPV and more abnormal Pap smears than does the general population in Antwerp, Belgium. The hrHPV prevalence in FSWs is similar to that reported in the literature. The need for tailored intervention programmes should be investigated further.},
  articleno    = {477},
  author       = {Vorsters, Alex and Cornelissen, Tine and Leuridan, Elke and Bogers, Johannes and Vanden Broeck, Davy and Benoy, Ina and Goossens, Herman and Hens, Niel and Van Damme, Pierre},
  issn         = {1471-2458},
  journal      = {BMC PUBLIC HEALTH},
  keywords     = {CERVICAL-CANCER,INFECTION,WORLDWIDE,WOMEN,AGE,METAANALYSIS,HISTORY,PCR,Human papilloma virus,Female sex workers,Epidemiology,Cervical,cancer,Prevention},
  language     = {eng},
  pages        = {8},
  title        = {Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium},
  url          = {http://dx.doi.org/10.1186/s12889-016-3099-5},
  volume       = {16},
  year         = {2016},
}

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