Analysis on the Risk Factors of Cervical Human Papilloma Virus Infected of Women in Rural Area of Chaozhou, Guangdong Province

doi:10.3877/cma.j.issn.1673-5250.2013.05.008

Objective

To investigate the prevalence and risk factors of high risk human papilloma virus (HPV) among women in rural area of Chaozhou city, Guangdong province and provide scientific evidence for public health strategy in rural area of China.

Methods

From March to October 2010, a total of 12 542 women aged 35-59 years old in rural area of Chaozhou city, Guangdong Province in China were recruited. They were free detected the 13 kinds of high risk HPV type in cervix by real-time quantitative PCR with fluorescent test, and investigated the risk factors face to face by questionnaire, then analyzed the risk factors by χ² test and multiple factor unconditional logistic regression model. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangdong Women and Children Hospital. Informed consent was obtained from all participants.

Results

Among 12 542 detected women, the prevalence of 13 kinds of high risk HPV was 8.06% (1011/1254). Through multiple factor unconditional logistic regression model analyzed, it showed risk factors on high risk HPV infected including gravidity equal or more than three times [OR=1.24, 95%CI(1.09-1.41), P<0.01], first marriage age less than 24 years old [OR=1.16, 95%CI(1.01-1.32), P=0.03], cervical appearance abnormal [OR=1.21, 95%CI(1.05-1.39), P=0.01], gynecological surgery history [OR=1.68, 95%CI(1.15-2.46), P=0.01], husband drink [OR=1.45, 95%CI(1.27-1.65), P<0.01], received irregularly gynecological diseases examination [OR=1.43, 95%CI(1.08-1.88), P=0.01], less participation of gynecological diseases examination [OR=1.81, 95%CI(1.26-2.60), P<0.01] and husband's occupation was manager or clerk or civil servant [OR=1.71, 95%CI(1.24-2.37), P<0.01].

Conclusions

High risk HPV infections among women aged 35-59 years old in rural area of Chaozhou city were frequently, there was a higher infected rate of high risk HPV in rural women who had gravidity equal or more than three times, cervical appearance abnormal, gynecological surgery history, irregularly or less participation of gynecological diseases examination, husband drink and his occupation was manager, clerk or civil servant.

Key words: human papilloma virus, risk factor, rural area, logistic regression

表1 本组12 542例受检者相关变量的差异性比较[n(%)]

Table 1 Comparison of variable difference among 12 542 women [n(%)]

变量		高危型HPV阳性率	χ²	P
孕次		?	?	?
?	≥3次	520 (8.94)	11.22	0.00
?	<3次	491 (7.30)	?	?
分娩次数		?	?	?
?	≥3次	363 (9.18)	9.77	0.00
?	<3次	648 (7.55)	?	?
人工终止孕次		?	?	?
?	≥1次	196 (9.21)	4.54	0.03
?	0	815 (7.83)	?	?
流产总次数		?	?	?
?	≥1次	277 (9.21)	7.07	0.01
?	0	734 (7.70)	?	?
首次妊娠年龄		?	?	?
?	<25岁	430 (8.69)	4.41	0.04
?	≥25岁	581 (7.65)	?	?
初次结婚年龄		?	?	?
?	<24岁	419 (8.83)	6.12	0.01
?	≥24岁	592 (7.59)	?	?
妇科手术史		?	?	?
?	有	32(12.65)	7.33	0.01
?	无	979 (7.97)	?	?
本人饮酒		?	?	?
?	是	24(12.50)	5.18	0.02
?	否	987 (7.99)	?	?
丈夫饮酒		?	?	?
?	是	506 (9.59)	28.75	<0.001
?	否	505 (6.95)	?	?
接受妇科检查情况		?	?	?
?	定期接受	67 (6.57)	14.97	0.00
?	不定期接受	399 (8.66)	?	?
?	有病时就诊	481 (7.58)	?	?
?	很少接受	64(11.23)	?	?
丈夫职业		?	?	?
?	以外出打工为主	263 (7.94)	18.04	0.00
?	以干农活为主	314 (7.98)	?	?
?	农活、外出打工兼顾	97 (6.25)	?	?
?	管理、文员、公务员	50(11.66)	?	?
?	个体、服务业	164 (8.13)	?	?
?	其他	123 (9.50)	?	?

表1 本组12 542例受检者相关变量的差异性比较[n(%)]

Table 1 Comparison of variable difference among 12 542 women [n(%)]

变量		高危型HPV阳性率	χ²	P
孕次		?	?	?
?	≥3次	520 (8.94)	11.22	0.00
?	<3次	491 (7.30)	?	?
分娩次数		?	?	?
?	≥3次	363 (9.18)	9.77	0.00
?	<3次	648 (7.55)	?	?
人工终止孕次		?	?	?
?	≥1次	196 (9.21)	4.54	0.03
?	0	815 (7.83)	?	?
流产总次数		?	?	?
?	≥1次	277 (9.21)	7.07	0.01
?	0	734 (7.70)	?	?
首次妊娠年龄		?	?	?
?	<25岁	430 (8.69)	4.41	0.04
?	≥25岁	581 (7.65)	?	?
初次结婚年龄		?	?	?
?	<24岁	419 (8.83)	6.12	0.01
?	≥24岁	592 (7.59)	?	?
妇科手术史		?	?	?
?	有	32(12.65)	7.33	0.01
?	无	979 (7.97)	?	?
本人饮酒		?	?	?
?	是	24(12.50)	5.18	0.02
?	否	987 (7.99)	?	?
丈夫饮酒		?	?	?
?	是	506 (9.59)	28.75	<0.001
?	否	505 (6.95)	?	?
接受妇科检查情况		?	?	?
?	定期接受	67 (6.57)	14.97	0.00
?	不定期接受	399 (8.66)	?	?
?	有病时就诊	481 (7.58)	?	?
?	很少接受	64(11.23)	?	?
丈夫职业		?	?	?
?	以外出打工为主	263 (7.94)	18.04	0.00
?	以干农活为主	314 (7.98)	?	?
?	农活、外出打工兼顾	97 (6.25)	?	?
?	管理、文员、公务员	50(11.66)	?	?
?	个体、服务业	164 (8.13)	?	?
?	其他	123 (9.50)	?	?

表2 非条件多因素logistic回归分析变量赋值

Table 2 Variable assignment for unconditional binary logistic regression analysis

变量	赋值
初次结婚年龄(岁)	0：≥24，1：<24
首次妊娠年龄(岁)	0：≥25，1：<25
分娩次数(次)	0：<3，1：≥3
自然流产次数(次)	0：0，1：≥1
人工终止妊娠术次数(次)	0：0，1：≥1
终止妊娠术总次数(次)	0：0，1：≥1
宫颈治疗次数	0：0，1：≥1
宫颈异常	0：0，1：≥1
女性饮酒	0：0，1：≥1
丈夫饮酒	0：0，1：≥1

表2 非条件多因素logistic回归分析变量赋值

Table 2 Variable assignment for unconditional binary logistic regression analysis

变量	赋值
初次结婚年龄(岁)	0：≥24，1：<24
首次妊娠年龄(岁)	0：≥25，1：<25
分娩次数(次)	0：<3，1：≥3
自然流产次数(次)	0：0，1：≥1
人工终止妊娠术次数(次)	0：0，1：≥1
终止妊娠术总次数(次)	0：0，1：≥1
宫颈治疗次数	0：0，1：≥1
宫颈异常	0：0，1：≥1
女性饮酒	0：0，1：≥1
丈夫饮酒	0：0，1：≥1

表3 相关高危型HPV感染危险因素的非条件logistic回归分析结果

Table 3 Results of unconditional binary logistic regression analysis on risk factors of high risk HPV infected

变量		coefficient B	sS.E.	Wald	df	Sig.(P value)	OR	95% CI
孕次		0.21	0.07	10.40	1.00	0.00	1.24	1.09～1.41
初次结婚年龄		0.14	0.07	4.58	1.00	0.03	1.16	1.01～1.32
宫颈外观异常		0.19	0.07	6.92	1.00	0.01	1.21	1.05～1.39
妇科手术史		0.52	0.19	7.26	1.00	0.01	1.68	1.15～2.46
丈夫饮酒		0.37	0.07	30.71	1.00	0.00	1.45	1.27～1.65
妇科体检		?	?	17.35	3.00	0.00	?	?
?	定期	1.00	0.00	1.00	1.00	1.00	1.00	?
?	不定期	0.36	0.14	6.40	1.00	0.01	1.43	1.08～1.88
?	有病时就诊	0.16	0.14	1.40	1.00	0.24	1.18	0.90～1.54
?	很少接受	0.59	0.19	10.19	1.00	0.00	1.81	1.26～2.60
丈夫职业		?	?	24.11	5.00	0.00	?	?
?	以外出打工为主	1.00	0.00	1.00	1.00	1.00	1.00	?
?	以干农活为主	0.00	0.09	0.00	1.00	0.96	1.00	0.85～1.19
?	农活、外出打工兼顾	－0.21	0.12	2.91	1.00	0.09	0.81	0.64～1.03
?	管理、文员、公务员	0.54	0.17	10.57	1.00	0.00	1.71	1.24～2.37
?	个体、服务业	0.08	0.11	0.53	1.00	0.47	1.08	0.88～1.33
?	其他	0.30	0.12	6.72	1.00	0.01	1.35	1.08～1.70

表3 相关高危型HPV感染危险因素的非条件logistic回归分析结果

Table 3 Results of unconditional binary logistic regression analysis on risk factors of high risk HPV infected

变量		coefficient B	sS.E.	Wald	df	Sig.(P value)	OR	95% CI
孕次		0.21	0.07	10.40	1.00	0.00	1.24	1.09～1.41
初次结婚年龄		0.14	0.07	4.58	1.00	0.03	1.16	1.01～1.32
宫颈外观异常		0.19	0.07	6.92	1.00	0.01	1.21	1.05～1.39
妇科手术史		0.52	0.19	7.26	1.00	0.01	1.68	1.15～2.46
丈夫饮酒		0.37	0.07	30.71	1.00	0.00	1.45	1.27～1.65
妇科体检		?	?	17.35	3.00	0.00	?	?
?	定期	1.00	0.00	1.00	1.00	1.00	1.00	?
?	不定期	0.36	0.14	6.40	1.00	0.01	1.43	1.08～1.88
?	有病时就诊	0.16	0.14	1.40	1.00	0.24	1.18	0.90～1.54
?	很少接受	0.59	0.19	10.19	1.00	0.00	1.81	1.26～2.60
丈夫职业		?	?	24.11	5.00	0.00	?	?
?	以外出打工为主	1.00	0.00	1.00	1.00	1.00	1.00	?
?	以干农活为主	0.00	0.09	0.00	1.00	0.96	1.00	0.85～1.19
?	农活、外出打工兼顾	－0.21	0.12	2.91	1.00	0.09	0.81	0.64～1.03
?	管理、文员、公务员	0.54	0.17	10.57	1.00	0.00	1.71	1.24～2.37
?	个体、服务业	0.08	0.11	0.53	1.00	0.47	1.08	0.88～1.33
?	其他	0.30	0.12	6.72	1.00	0.01	1.35	1.08～1.70

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