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Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain: the CLEOPATRE study

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Background: Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of
precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate sociodemographic,
lifestyle, and medical factors for potential associations with cervical HPV infection in women
undergoing cervical cancer screening in Spain.
Methods: The CLEOPATRE Spain study enrolled 3 261 women aged 18–65 years attending cervical cancer
screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological
examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV
genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was
used to identify putative risk factors for HPV infection.
Results: A lifetime number of two or more sexual partners, young age (18–25 years), a history of genital warts, and
unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban
community, country of birth other than Spain, low level of education, and current smoking status were also
independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was
observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of
infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were
current smokers (P for interaction, 0.01).
Conclusion: This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain.
The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In
addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking
with an increased risk of HPV infection.

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BMC Infectious Diseases, 2012, vol. 12,  p. 145

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Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)

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Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain: the CLEOPATRE study