HPV Prevalence Among Inuit Women in Northern Quebec, Canada: A Pre- and Post-Vaccination Analysis

To assess changes in high-risk HPV prevalence among Inuit women in Nunavik following the introduction in 2008 among 12-year-old girls of the quadrivalent HPV vaccine program in Quebec.

A total of 169 Inuit women aged 25-65 were recruited in Kuujjuaq, Nunavik, between July 2022 and December 2024. Participants self-collected cervico-vaginal samples under nurse supervision. HPV DNA testing was performed using real-time PCR (Cobas 4800), detecting HPV 16, 18, and 12 other high-risk types. Results were compared with historical data from 473 Inuit women (2002-2007), using the same genotypic categories. Age-stratified prevalence ratios (PR) were calculated to assess differences over time and odds ratios (OR) for HPV 16/18 detection by vaccination status.

Among 148 participants with results, overall high-risk HPV prevalence increased from 15.9% pre-vaccination to 22.3% post-vaccination, driven by a significant rise in other high-risk types among women aged 40+ (from 5.8% to 16.4%; PR=2.80, 95% CI: 1.16-6.75). HPV 16/18 prevalence showed a non-statistically significant decline among the 25-29 age group (6.8%-3.3%). Only one vaccinated participant tested positive for HPV 16/18 (OR=0.29, 95% CI: 0.0062-2.54).

The quadrivalent HPV vaccine has reduced HPV 16/18 prevalence in the targeted younger population. Continued surveillance is warranted, particularly for nonvaccine high-risk types.