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Unveiling Optimal Cervical Cancer Screening Age Range: Study of HPV Infection Among 75,719 Women in Indonesia's
Tofan Widya Utami1, Laila Nuranna1, Gatot Purwoto1
1Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
Objectives:
Human papillomavirus (HPV) is the primary cause of cervical cancer, a global health crisis. Indonesia is placed as having the highest cervical cancer incidence and fatality in Southeast Asia. Currently, under the National Cervical Cancer Elimination (NCCE) plan, Indonesia has extended HPV DNA-based screening from 30-50 to 30-69 years old. However, various factors can lead to inadequate virus clearance in younger populations, and Indonesia has not yet had a large-scale analysis of age-specific HPV infection reports, leaving the ideal screening age uncertain. Therefore, this study aims to investigate age-specific HPV prevalence in Indonesia to inform the optimal age range for cervical cancer screening.
Methods:
In this retrospective cross-sectional study, 75,719 subjects' data were utilized from all metropolitan regions in Indonesia from 2012-2020, who were tested with HPV DNA using PCR (SPF10-DEIA-LiPA25) and hybridization. The data were then analyzed by age and HPV genotype using IBM SPSS 27.0.
Results:
12.62% of 75,719 women aged 13-75 are HPV-positive. Women aged 30-39 (39.56%) and 40-49 (21.1%) had the highest infection rates, followed by 25-29 (18.9%) and those below 25 years (8.8%). This contrasts with the infection rates of women aged 60-65 (1.5%) and 66-69 (0.6%). Across all age categories, HPV52, HPV16, and HPV58 were the most prevalent high-risk genotypes, with substantial variations in infection rates (p <0.001). High-risk HPV outnumbered low-risk HPV in all age categories.
Conclusion:
HPV-positive prevalence in the younger population, particularly among those aged 25-29, is frequent in Indonesia. After age 65, HPV-positive cases drop significantly. Several variables contribute to this. This study recommends adjusting cervical cancer screening to Indonesian women aged 25-65.
