Prevalence and age distribution of human papillomavirus infection in a population of Inuit women in Nunavik, Quebec.

OBJECTIVES Our aim was to study the prevalence and age distribution of human papillomavirus (HPV) infection among Inuit women in Nunavik, northern Quebec, a population at high risk of cervical cancer. METHODS We recruited a cohort of Inuit women seeking routine care and living primarily in four communities of the Nunavik region. Pap smears were done and cervical specimens were tested for HPV-DNA using the PGMY-Line blot assay. RESULTS From January 2002 until December 2007, 629 women were recruited into the study and had their cervical specimens tested. Of 554 women with complete results, the overall and high-risk HPV prevalence were 28.9% and 20.4%, respectively. Multiple-type infections were observed in 40% of HPV-positive subjects. The most common HPV type was HPV-16 (n = 31), and other common high-risk types included HPV-31, HPV-58, and HPV-52. The most prevalent papillomavirus species were alpha-9 (60% of infections), alpha-3 (44%), and alpha-7 (31%). Age-specific prevalence of low-risk HPV, high-risk HPV, and overall HPV showed a U-shaped curve. Of women with baseline cytology, 6.5% had an abnormal result, either atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesion (LSIL), or high-grade intraepithelial lesion (HSIL). HPV-16, HPV-31, and HPV-58 were some of the most common high-risk types detected in both LSIL and HSIL specimens. CONCLUSIONS Overall and high-risk HPV prevalence was elevated in this population of Quebec Inuit women when compared with other populations that have been studied in Canada. Different HPV types seem to be important as contributors to the overall burden of infection and to the presence of cervical abnormalities, which may have implications for developing cervical screening and vaccination programs.