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Human Papillomavirus Infection and the Association With Abnormal Pap Findings in Yukon, Canada

Jiang, Ying MD1; Hanley, Brendan2; Brassard, Paul3; Severini, Alberto4; Lo, Jane5; O’Donovan, Shawn2; Duncan, Lori6; Luo, Zhong-Cheng7; Tohme, Sarah4; Mao, Yang1; Morrison, Howard PhD1

Journal of Lower Genital Tract Disease: July 2013 - Volume 17 - Issue 3 - p 346–353
doi: 10.1097/LGT.0b013e31826e2b73
Basic Science

Objective Certain types of the human papillomavirus (HPV) are highly associated with cervical cancer or dysplasia, but its prevalence is largely unknown in northern Canada where there is significant aboriginal representation and unique barriers to accessing care. This study determined the prevalence of HPV infection and its association with cervical cancer precursor lesions in Yukon, Canada.

Materials and Methods This was a cross-sectional study of 1,542 women attending routine Pap smear screening in 14 communities in Yukon, from February 2009 to June 2010. Type-specific HPV infection was detected by an in-house Luminex assay. Cervical Pap cytology was evaluated by pathologists blinded to HPV test results.

Results The overall HPV prevalence rate in Yukon women was higher than those reported in some Canadian provinces and other countries. Human papillomavirus infection prevalence rates were 24.5% for any type, 18.4% for high-risk types, 6.2% for HPV types 16 or 18, 6.7% for HPV α-7 species, and 10.6% for HPV α-9 species. Human papillomavirus infection was strongly associated with single marital status or having 2 or more sexual partners in the past year. Human papillomavirus infection (overall, high-risk types, HPV-16/18, α-7, or α-9 species) was strongly associated with Pap cytological abnormalities (adjusted odds ratios ranged from 8.4 to 44.2).

Conclusions As in other areas of northern Canada, HPV prevalence for high-risk types and α-7 species is high among women in the Yukon. Sexual behavioral factors strongly influence HPV prevalence rates. The findings may have implications for HPV vaccination and health promotion programs in northern regions.

Human papillomavirus prevalence rates for high-risk types and α-7 species are high among women in the Yukon territories, and it is strongly influenced by sexual behavioral factors.

1Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario; 2Department of Health and Social Services, Whitehorse, Yukon; 3Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec; 4National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba; 5Provincial Health Services Authority Laboratories, British Columbia Cancer Agency, Vancouver, British Columbia; 6Council of Yukon First Nations, Whitehorse, Yukon; and 7Department of Obstetrics and Gynecology, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada

Reprint requests to: Howard Morrison, PhD, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, 785 Carling Ave, Ottawa, Ontario, Canada K1A 0K9. E-mail:

This study was supported by the Government of Canada International Polar Year Program and Public Health Agency of Canada.

The authors have declared they have no conflicts of interest.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology