ArticlePloS one2019
Factors associated with high-risk human papillomavirus infection and high-grade cervical neoplasia: A population-based study in Paraguay.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Exploring the role of cervicovaginal microbiota as risk factor for cervical cancer in Sub-Saharan Africa: a systematic review and meta-analysis : By.BMC women's health · 2025Pooled it
- Prediction Score of Cervical Intraepithelial Neoplasia Grade II or Higher (CIN2+) in Patients with Low-Grade Cytology (ASC-US, LSIL) and HPV- Negative or Non-type 16/18 High-Risk HPV-Positive Results.Asian Pacific journal of cancer prevention : APJCP · 2026Article
- Prevalence and genotype distribution of high-risk human papillomavirus infections among women in selected communities in the Philippines: Results of the defeat HPV study.Journal of virus eradication · 2026Article
- Exploring Human Papillomavirus 16 Long Control Region Variants in Paraguayan Women: Comparing Variant Diversity to Transcriptional Activity and Cervical Lesion Severity.International journal of microbiology · 2026Article
- Integrating active surveillance and HPV vaccination for high-risk CIN2: a strategy to reduce disease progression.Frontiers in medicine · 2026Article
- Prevalence and Risk Factors of Cervical Lesion Among Married Women With Low Socioeconomic Status: A Study Based on a Cervical Cancer Screening Program.International journal of public health · 2025Article
- Genital infections in high-risk human papillomavirus positive Paraguayan women aged 30-64 with and without cervical lesions.PloS one · 2024Article
- Human Papillomavirus Prevalence and Associated Factors in Indigenous Women in Ecuador: A Cross-Sectional Analytical Study.Infectious disease reports · 2023Article
- Systematic literature review of primary and secondary cervical cancer prevention programs in South America.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Changes in High-Risk HPV Infection Prevalence and Associated Factors in Selected Rural Areas of China: A Multicenter Population-Based Study.Frontiers in medicine · 2022Article
- Clinical implementation of a cervical cancer screening program via co-testing at a university hospital.PloS one · 2022Article
- Behavioral factors associated with multiple-type HPV genital infections: data from a cross-sectional study in young women in Brazil.Reproductive health · 2021Article
- Severe cervical inflammation and high-grade squamous intraepithelial lesions: a cross-sectional study.Archives of gynecology and obstetrics · 2021Article
- The contribution of Latin American research to HPV epidemiology and natural history knowledge.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2020Review
- Histone Deacetylase Inhibitors as Therapeutic Interventions on Cervical Cancer Induced by Human Papillomavirus.Frontiers in cell and developmental biology · 2020Review
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22 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundCervical cancer (CC) is one of the leading causes of cancer mortality among women from Paraguay, with high incidence and mortality rates (31.2 and 16 per 100 000 women, respectively). Although the risk factors associated with high-risk human papillomavirus (hrHPV) infection and preneoplastic cervical lesions are widely studied, population-based characteristics of particular settings may influence the feasibility of HPV-based CC screening implementation. This study aimed to explore factors associated with hrHPV infection and high-grade cervical neoplasia in hrHPV-positive (hrHPV+) women from Paraguay.
methodsA total of 5677 women aged 30-64 years from the Central Department of Paraguay were screened with HPV test (Hybrid Capture 2) and Pap smear. Sociodemographic and risk factor interviews were conducted. hrHPV+ women were referred to colposcopy and women with an abnormal colposcopy had a biopsy taken. The outcomes recorded were the hrHPV status and the presence of high-grade cervical intraepithelial neoplasia or worse (CIN2+) among hrHPV+ women. Associations were investigated using multivariate logistic regressions.
resultshrHPV prevalence was 13.8% (95%CI 13.0-14.8). This value decreased with the age of women (p-trend<0.001) and increased with the lifetime number of sexual partners (p-trend<0.001) and number of previous female partners of their current male partner if women had had one lifetime sexual partner (p-trend<0.001), increasing from 3.06 (95%CI 0.073-20.9) if partners had had one previous female partner to 9.19 (95%CI 2.36-61.1) if they had had eight or more. In hrHPV+ women, CIN2+ prevalence was 10.7% (95%CI 8.58-13.2) and increased with time since the last Pap smear (p-trend<0.001) and with the increasing number of pregnancies (p-trend = 0.05).
conclusionIn these settings, the sexual behavior of women and their male partners is associated with hrHPV infection. In hrHPV+ women, underscreening practices and multiple pregnancies are associated with CIN2+. This knowledge can contribute to public health policies for CC prevention and control in Paraguay.
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