1. ¹Department of Public Health, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland
2. ²National Cancer Registry Ireland, Elm Court, Boreenmanna Road, Cork, Ireland
3. ³Histopathology Department, Queen's Medical Centre, University Hospital NHS Trust, Nottingham, England
4. ⁴Canada Research Chair in Human Genome Epidemiology, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
5. ⁵Department of Obstetrics & Gynaecology, University of Aberdeen, Foresterhill, Aberdeen, Scotland
6. ⁶Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham Medical School, Nottingham, England

Correspondence: SC Cotton, E-mail: s.c.cotton@abdn.ac.uk

⁷Principal authors who contributed equally to this work.

Received 23 February 2007; Revised 25 April 2007; Accepted 2 May 2007; Published online 22 May 2007.

Abstract

The world age-standardised prevalence of high-risk HPV (hrHPV) infection among 5038 UK women aged 20–59 years, with a low-grade smear during 1999–2002, assessed for eligibility for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) was 34.2%. High-risk HPV prevalence decreased with increasing age, from 61% at ages 20–24 years to 14–15% in those over 50 years. The age-standardised prevalence was 15.1, 30.7 and 52.7%, respectively, in women with a current normal, borderline nuclear abnormalities (BNA) and mild smear. In overall multivariate analyses, tertiary education, previous pregnancy and childbirth were associated with reduced hrHPV infection risk. Risk of infection was increased in non-white women, women not married/cohabiting, hormonal contraceptives users and current smokers. In stratified analyses, current smear status and age remained associated with hrHPV infection. Data of this type are relevant to the debate on human papillomavirus (HPV) testing in screening and development of HPV vaccination programmes.