Background:
A 1998 IARC survey reported that Northern Vietnam has the lowest reported HPV prevalence in the world, and attributed it to its socio-economic isolation after the war. Vietnam is now the second fastest growing economy in the world, averaging over 7% annual growth in the past 5 years.

Objective:
Our first aim is to determine the current prevalence of high-risk HPV (HHPV) infection detected through self and physician-collected cytobrush samples, and to describe associated characteristics. The second aim is to determine the correlation between the two sampling methods.

Method:
We enrolled 1238 married women from the same communes that participated in the 1998 survey. Each participant underwent a blood draw, Pap smear, a self and a physician-collected cytyobrush sample, and a questionnaire. All sets of cytyobrush samples were analyzed for HHPVby Digene HCII assay; 222 subsets of HCII-positive (by either sample) and HCII-double negative cytobrushes where then tested for HPV DNA by PCR.

Result:
Detection of high risk HPV DNA was 4.1% by physician samples and 3.9% by self samples. HHPV rates peaked among the youngest age group 18-20 years. A new type, HPV 52 was detected in this population. Correlates associated with HHPV infection were smoking, SES index, and HSV-2 infection for both samples. A high kappa of 0.82 was observed between sampling methods.

Conclusion:
A three-fold higher prevalence and a new type of high risk HPV was detected in a previously low risk population. Our profile of high-risk HPV-infected women in Hanoi today has begun to shift to the profile observed among urban, high-risk Southern women in 1998.

Implications:
With 60% of the population < 25 years, increases in HPV will multiply future cervical cancer burden and underline the urgency for a national screening program. Self testing using a cytobrush detected the most common High-risk HPV types as well as physician testing.