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TP 77 Human Papillomavirus Infection and Cervical Cancer Prevention in Britain: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Tuesday, June 10, 2014
International Ballroom
Clare Tanton, PhD1, Kate Soldan, PhD2, Simon Beddows, PhD2, Jo Waller, PhD3, Soazig Clifton, BSc1, Nigel Field, MB PhD1, Cath Mercer, BSc, MSc, PhD4, Catherine Ison, Prof, PhD5, Anne Johnson, MBBS, MD1 and Pam Sonnenberg, MB BCh, MSc, PhD4, 1Research Department of Infection and Population Health, University College London, London, United Kingdom, 2National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom, 3University College London, London, United Kingdom, 4Department of Infection and Population Health, University College London, London, United Kingdom, 5Sexually Transmitted Bacteria Reference Unit, Microbiology Services Division, Public Health England, London, United Kingdom

Background:  Prevention of cervical cancer in Britain has included cervical screening since 1988. In 2008, a vaccination programme for human papillomavirus (HPV), school-based in 12-13 year olds with a catch-up programme in 14-17 year olds, was introduced. Population-based data linking sexual and demographic risk factors with biological high-risk (HR-)HPV prevalence, cervical screening attendance and HPV vaccination uptake are needed to inform cervical cancer prevention strategies.

Methods:  The third British National Survey of Sexual Attitudes & Lifestyles (Natsal-3), a probability sample survey of men and women aged 16-74, resident in Britain was undertaken in 2010-12 and interviewed 8869 women. Urine samples collected from 2569 women aged 16-44 years who reported at least one lifetime sexual partner were tested for HPV. In multi-variable analyses we explored risk factors for HR-HPV, non-attendance for cervical screening and non-completion of the 3-dose HPV vaccination course.

Results:  HR-HPV was detected in 15.9% of women and was associated with risky sexual behaviour, younger age, relationship status, lower social class and smoking. Not having attended for cervical screening in the last 5 years was reported by 8.1% of women aged 26-49 and this was similar in those with and without HR-HPV detected. Not attending for cervical screening in the past 5 years was associated with fewer partners, young age, housing status, Asian ethnicity and smoking. 61.5% of women eligible for the HPV catch-up programme completed the vaccination course. Non-completion was associated with increasing age at eligibility, lower education, non-white ethnicity, smoking, ever being pregnant and having 2 or more partners without a condom in the past year.

Conclusions:  Socio-economic markers and smoking were associated with HR-HPV positivity, non-completion of vaccination and non-attendance at screening. Special efforts are needed to ensure those who missed vaccination are captured by the cervical screening programme to avoid widening of cervical cancer disparities in these catch-up cohorts.

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