ABSTRACT
BACKGROUND: The high rate of cervical cancer among aboriginal women of northern Canada has prompted the search for more aggressive methods to augment Papanicolaou (Pap) screening in this population. Nearly all cervical cancers result from oncogenic human papillomavirus (HPV) infections. This has generated interest for incorporating HPV testing into the current screening program. GOALS: To determine the prevalence of oncogenic HPVs in Nunavut, and to assess the association between HPV and squamous intraepithelial lesions (SIL). STUDY DESIGN: A cross-sectional study was conducted on the Pap-screened populations in 19 communities of Nunavut, Canada. Liquid-based cytology was used to screen for SIL. HPV testing was performed using the Hybrid Capture II assay. Correlates of HPV infection and SIL were assessed by logistic regression with control for potential confounders. RESULTS: In 1290 women ages 13 to 79 years, the prevalence rate was 26% for oncogenic HPV and 6.9% for SIL. The odds ratio for the association between HPV and SIL was 37.9 (95% CI, 17.7-80.8) after multivariate adjustment. This association increased markedly with increasing viral load. More than 90% of the women with squamous intraepithelial lesions had positive test results for HPV. More than 75% of the women who had positive test results for HPV but negative test results for SIL were younger than 30 years. CONCLUSION: The results of this study form the basis for further evaluation of the role that liquid-based cytology and HPV testing plays and will contribute to the strategy for cervical cancer prevention in Nunavut.
Subject(s)
Carcinoma, Squamous Cell/epidemiology , DNA, Viral/isolation & purification , Papillomaviridae/genetics , Papillomavirus Infections/epidemiology , Tumor Virus Infections/epidemiology , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Neoplasms/epidemiology , Adolescent , Adult , Age Factors , Aged , American Indian or Alaska Native/statistics & numerical data , Asian People/genetics , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/prevention & control , Carcinoma, Squamous Cell/virology , Cross-Sectional Studies , Female , Humans , Logistic Models , Middle Aged , Northwest Territories/epidemiology , Odds Ratio , Papanicolaou Test , Papillomaviridae/isolation & purification , Prevalence , Surveys and Questionnaires , Uterine Cervical Neoplasms/genetics , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/virology , Vaginal Smears/statistics & numerical data , Women's Health , Uterine Cervical Dysplasia/genetics , Uterine Cervical Dysplasia/prevention & control , Uterine Cervical Dysplasia/virologyABSTRACT
Current trends indicate increases in the numbers of Americans participating in exercise and conditioning programs. These numbers are coupled with simultaneous interest by practitioners and researchers in the potential benefits associated with exercise as well as with activity participation to restore or promote general health. This annotated bibliography includes a number of revlews as well as efficacy studies exploring the potential benefits of exercise, particularly aerobic exercise, on physical and mental health. These references are provided as a resource for therapists to become aware of the present status of exercise-related research as well as the nature of exercise and activity programs being developed and explored in practice today.
