Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain: the CLEOPATRE study.

BACKGROUND: Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain. METHODS: The CLEOPATRE Spain study enrolled 3 261 women aged 18-65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection. RESULTS: A lifetime number of two or more sexual partners, young age (18-25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01). CONCLUSION: This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection.

The burden of hospitalizations for anus and penis neoplasm in Spain (1997-2008).

An epidemiological retrospective study has been performed to assess the burden of hospitalization by anus and penis neoplasm in the general population in Spain. All hospital discharges and deaths related to anal malign neoplasm and penile malign neoplasm from 1997 to 2008 in Spain were obtained. A total of 19,608 hospital admissions were recorded during the study period: 11,965 were related to anal malign neoplasm (4,992 in women and 6,973 in men) and 7,643 to penis malignant neoplasm. This corresponds to a hospitalization rate of 1.97 (CI 95%: 1.91-2.02) hospitalizations per 100,000 women/ year, 2.84 (CI 95%: 2.77-2.91) hospitalizations per 100,000 men/ year and 3.11 (CI 95%: 3.04- 3.18) hospitalizations per 100,000 men/ year, respectively during the study period.   The hospitalization rate increased significantly during the study period in all locations. It also increased significantly with age for all locations. Hospitalization and mortality rates in men were 50% higher than in women A total of 530 deaths related to penis malignant neoplasm and 738 deaths related to anus malignant neoplasm in men and 488 in women were reported during the 12-y study period. Although a decrease in smoking prevalence has led to a decrease in the incidence of cancers in the last decade, the hospitalizations due to anal and penile malign neoplasm have not declined in our study. This might be attributed to a high prevalence of HPV infection in these particular genital malign neoplasms.

Epidemiology of herpes zoster infection among patients treated in primary care centres in the Valencian community (Spain).

BACKGROUND: There is little available data regarding the epidemiology of herpes zoster (HZ) in Spain. This study's main goal was to estimate the annual incidence of HZ in the Autonomous Community of Valencia. METHODS: From December 1st 2006 to December 1st 2007, a prospective study was carried out in 24 primary health care centres that together provide care for a population of 36,030 persons aged >14 years. We included all adult patients with a clinical diagnosis of HZ who were seen at these centres during the one-year study period. Demographic (i.e., age, gender, and area of residence) and clinical data were also collected from these patients. RESULTS: A total of 146 cases of HZ were identified during the study period. The annual incidence of HZ was 4.1/1,000 individuals >14 years of age (95% confidence interval [CI]: 3.4-4.7). Cases of HZ were predominantly unilateral and most commonly affected women and people living in rural areas. The most frequently reported symptoms were pain, dysesthesia and itching. A total of 46% of patients also had underlying illnesses (e.g., chronic diseases and/or malignancy) and 24% of patients experienced complications, which were mostly ocular in nature. A total of 91% of patients were treated with antiviral drugs. The median time from symptoms onset to diagnosis was 6.3 days (range: 2.0-8.3). CONCLUSIONS: HZ is a common illness in our region (especially in the older population) that causes a significant clinical burden on primary care providers.