Contents lists available at ScienceDirect Cancer Epidemiology journal homepage: www.elsevier.com/locate/canep Prevalence and age-wise distribution of Human Papillomavirus type 16/18 infections among hospital screened women of a peri-urban area in West Bengal: Impact of socio-demographic factors Amrapali Bhattacharya a , Shrinka Sen a,1 , Paramita Mandal a,2 , Sweta Sharma Saha a,3 , Somosree Sarkar a,4 , Om Prakash Pathak b , Lena Biswas b , Jayeeta Roy b , Rimpa Banerjee b , Ranita Roy Chowdhury b , Manidip Pal b , Ankur Mukherjee a,5 , Sharmila Sengupta a, ⁎ a National Institute of Biomedical Genomics, P.O.: N.S.S., Kalyani 741251, West Bengal, India b Department of Obstetrics & Gynecology, College of Medicine & J.N.M. Hospital, WBUHS, P.O. Kalyani, Nadia 741235, West Bengal, India ARTICLE INFO Keywords: Cervical cancer Hospital-based screening HPV16 and 18 Age-related prevalence Hindu and Muslim women Parity Oral contraceptive use ABSTRACT Background: We undertook the current study on cervical Human Papillomavirus (HPV) prevalence along with cytology in women visiting the Gynecology Out-patient Department of a hospital for common gynecological ailments, subsequent to our earlier population-based study on HPV prevalence from India. Methods: We analyzed data on cervical-cytology (Pap smears) and PCR-based molecular detection of HPV in- fection along with socio-demographic variables (N = 696). Results: We identified 36.84% HPV-positive women amongst whom, HPV16 and 18 together predominated (79.37%) over other HPV types (20.63%). Contrarily, only 6.4% women revealed abnormal cytological lesions, of which, 46.51% were HPV-positive and 95% of such women harbored HPV16/18, while 5% harbored other HPV types. Individuals with normal cytology portrayed 36.09% HPV infections, of which, 77.97% were HPV16/ 18-positive and 22.03% harbored other HPV types. Overall HPV prevalence decreased significantly (p trend = 0.047) with increase in age, but HPV16/18 infections were significantly over-represented compared to the other HPV types across all age-groups. Specifically, HPV16 prevalence increased (p trend < 0.01) with increase in severity of cervical lesions. HPV16 prevalence did not differ between the Hindus and Muslims but HPV18 was significantly higher among the cytologically normal Muslim women (24.14%, p = 0.02), compared to the Hindus (11.91%), specifically among those ≥ 30 years of age. There was a significant (p < 0.05) over- representation of HPV16 prevalence among women who were users of oral contraceptive-pills, irrespective of cytology. Conclusions: Our study highlights the need for HPV16/18-based screening of cervical cancers in India con- sidering the immense socio-cultural and genetic diversity at the population level. 1. Introduction Infection with Human Papillomavirus (HPV) and viral persistence in the host cervical epithelial cells are established as major etiologic fac- tors for cervical cancer (CaCx) development [1–3]. The disease devel- opment process is often preceded by a prolonged pre-cancerous phase https://doi.org/10.1016/j.canep.2018.03.005 Received 3 October 2017; Received in revised form 8 March 2018; Accepted 11 March 2018 ⁎ Corresponding author. 1 Present address: Transcription and Disease Laboratory, Molecular Biology and Genetics Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru 560064, Karnataka, India. 2 Present address: Department of Zoology, The University of Burdwan, Golapbag Campus, Bardhaman 713104, West Bengal, India. 3 Present address: Department of Gynecologic Oncology, Tata Medical Center, 14, MAR (E-W), Kolkata 700156, West Bengal, India. 4 Present address: Cognizant Technology Solution, Plot–GN 34/3, Salt Lake Electronics Complex, Kolkata 700091, West Bengal, India. 5 Present address: Cytel Statistical Software and Services Pvt. Ltd., 6th Floor, A Wing, Lohia Jain IT Park, Chandni Chowk, Paud Road, Kothrud, Pune 411038, Maharashtra, India. E-mail addresses: amrapalibiotech@gmail.com (A. Bhattacharya), shrinka.genetics@gmail.com (S. Sen), paramita.mandal2@gmail.com (P. Mandal), swetasharma86@gmail.com (S. Sharma Saha), somosree314@gmail.com (S. Sarkar), omprakashpathak48@yahoo.in (O.P. Pathak), drlenabiswas@gmail.com (L. Biswas), roymitrajayeeta@gmail.com (J. Roy), rimpa.bandyopadhyay@yahoo.com (R. Banerjee), ranitasinha@gmail.com (R. Roy Chowdhury), manideep2b@yahoo.com (M. Pal), rantumu@gmail.com (A. Mukherjee), ssg1@nibmg.ac.in (S. Sengupta). Abbreviations: HPV, Human Papillomavirus; PAP, Papanicolaou; PCR, polymerase chain reaction Cancer Epidemiology 54 (2018) 31–37 1877-7821/ © 2018 Elsevier Ltd. All rights reserved. T