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Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population
  1. Su Pei Khoo1,
  2. Nirmala Bhoo-Pathy1,
  3. Siew Hwei Yap1,
  4. Mohd Khairul Anwar Shafii1,
  5. Nazrilla Hairizan Nasir2,
  6. Jerome Belinson3,
  7. ShriDevi Subramaniam4,
  8. Pik Pin Goh4,
  9. Ming Zeng5,
  10. Hong Dong Tan5,6,
  11. Patti Gravitt7,
  12. Yin Ling Woo1
  1. 1 Faculty of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  2. 2 Division of Family Health Development, Ministry of Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  3. 3 Preventive Oncology International Inc and the Cleveland Clinic, Cleveland, Ohio, USA
  4. 4 National Clinical Research Centre, Ministry of Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  5. 5 Beijing Genome, Shenzhen, China
  6. 6 Complete Genomics, San Jose, California, USA
  7. 7 Milken Institute of Public Health, George Washington University, Washington, District of Columbia, USA
  1. Correspondence to Dr Yin Ling Woo, Faculty of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, 50603, Malaysia; ylwoo{at}


Objectives Cervical cancer is a largely preventable disease, and the strategic implementation of a cervical cancer prevention programme is partly dependent on the impact of human papillomavirus (HPV) infection interpreted within the context of the country’s sociodemographic attributes. The objective of this study is to determine the prevalence of cervicovaginal HPV infection among a healthy, community-based, multiethnic Malaysian population. The HPV prevalence was subsequently correlated to the individual’s sociodemographics and sexual/reproductive history. Of significance, the observed prevalence captured was in a birth cohort not included in the national school-based HPV vaccination programme.

Methods This was a cross-sectional study where 1293 healthy women aged between 18 and 60 years were recruited via convenience sampling from five community-based clinics in Selangor, Malaysia. Cervicovaginal self-samples were obtained and DNA was extracted for HPV detection and genotyping. A comprehensive questionnaire was administered to determine the sociodemographics and behavioural patterns of participants.

Results The median age at enrolment was 37 years old (IQR: 30–47). In total, 86/1190 (7.2%) of the samples collected were positive for HPV infection, with the highest HPV prevalence (11.9%) detected in the subgroup of 18–24 years old. The top three most prevalent HPV genotypes were HPV 16, 52 and 58. The independent risk factors associated with higher rates of HPV infection included Indian ethnicity, widowed status and women with partners who are away from home for long periods and/or has another sexual partner.

Conclusions The overall prevalence of HPV infection in this Malaysian multiethnic population was 7.2%, with 6.5% being high-risk genotypes. The top three most common high-risk HPV types were HPV 16, 52 and 58. This information is important for the planning of primary (HPV vaccination) and secondary (screening) cervical cancer prevention programmes in Malaysia.

  • cervical neoplasia
  • epidemiology (general)
  • hpv
  • screening

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  • Handling editor Jackie A Cassell

  • Contributors YLW, PG, NHN, NB-P and JB conceptualised the study. YLW, PG, PPG, NHN, NB-P and JB contributed to human resources and execution of the study. SPK, SHY, MKAS, NHN and SS recruited the volunteers. SPK, PG and YLW wrote the manuscript. JB, MZ and HDT contributed to HPV DNA testing. All authors reviewed and revised the manuscript before submission.

  • Funding This study was supported by University Malaya High Impact Research Grant (grant no: UM.C/625/1/HIR/MOHE/MED/12), University Malaya Research Grant (RP029-14HTM), National Clinical Research Centre of the Ministry of Health of Malaysia, Beijing Genome Institute, Preventive Oncology International, and an investigator-initiated study grant by Merck Sharp and Dohme (Malaysia).

  • Competing interests None declared.

  • Ethics approval The study received approval from the Medical Research Ethics Committee (NMRR-13-444-14609) and the University of Malaya Medical Ethics Committee (MREC989.32).

  • Provenance and peer review Not commissioned; externally peer reviewed.