J Gynecol Oncol.  2009 Mar;20(1):1-7. 10.3802/jgo.2009.20.1.1.

Current status of cervical cancer and HPV infection in Korea

• Kim YT

• KMID: 2055640
• DOI: http://doi.org/10.3802/jgo.2009.20.1.1

Abstract

Cervical cancer is an important cause of cancer-related deaths in women in developing countries. In Korea, cervical cancer is the third leading cancer among females and is fifth highest in mortality. The persistent oncogenic human papillomavirus (HPV) infections are the greatest risk of developing cervical intraepithelial neoplasia and invasive cancer. The overall prevalence of HPV was 10.4% in Korea and strong risk factors for HPV infection included a young age at sexual debut. The National Cancer Screening Program, which includes cervical cancer screening, has the following principles: the main screening tool is the Papanicolaou test conducted by gynecologists, which targets all women age 30 and over, and which is done every 2 years. HPV DNA tests have not yet been permitted as a screening test for cervical cancer in Korea; however, these are conducted along with a Pap test for screening cervical cancer in the clinic. The use of prophylactic HPV vaccine has been accepted in Korea; The Korean Society of Gynecologic Oncology and Colposcopy's recommendation for routine vaccination is for females aged 15-17 years with a catch-up vaccination recommended for females aged 18-26 years who have not been previously vaccinated. However, many people in Korea are not familiar with the HPV vaccine. Therefore, it is necessary to improve awareness for the disease and HPV vaccination and to establish the effective strategies to obtain funding for HPV vaccination. In the future, cervical cancer is expected to disappear throughout the world, including the Asia Pacific region, through a combination of vaccination and qualified screening programs for cervical cancer.

Keyword

Cervical cancer; Human papillomavirus vaccines

MeSH Terms

Aged
Asia
Cervical Intraepithelial Neoplasia
Developing Countries
Early Detection of Cancer
Female
Financial Management
Human Papillomavirus DNA Tests
Humans
Korea
Mass Screening
Papillomavirus Vaccines
Prevalence
Risk Factors
Uterine Cervical Neoplasms
Vaccination
Vaginal Smears
Papillomavirus Vaccines

Figure

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  Fig. 1 Age-specific incidence rates of invasive cervical cancer in Korea (1993-2002). Adapted from the National Cancer Incidence Database by the Korean Central Cancer Registry (Chung HH et al.9).

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  Fig. 2 Rate of HPV infection by age group in Asan Medical Center, Seoul, Korea, March 2002-December 2002 (N=389) (Joo WD et al.14). The overall prevalence of HPV infection was 12.6 (389/3091) and calculated 15.5% when standardized. The prevalence of HPV infection was 24.1% (14/58), 14.3% (64/446), 13.7% (165/1,206), 9.5% (93/977), 13.3% (50/376) and 10.7% (3/28) in the third, fourth, fifth, sixth, seventh, and eighth decade of age, respectively. The prevalence of HPV infection was significantly higher in patients between 20 and 30 yr than in other age groups (p=0.003).

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  Fig. 3 Prevalence of HPV types by cytological findings in women in Busan, Korea, 1999-2001 (N=863) (Shin HR et al.28). Distribution of cytological findings was as follows: Normal was 95.3%, ASCUS was 2.1%, LSIL was 1.9%, HSIL was 0.4%, Carcinoma in situ was 0.1% and Invasive cervical cancer was 0.2%. Overall, 90 women (10.4%) were positive for HPV DNA. HPV prevalence was 8.5% among cytologically normal women, 22.2% among those with ASCUS, 52.9% among those with LSIL and 100% among 7 women with HSIL or worse. The most common HPV types were HPV 70, HPV 16 and HPV 33. ASCUS: atypical squamous cells of undetermined significance, LSIL: low-grade squamous intraepithelial lesion, HSIL: high-grade squamous intraepithelial lesions.

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