Background: Cancer is among the leading contributors to morbidity and mortality in the Pacific, but the magnitude of
the problem and the potential for prevention have not been comprehensively studied. Over the past decade, cervical
cancer has been the most common cancer among women in Fiji with an age standardised cervical cancer incidence
rate of 51 per 100,000. This rate is among the highest in the South Pacific region and in the world. This high cervical
cancer incidence rate is likely linked to the low cervical screening rate, but it points also to the possibility of a high
burden of human papillomavirus (HPV) infection.
Methods: We conducted a population-based survey in Fiji to provide information on human papillomavirus (HPV)
prevalence, and the distribution of individual HPV types in a Fijian health-sub-district. We included 1,261 women aged
between 16 and 64 years. A general primer GP5+/6+ mediatedpolymerase chain reaction (PCR) assay was used for HPV
testing of 44 HPV types.
Results: The crude HPV prevalence in 1,244 women with an adequate HPV sample was 24.0% (95% confidence interval
(CI), 21.7-26.4%) and the corresponding age standardised prevalence was 25.5% (95% CI, 23.1-28.1%). The prevalence of
high-risk HPV types was 13.6% (95% CI, 11.8-15.6%). Among 1,192 women with adequate cytological results, 13 (1.1%)
showed cervical abnormalities, the majority of which were high-grade intraepithelial lesions or worse. HPV prevalence
declined from 35.8% in women aged <25 years to 18.6% in those aged 55–64 years of age. After adjustment, the only
variables significantly associated with HPV-positivity were age (ranging from odds ratio (OR) 0.57 (95% CI, 0.36-0.89) for
25–34 year-old-women to OR 0.43 (95% CI, 0.20-0.89) for 55–64 year-old-women) and ‘husband’s extramarital sexual
relationships’ (OR 1.69; 95% CI, 1.17-2.34).
Conclusion: These findings on HPV provide key information for future policy decisions on the most appropriate
methods of cervical cancer prevention in Fiji and in the Pacific region