Impact of menopausal status on human papillomavirus detection and cervical neoplasia in middle-aged Senegalese women
5 affiliations
- 1Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- 2Service des Maladies Infectieuses Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Sénégal
- 3Department of Pathology, School of Medicine, University of Washington, Seattle, Washington, United States of America
- 4Division of Allergy and Infectious Diseases, School of Medicine, University of Washington, Seattle, Washington, United States of America
- 5Department of Global Health, University of Washington, Seattle, Washington, United States of America
Abstract
Hormonal and immunologic changes related to menopause may play a role in human papillomavirus (HPV) and cervical neoplasia detection, yet this relationship has not been examined in West African populations, where cervical cancer remains a leading cause of cancer-related death. The purpose of this study was to assess whether menopausal status is associated with HPV and cervical neoplasia detection in Senegalese women aged 40–60. We conducted a secondary analysis of three prospective cervical cancer studies in Dakar, Senegal (1998–2011). Participants with known menopausal status and a satisfactory HPV test (N = 3,118) and/or Pap smear (N = 2,907) were included, excluding those with cervical cancer or pregnancy; participants without known HIV status were additionally excluded from the cervical neoplasia analysis. Multivariable logistic regression and generalized estimating equations were used to estimate adjusted odds ratios and 95% confidence intervals, adjusting for age, gravidity, and HIV status. Compared with premenopausal women, postmenopausal women had significantly higher odds of HPV detection (OR = 1.48; 95% CI: 1.18, 1.85), including both high-risk (OR = 1.55; 95% CI: 1.25, 1.93) and low-risk types (OR = 1.64; 95% CI: 1.30, 2.08). Odds of cervical neoplasia were elevated, but non-significant, among postmenopausal women (OR = 1.36; 95% CI: 0.97, 1.90), with increased odds for both high-grade (OR = 1.43; 95% CI: 0.90, 2.28) and low-grade lesions (OR = 1.30; 95% CI: 0.84, 2.02). However, in a sensitivity analysis restricted to participants with known HIV status, these cervical neoplasia odds were attenuated, suggesting caution in interpreting the magnitude of these findings. These findings suggest menopause may contribute to HPV persistence or reactivation, and development of cervical neoplasia. Our results highlight the importance of continued surveillance for HPV and cervical neoplasia among older women, particularly in low-resource settings with disproportionately high cervical cancer burden.
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BibTeX
@article{spencer2026impact,
title = {{Impact of menopausal status on human papillomavirus detection and cervical neoplasia in middle-aged Senegalese women}},
author = {Emily R. Spencer and Rachel L. Winer and Selly Ba and Marie Pierre Sy and John Lin and Qinghua Feng and Geoffrey S. Gottlieb and Papa Salif Sow and Nancy B. Kiviat and Stephen E. Hawes},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0358080},
url = {https://doi.org/10.1371/journal.pone.0358080},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of menopausal status on human papillomavirus detection and cervical neoplasia in middle-aged Senegalese women
AU - Emily R. Spencer
AU - Rachel L. Winer
AU - Selly Ba
AU - Marie Pierre Sy
AU - John Lin
AU - Qinghua Feng
AU - Geoffrey S. Gottlieb
AU - Papa Salif Sow
AU - Nancy B. Kiviat
AU - Stephen E. Hawes
PY - 2026
DA - 2026/09/11
JO - PLOS One
DO - 10.1371/journal.pone.0358080
UR - https://doi.org/10.1371/journal.pone.0358080
AB - Hormonal and immunologic changes related to menopause may play a role in human papillomavirus (HPV) and cervical neoplasia detection, yet this relationship has not been examined in West African populations, where cervical cancer remains a leading cause of cancer-related death. The purpose of this study was to assess whether menopausal status is associated with HPV and cervical neoplasia detection in Senegalese women aged 40–60. We conducted a secondary analysis of three prospective cervical cancer studies in Dakar, Senegal (1998–2011). Participants with known menopausal status and a satisfactory HPV test (N = 3,118) and/or Pap smear (N = 2,907) were included, excluding those with cervical cancer or pregnancy; participants without known HIV status were additionally excluded from the cervical neoplasia analysis. Multivariable logistic regression and generalized estimating equations were used to estimate adjusted odds ratios and 95% confidence intervals, adjusting for age, gravidity, and HIV status. Compared with premenopausal women, postmenopausal women had significantly higher odds of HPV detection (OR = 1.48; 95% CI: 1.18, 1.85), including both high-risk (OR = 1.55; 95% CI: 1.25, 1.93) and low-risk types (OR = 1.64; 95% CI: 1.30, 2.08). Odds of cervical neoplasia were elevated, but non-significant, among postmenopausal women (OR = 1.36; 95% CI: 0.97, 1.90), with increased odds for both high-grade (OR = 1.43; 95% CI: 0.90, 2.28) and low-grade lesions (OR = 1.30; 95% CI: 0.84, 2.02). However, in a sensitivity analysis restricted to participants with known HIV status, these cervical neoplasia odds were attenuated, suggesting caution in interpreting the magnitude of these findings. These findings suggest menopause may contribute to HPV persistence or reactivation, and development of cervical neoplasia. Our results highlight the importance of continued surveillance for HPV and cervical neoplasia among older women, particularly in low-resource settings with disproportionately high cervical cancer burden.
SN - 1932-6203
ER -