Prevalence of human papilloma virus genotypes 16, 18 in women with abnormal cervical cytology smears (abnormal Pap smear) attending Erbil Maternity Teaching Hospital
Background and objective: Cervical cancer is the fourth most common cancer among women. Carcinogenic Human Papilloma Virus (HPV) infection is the major etiological agent for cervical cancer, of which70% are caused by HPV-16 and HPV-18 genotype infection. This study aimed to detect high risk HPV (16,18) in women with different abnormalities in pap smear to allow subsequent more accurate management of the cases and provide information that assists in future development of guidelines in our hospital.
Methods: We performed a cross-sectional study on 100 ladies with an abnormal pap smear. Subjects were interviewed and underwent cervical testing with broom using liquid based samples to confirm the cytological abnormality and test for HPV genotypes 16 and 18 using Polymerase Chain Reaction (PCR). Then, colposcopy referral was done according to local protocols.
Results: The median age of the subjects was 34. The prevalence of HPV genotypes 16,18 in the whole studied sample was 36%. Various studied risk factors showed significant association with abnormal pap smear and positive HPV genotypes 16,18, including the number of partners, increasing parity, age at first pregnancy, and smoking. Data were analyzed by the statistical package for the social sciences (version 23).
Conclusion: The prevalence of HPV 16,18 was 36% in the sample, with the highest proportion being among those with high-grade lesions. Those using natural methods of contraception had higher rates of infection in comparison with other methods.
Bray F, Ferlay J, SoerjomataramI, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Ca Cancer J Clin 2018; 68:394–424.
Muñoz N, Bosch FX, Castellsagué X, Díaz M, de Sanjose S, Hammouda D, et al, Against which human papillomavirus types shall we vaccinate and screen? The international perspective. Int J Cancer 2004; 111(2):278–85.
Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S.Human papillomavirus and cervical cancer.Lancet 2007; 370(9590):890–907.
Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsagué X, Shah KV. International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348:518–27.
Stevens MP, Garland SM, Tan JH, Quinn MA, Petersen RW, Tabrizi SN. HPV genotype prevalence in women with abnormal pap smears in Melbourne, Australia. J Med Virol 2009; 81(7):1283–91.
World Health Organization. Comprehensive cervical cancer control. A guide to essential practice. Geneva. (Accessed September 19, 2018, at http://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer).
McGraw SL, Ferrante JM .Update on prevention and screening of cervical cancer. World J Clin Oncol 2014; 5(4):744–52.
Oxford University Press USA. HPV testing is better than the Pap test at detecting cervical cancer. (Accessed October 17, 2018, at https://www.eurekalert.org/pub_releases/2017-11/oupu-hti111317.php).
Franco EL, Cuzick J, Hildesheim A,de Sanjosé S. Issues in planning cervical cancer screening in the era of HPV vaccination. Vaccine 2006; 24(Suppl 3):S171–7.
Schiffman M, Kinney WK, Cheung LC, Gage JC, Fetterman B, Poitras NE. Relative Performance of HPV and Cytology Components of Cotesting in Cervical Screening. J Natl Cancer Inst 2018; 110(5):501–8.
Ogilvie GS, van Niekerk D, Krajden M, Smith LW, Cook D, Gondara L, et al. Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial. JAMA 2018; 320(1):43–52.
Youssef MA, Abdelsalam L, Harfoush RA, Talaat IM, Elkattan E, Mohey A,et al. prevalence of human papilloma virus (HPV) and its genotypes in cervical specimens of Egyptian women by linear array HPV genotyping test.Infect Agent Cancer 2016; 11:6.
Dursun P, Senger S, Arsalan H, Kuscu E, Ayhan A. Human papillomavirus (HPV) prevalence and types among Turkish women at a gynecology outpatient unit. BMC Infectious Diseases 2009; 9:191.
Sargent A, Bailey A, Almonte M, Turner A, Thomson V, Pito J, et al. Prevalence of type specific HPV infection by age and grade of cervical cytology:data from ARTISTIC trial. British journal of cancer. Br J Cancer 2008; 98(10):1704–9.
Lam JU, Rebolj M, Dugué PA, Bonde J, von Euler-Chelpin M, Lynge E.Condom use in prevention of Human Papillomavirus infections and cervical neoplasia: systematic review of longitudinal studies. J Med Screen 2014; 21(1):38–50.
Kim HS, Kim TJ, Lee IH, Hong SR. Associations between sexually transmitted infections, high-risk human papillomavirus infection, and abnormal cervical Pap smear results in OB/GYN outpatients. J Gynecol Oncol 2016; 27(5):e49.
Kahn JA, Rosenthal SL, Succop PA, Ho GY, Burk RD. Mediators of the association between age of first sexual intercourse and subsequent human papillomavirus infection. Pediatrics 2002; 109(1):E5.
Roden R, Wu TC. How will HPV vaccines affect cervical cancer? Nat Rev Cancer 2006; 6(10):753–63.
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