High-risk human papillomavirus infection in low risk women: incidence, patient characteristics, and clinical meaning for cervical cancer

Int J Med Sci. 2012;9(1):103-7. doi: 10.7150/ijms.9.103. Epub 2011 Dec 15.

Abstract

Objective: To investigate the incidence of high-risk human papillomavirus (HPV) infection and its clinical meaning.

Methods: Total 28,339 women attending our hospital for routine gynecologic care underwent Papanicolaou test (PAP test) and high-risk HPV tests. Biopsies were taken from some women and their results were compared.

Results: The prevalence of high-risk HPV infection is 24.15%. And the women aged 20-29 years had the highest prevalence (32.3%) compared to 30-70 years (P<0.05). Of the 28,339 women, 1369 (4.83%) had positive PAP test (ASCUS, LSIL, HSIL). Of the 1369 PAP-positive patients, only 16 (1.17%) were negative for HPV test. Of the 1353 patients positive on both tests, 510 (37.7%) had lesions higher than CINII on histology. Of the 1,611 patients who underwent biopsies, 350 underwent the loop electrical excision procedure, with 339 (96%) being positive for HPV test, including 16 with CINI, 48 with CINII/III, 74 with CIS, and 16 with cervical cancer. HPV test had a positive predictive value of 40.7% and a negative predictive value of 100% for higher than CINII.

Conclusion: Although HPV test has a burden of cost, considering its high negative predictive value, HPV test should be considered for more useful screening test.

Keywords: HPV infection; cervical cancer; screening test.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Female
  • Humans
  • Mass Screening
  • Middle Aged
  • Papanicolaou Test
  • Papillomaviridae / pathogenicity*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / virology*
  • Risk Assessment
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / virology*
  • Vaginal Smears / methods