Human papillomavirus (HPV) subtypes and their relationships with cervical smear results in cervical cancer screening: a community-based study from the central Anatolia region of Turkey

Int J Clin Exp Pathol. 2019 Apr 1;12(4):1391-1398. eCollection 2019.

Abstract

Objective: Cervical cancer can be diagnosed early by cancer screening programs. The aim of this study was to evaluate the cervical smear test results of healthy women.

Methods: We enrolled 94,848 healthy women from 30-65 years of age in whom both HPV typing and a cervical smear test was performed between 2014 and 2017.

Results: HPV was detected in 3001 women (3.16%). The mean age was 42 ± 8.94 years old. Positive HPV types were HPV16; HPV16 and multiple infection; HPV31; HPV51; HPV39; HPV52; HPV56; HPV18; HPV68; HPV35; HPV18 and multiple infection; HPV58; HPV45; HPV59; HPV16, HPV18 and multiple infection; HPV16 and 18; and HPV33, in descending order. Cytology results were normal in 63.61%. We also identified atypical squamous cells of undetermined significance in 6.60%, atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion in 0.73%, low-grade squamous intraepithelial lesion in 10%, high-grade squamous intraepithelial lesion and atypical glandular cells in 0.53%, and adenocarcinoma in situ in 0.03%. In terms of HPV subtypes, abnormal smear results were divided into an HPV16, HPV18, and multiple infection group (25%), an HPV35 group (23.61%), an HPV 16 and multiple infection group (22%), and an HPV16-only group (21.85%). Most cases of HPV (39.02%) and abnormal cytology (43.04%) were detected between the ages of 30 and 40.

Conclusions: This study is remarkable because it is a community-based study and includes a large population of healthy women to detect HPV prevalence, its subtype, and abnormal smear results.

Keywords: Papanicolaou test; human papilloma virus; primary care; screening.