Difference in prevalence of human papillomavirus genotypes in cytomorphologically normal cervical smears is associated with a history of cervical intraepithelial neoplasia

Int J Cancer. 1991 May 30;48(3):404-8. doi: 10.1002/ijc.2910480317.

Abstract

The prevalence of human papillomavirus (HPV) genotypes was investigated by the polymerase chain reaction (PCR) method in cytologically normal and abnormal cervical scrapes obtained from asymptomatic women (n = 1,346), participating in a triennial screening program for cervical cancer, and from a gynecological outpatient population (n = 593). In the symptom-free population oncogenic HPV types 16, 18, 31 and 33 were present in 1.5% of cytologically normal scrapes, while the overall HPV prevalence rate was 3.5%. Significantly, higher HPV prevalence rates of 7% (oncogenic HPV; p less than 0.01) and 14% (all HPV; p less than 0.01), respectively, were found in cytologically normal scrapes of the gynecologic outpatient population. It appeared that in this outpatient group 78% of the smears containing HPV 16 and 18 were associated with a history of cervical pathology, i.e. cervical intraepithelial neoplasia grade I to III. In smears with mild and severe dysplasia and smears suspected of carcinoma in situ from both populations, the overall HPV prevalence was 70%, 84% and 100%, respectively. In all squamous-cell carcinomas of the cervix (n = 50) HPV was detected. Frequencies of HPV 16 and 18 increased from 41% in mild dysplasia to 94% in cervical carcinomas. Since a low prevalence of HPV was found in cytomorphologically normal cervices of women without a clinicopathological history, the findings in this study suggest that HPV detection in population-based screening programs for cervical neoplasia can be an important tool in identifying women who are at risk of developing dysplasia and cervical cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / microbiology*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / prevention & control
  • Cervix Uteri / microbiology
  • Cervix Uteri / pathology
  • Female
  • Genotype
  • Humans
  • Incidence
  • Mass Screening
  • Middle Aged
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Polymerase Chain Reaction / methods
  • Prevalence
  • Uterine Cervical Dysplasia / microbiology*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / microbiology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / prevention & control
  • Vaginal Smears*