[Prevalence of human papillomavirus infection in Slovenian women with repeated Pap II smears].

Med Arh

Institut za mikrobiologiju, imunologiju i parazitologiju, Klinicki centar Univerziteta u Sarajevu, Bosna i Hercegovina.

Published: May 2005

AI Article Synopsis

  • Cervical Papanicolaou (Pap) smear screening is commonly used to detect precancerous lesions, but management of repeat abnormal results presents significant challenges.
  • A study of 148 women with multiple abnormal Pap smears found that HPV infections were present in 25.7% of samples, with a notably higher rate (37.8%) in women aged 30 and younger compared to older women (20.4%).
  • The research suggests that reliance solely on Pap smears may be insufficient due to their low sensitivity, and that molecular testing for HPV should be used as a complementary method for better detection of cervical issues.

Article Abstract

In the detection of precancerous lesions the cervical Papanicolaou smear screening is used in Slovenia and worldwide. Management of patients with repeat abnormal smears (Pap II) represents a great and complex clinical and public health problem. Repeated cytologic examinations are routine procedure in many countries, also in Slovenia, although the sensitivity of Pap smear testing in the detection of cervical intraepithelial neoplasia (CIN) II and III is relatively low. In cases of abnormal squamous cells and mildly dyskaryotic cells the presence of infections with high-risk HPV genotypes is being increasingly used as a complementary method to Pap smear testing. In the study we enrolled 148 cervical samples of women who within two years had three subsequent Pap II smears (abnormal squamous cells or mildly dyskaryotic cells). The prevalence of HPV infections was determined using three molecular tests: Hybrid Capture 2 (hc2) test and two variants of polymerase chain reaction (PCR-PGMY11/PGMY09 and PCR-CPI/CPIIG). HPV infection was detected in 25.7% of women. In women aged < or = 30 years a statistically significant higher prevalence of HPV infections was found (37.8%) than in women aged > 30 years (20.4%). Our findings show that repeat Pap smear as the method of follow-up and detection of precancerous lesions of the observed population do not provide relevant results due to low prevalence of HPV infections in Slovenia, which indirectly indicates low sensitivity and specificity of Pap smear testing. In the detection of HPV infections, molecular methods are thus sensitive screening tests to be used complementary to cytologic tests in women with abnormal squamous cells and mildly dyskaryotic cells.

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