Distribution of genital HPV infection in women of reproductive age group in a north Indian city screened for cervical cancer by Pap smears
Keywords:
Cervical carcinoma, HPV, Pap smears, PCR
Abstract
INTRODUCTION:Carcinoma cervix is one of the leading causes of morbidity and mortality worldwide but has a benefit of being identified at a precancerous stage before the invasion starts and hence is amenable to early detection and treatment. HPV infection as the etiological agent of carcinoma cervix and its precursor lesions is well established. High risk HPV (16,18) is most commonly associated with invasive cervical carcinomas worldwide. The aim of this study is to find the prevalence of genital HPV infection in women of reproductive age group in a north Indian city that were screened for cervical cancer by Pap smears.METHODS:The was a prospective study conducted from Jan 2014 to June 2016 on women in reproductive age group (< 49 years) who were screened for cervical cancer by Pap smears and HPV testing was done by PCR (sample was sent to higher center for testing). HPV was classified into high risk HPV DNA and low risk HPV DNA. Proper informed consent was taking from the participating women.RESULTS:A total of 1549 tests were received during the above period.1068 (69%) were CPS and 481 (31%) were LBC. HPV testing was carried out in 169 cases of which 20 cases were found to be positive for HPV DNA (11.8%). High risk DNA was found in 17 cases (85%) and low risk DNA in 03 cases (15%). The annual rate of HPV detection showed a gradual slight increase from 10.3% in 2014 to 12.8% in 2016. Abnormal cytological findings were detected only in 5/20 cases (25%), which were subjected to HPV DNA testing pressing home the advantage of HPV testing in the reproductive age group.CONCLUSION:The study still establishes the important role of HPV as an etiological agent in carcinoma cervix and the need to get HPV testing included in the cervical cancer-screening program so as to diagnose the precursor lesions at an early stage leading to early treatment and reduction in morbidity and mortality from a world wide prevalent and preventable cancer.References
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13. Burd EM. Human Papillomavirus and cervical Cancer. Clin Microbiol Rev 2003;16(1):1-17.
14. Kaarthigeyan K. Cervical cancer in India and HPV vaccination. Indian J Med Paediatr Oncol 2012;33(1):7-12.
15. Brotherton JM, Fridman M, May CL. Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. Lancet 2011;377:2085-92.
2. Anthony SNA, Famooto AO, Dareng EO, et al. Age-specific prevalence of human papilloma virus infection among Nigerian women. BMC Public Health 2014;14:656.
3. Rama CH, Martins CMR, Derchain SFM, Filho AL, Gontijo RC, Sarian LOZ. Prevalence of genital HPV infection among women screened for cervical cancer. Rev Saude Publica 2008; 42(1):1-7.
4. Moyer VA. Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med2012;156:880-91.
5. Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Womens Health 2015;7:405-14.
6. Marks MA, Gupta S, Liaw KL, Tadasse A, Kim E, Phongnarisorn C. Prevalence and correlates of HPV among women attending family-planning clinics in Thailand. BMC Infect Dis 2015;15:159-68.
7. Thomas JO, Herrero R, Omigbodun AA, et al. Prevalence of papillomavirus infection in women in Ibadan, Nigeria: a population-based study. Br J Cancer. 2004;90(3):638-45.
8. Saslow D, Solomon D, LawsonHW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer. AJCP. 2012;137:516-542.PMID: 22431528
9. Stoler MH. HPV for cervical cancer screening: is the era of the molecular pap smear upon us. J Histochem Cytochem. 2001; 49:1197-1198. PMID: 11511693
10. Denny L. Cervical cancer: prevention and treatment. Discov Med 2012;14(75):125-31.
11. Walboomers JM, Jacobs MV, Manos MM, FX Bosch, Kummer JA, Shah KV. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999;189(1):12-9.
12. Clifford GM, Smith JS, Plummer M, Munoz N, Franceschi S. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br j Cancer 2003;88(1):63-73.
13. Burd EM. Human Papillomavirus and cervical Cancer. Clin Microbiol Rev 2003;16(1):1-17.
14. Kaarthigeyan K. Cervical cancer in India and HPV vaccination. Indian J Med Paediatr Oncol 2012;33(1):7-12.
15. Brotherton JM, Fridman M, May CL. Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. Lancet 2011;377:2085-92.
Published
"15-12-2016"
Section
Original Article
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