Purpose To determine the extent of cervical atypia and high-(cancer) risk (HR) human papillomavirus (HPV) infection among girls in our LSUHSC-S population, we manually reviewed records for a one-year period (September 2003-August 2004).
Methods Our cohort consisted of 2201 girls, aged 11-19 years, who underwent a pelvic examination with cytologic screening. Signal amplification using a probe cocktail which detects 13 HR types (Digene Hybrid Capture 2) is performed on all liquid-based gynecology specimens that are read as having atypical squamous cells of undetermined significance (ASCUS), atypical glandular cells (AGC) or ASC-cannot rule out high grade squamous intraepithelial lesion (ASC-H). HPV testing on specimens showing higher grade atypia is rarely done, unless specifically ordered by a clinician.
Results Of the total 2201 Pap smears from girls less than 20 years old, 24% were abnormal: 10% had atypical cells, 13% had low grade squamous intraepithelial lesions, and 1% had high grade lesions. Of 234 girls with atypical cells who underwent reflex testing, 85% had virologic evidence of HR HPV. (table)
Conclusion Cervical atypia is common among 11-19 year-old girls at LSUHSC who underwent pelvic examinations; 85% with cervical atypia had evidence of HR HPV infection. This underestimates the true prevalence of HR HPV among these adolescents since HR HPV testing was not performed on girls with normal cytology. Although most HPV infections are transient, these data should be considered when planning HPV vaccine trials.
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