BackgroundPersistent infection with High Risk Human Papillomavirus (HR HPV) typesplaysamajor role in the development of cervical cancer. Therefore, the detection of HR HPV types is an essential part of cervical cancer screening. The aim of this study was to estimate the prevalence of HR HPV infection among healthy women undergoing routine cervical cancer screening in Iran.MethodsIn this cross-sectional study,the results of HPV DNA typing in 2453 normal Iranian womenwhowere referred for routine cervical cancer screening from September 2015 to March 2017 were analyzed. Participants were screened using COBAS assay for HPV DNA typing and liquid based cytology.ResultsA total of 2453 healthy sexually active women were included in this study. The mean age was 35.1 ± 8.08 years. The overall prevalence of HR HPV infection was 10.3%. HPV16 was found in 73 (3%) women. The prevalence of HPV18 and other HR HPV typeswere 16(0.7%) and166 (8.2%),respectively. Approximately, 5% of the study population had an abnormal cervical cytology (ASCUS or worse), of whom 34% were infected by HR HPV.ConclusionThe prevalence of HR HPV infection among Iranian women has increased in the recent years which indicates the need for public education and health planning toprevent this cancer through vaccination and early diagnosis using screening tests.HPV DNA typing, diagnosisand the distribution of prevalent genotypes should be considered in the development of comprehensive cervical cancer prevention programs in Iran.
Background:Anal cancer is uncommon. Although uncommon, the incidence of anal cancer has increased among the general population of the United States and other countries over the past 30 years. We evaluated anal cytology in women with the history of abnormal pap smear, cervical intraepithelial neoplasia, cervical cancer and high risk HPV for anogenital dysplasia.Methods:In this cross-sectional study, 153 patients over the age of 21 years, referred to Imam Hossein Hospital in 1395-1396 who were being monitored due to abnormal pap smear, cervical cancer, CIN and high risk HPV, were evaluated with anal cytology for anogenital dysplasia.Results:153 patients were enrolled in four main groups. Among those with a history of abnormal pap smear (39 patients), only 25% of the patients with HSIL had abnormal anal pap smear, and the rest of them had negative anal smear. Among those with a history of CIN (61 patients), patients with CIN III, 30.8% had abnormal anal smear, while the rest had a negative anal smear. Among those with a high risk of HPV (23 patients), 50% of the patients with concurrent positive HPV 16 and 18 had anal abnormal smear. Patients with a history of cervical cancer (30 patients) who had radiotherapy with or without surgery showed a negative anal smear. The ratio of anal SIL positive of individuals with a sexual partner was only 1.9%, while this ratio was 27.3% for those with more than one partner and this difference was statistically significant (P <0.0001). 15.4% of smokers had positive anal SIL test result, while, only 2.9% non-smokers had the same result, and this difference was statistically significant (P = 0.03). 20% of the patients who had anal intercourse showed a positive anal SIL score result, compared to 1% for those who did not. This difference was statistically significant (P <0.0001).Conclusion:Among people with a history of abnormal cervical pap smear, CIN, cervical cancer and high-risk HPV during the last 6 months, abnormal anal tests are most commonly seen in patients who had risk factors such as anal sex, cigarette, multi partner etc. with high grade interepithelial squamous cervix such as HSIL, CIN III, HPV 16 and 18; more studies in larger sample size are needed to have the better conclusion.
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