The findings suggest that p16INK4a immunostaining can improve the accuracy of cytological examination and HPV DNA test and may be particularly useful in the triage of low-grade lesions.

Background Infection with human papillomaviruses (HPVs) can cause benign and malignant tumours in the anogenital tract and the oropharynx both in men and women. The aim of the presented study was to investigate cervical, anal, and oral HPV-detection rates among women referred to colposcopy for abnormal Cervical Cancer (CaCx) screening results and assess the concordance of HPV-types among these anatomical sites. Methods Women referred to colposcopy at a single centre due to abnormal cytology, conducted for CaCx screening, were subjected to cervical Liquid-based Cytology (LBC) smear testing, anal and oral sampling. Routine colposcopy consisted in multiple biopsies and/or Endocervical Curettage (ECC). HPV-detection was performed by PCR genotyping in all three anatomical sites. In high-risk (hr) HPV-DNA positive samples either from anal canal or oral cavity, anal LBC cytology and anoscopy were performed, or oral cavity examination respectively. Descriptive statistics was used for the analysis of HPV-detection rates and phi-coefficient for the determination of HPV-positivity concordance between the anatomical sites. Results Out of 118 referred women, hr. HPV-DNA was detected in 65 (55.1%), 64 (54.2%) and 3 (2.5%) at cervix, anal canal and oral cavity respectively while low-risk HPV-DNA was detected in 14 (11.9%) and 11 (9.3%) at cervix and anal canal respectively. The phi-coefficient for cervix/anal canal was 0.392 for HPV16, 0.658 for HPV31, 0.758 for HPV33, − 0.12 for HPV45, 0.415 for HPV52 and 0.473 for HPV58. All values were statistically significant (p < 0.001). Conclusions The results suggest that most HPV-types, high-risk and low-risk, detected in the cervix of women with prevalent cervical dysplasia, correlate with the ones detected in their anal canal. This particularly applies for the HPV-types included in the nonavalent HPV-vaccine (HPVs 6/11/16/18/31/33/45/52/58).

Midwives play an important role in the implementation of cervical cancer screening. We assessed the knowledge of human papillomavirus (HPV) infection and of its relationship with cervical cancer in 107 midwives and 29 graduating midwifery students. The majority of midwives (78.5%) were aware that a viral infection causes cervical cancer, whereas only 48.3% of the students knew this (p = 0.003). Only one midwife (0.9%) was not aware of HPV infection compared with 10.3% of the students (p = 0.029). Midwives were also more knowledgeable of the relationship between HPV infection and cervical cancer and of the availability of a vaccine against HPV infection (p = 0.005 and p < 0.0001, respectively). In conclusion, Greek midwives have a satisfactory level of knowledge about cervical cancer and HPV infection, in contrast to midwifery students. It is important to better educate midwifery students in order to facilitate the incorporation of HPV testing and vaccination in clinical practice.

Plenty of authors propose outpatient hysteroscopy\ud as the gold standard diagnostic method for the\ud evaluation of endometrial pathology. This statement has\ud been strengthened in the recent years due to the wide use of\ud smaller diameter hysteroscopic devices, which have made\ud the dilation of the cervix and the use of anesthesia\ud unnecessary. The main purpose of this paper is to\ud summarize the indications of diagnostic hysteroscopy. In\ud this review, we used the most recent publications in\ud MEDLINE and Cochrane Library in order to specify the\ud indications of diagnostic hysteroscopy and the experience\ud that have been obtained till today in the management of\ud certain pathological uterine conditions. The key words we\ud used were diagnostic hysteroscopy, abnormal uterine\ud bleeding, infertility, endometrial cancer. Hysteroscopy provides\ud an accurate method of evaluation and direct visualization\ud of the endometrial cavity and moreover directed biopsy\ud and sampling of suspected lesions. Last years with the\ud continuous development in the hysteroscopy devices, plenty\ud of women benefit surgical hysteroscopy techniques for uterine abnormalities. Hysteroscopy is useful for the diagnosis in\ud patients with abnormal uterine bleeding, with endometrial\ud cancer and in infertile women. Hysteroscopy has the unique\ud advantage of combining a thorough procedure with great\ud diagnostic accuracy. The only disadvantage is that hysteroscopy\ud requires specific teaching and training and has a long\ud learning curve