High-risk human papillomavirus infection among women with pap smear tests negative for intraepithelial lesions or malignancy

Abstract

High-risk human papillomavirus infection among women with pap smear tests negative for intraepithelial lesions or malignancyCervical cancer is one of the most common cancers in United Arab Emirates (UAE) as well as in the world; high-risk human papillomavirus (HR-HPV) infection is found to be the most common cause of cervical cancer. The objective of the study is to evaluate the status of HR-HPV infection among women with Pap smear tests negative for intraepithelial lesions/malignancy (NILM). This cross-sectional study was conducted at the GMC Hospital and Gulf Medical University Histopathology/Cytology and Molecular Biology Laboratories within a period of 6 months from December 2011-May 2012. All pertinent patients' data were obtained from medical records. A total of 50 patients were included in the study. Cytology (PreservCyt) samples were tested for HR-HPV, using the polymerase chain reaction (PCR) based test AMPLICOR HPV. This test is designed to detect 13 HR-HPV type. Data was analyzed using the Statistical Package for Social Sciences (SPSS) software package and was presented mainly as percentages of total sample size. Results: Of the 50 patients, fi ve (10%) were positive for HR-HPV. Only four patients out of the 50 patients (8%) underwent Pap smear test as voluntary routine check-up, while 46 patients (92%) underwent the test because they were symptomatic. Conclusions: We acknowledge the small size of our working sample, but in view of very limited data in the region and due to strong cultural taboos against the topic, we have drawn some high level statistical conclusion and found that a moderately high prevalence of HR-HPV positive patients among women with Pap smear test NILM was detected in UAE, a country where no community based cervical cancer screening program is practiced. The rate of opportunistic/voluntary cervical screening was very low indicating poor or lack of awareness about the importance of Pap smear test as a tool to screen cervical epithelial changes among study population. The results presented in this study may provide valuable data for physicians involved in decision-making regarding the current situation related to cervical screening practice and HPV infection in UAE. Key words: Cervical cancer, HPV, UAEOriginal Article INTRODUCTIONIn spite of the fact that cervical cancer is considered a preventable disease it is one of the most common cancers among women worldwide. In 2008 cervical cancer was the third most common cancer in women worldwide after breast and colorectal cancer, with an estimated 529,000 new cases and 275,000 deaths, of which 88% were in developing countries. In some regions it is the number one cause of cancer-related deaths. [1] In 2005 cervical cancer ranked sixth most common cancer in women in GCC countries, accounting for 3.6% of cancers among females. Age adjusted incidence rate in United Arab Emirates (UAE) reached 7.4 per 100,000 in 2008. [2] Like other cancers which are mainly caused by infectious agents, such as liver cancer and stomach cancer, the disease is...

The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology

“…These patients with normal Pap tests and HR-HPV types must be regularly followed up in accordance with international guidelines. This is because of the fact that women with HR-HPV positivity and negative Pap smear tests for intraepithelial lesions are at a high risk of having serious HPV induced lesions in the future [31]. Delayed follow-up may have jeopardized these patients at risk for serious epithelial changes.…”

“…Briefly HPV genotyping performed by the F-HPV typing™ multiplex PCR (Molgentix SL, Barcelona, Spain). The assay uses 16 specific primers amplifying within E6 and E7 regions of the HPV genome and permits the detection of 13 high risk genotypes (16,18,31,33,35,39,45, 51, 52, 56, 58, 59 and 68) and two low-risk genotypes (6 and 11). The presence of DNA of these HPV subtypes were detected by multiplex PCR amplification using type specific primers [14,15].…”

“…Although genital HPV types have been subdivided into high-risk (HR-HPV) types (frequently associated with invasive CC) and low-risk (LR-HPV) types (found mainly in genital warts), there is still no consensus on categorization of many HPV subtypes with low prevalence according to CC risk. Current epidemiologic data identifies 15 HPV types as high-risk types (16,18,31,33,35,39,45, 51, 52, 56, 58, 59, 68, 73, and 82) and 12 types (6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108) as low-risk types [9]. Moreover, infection with two specific high-risk HPVs (HPV-16 and HPV-18) is reported to be linked with 90% of all uterine cervical cancers, and more than half of other anogenital tumors, and a small percentage of head and neck tumors [10].…”

Improving the performance of reflex Human Papilloma Virus (HPV) testing in triaging women with atypical squamous cells of undetermined significance (ASCUS): A restrospective study in a tertiary hospital in United Arab Emirates (UAE)

“…The early age of marriage [34] and the high fecundity index in UAE (estimated to be 2.37 children/women in 2013) [35], with the subsequent modulation of the immune response to HPV might be contributing factors to these figures [36]. It is important to stratify the age patterns in relation to prevalence of HPV to help create the proper preventive screening protocols relevant to the community [22].…”

Knowledge and attitude towards cervical cancer among reproductive age group women in Gondar town, North West Ethiopia

“…A very low rate of cervical cancer screening tests is reported across literatures in low and middle-income countries [15,[19][20][21][22]. A study on health-seeking behavior of patients with cervical cancer in Ethiopia also revealed that women had a very low awareness of cervical cancer and they mostly prefer traditional remedies as a treatment option for the early stages of the disease.…”