Cervical Cytology and Human Papillomavirus Testing in Adolescent Women: Implications in Management of a Positive HPV Test.

Marilin Rosa,Amir Mohammadi

doi:10.1155/2014/165690

Abstract

Objectives. Consensus guidelines establish that HPV testing should not be used to manage adolescents with atypical squamous cells of undetermined significance (ASC-US). This study aimed to estimate the impact on follow-up of HPV testing after the first-time ASC-US diagnosis. Methods. From January 2009 to December 2010, all ASC-US diagnoses in adolescents were retrieved. Results. 1950 cervical cytologies were received from this population and 335 cases (17.1%) were reported as ASC-US. A total of 287 cases were included in the study. Cases were divided into control group (no HPV test; 46 cases) and case group (HPV test performed; 241 cases). On follow-up, in the control group, 43.4% patients had cytology, and 56.6% patients had no follow-up. The case group was divided into negative HPV (60 cases) and positive HPV (181 cases). In the negative-HPV group, 41.7% had cytology and 58.3% had no follow-up. In the positive-HPV group, 41% had cytology, 22% underwent colposcopy, and 37% had no follow-up. Patients with positive-HPV results were more likely to have follow-up than patients in the control and negative-HPV groups (63% versus 43.4% versus 41.7%, resp.). Conclusions. HPV infections are common in adolescents. A positive HPV test cannot predict which women will develop carcinoma. Adherence to current guidelines is recommended in this population.

Highlights

Human papillomavirus is one of the most common sexually transmitted infections in young women with prevalence rates as high as 82% in some populations [1]
Cervical cytology screening and HPV testing are not recommended in this population
Albeit screening guidelines published in 2006 established that HPV test should not be used in women under 21 years of age [3]; in our setting routine cervical cytology screening and HPV testing are commonly performed in this population

Summary

Introduction

Human papillomavirus is one of the most common sexually transmitted infections in young women with prevalence rates as high as 82% in some populations [1]. The majority of HPV infections are cleared by the immune system in a period of 2 to 3 years [1]. Persistent infections with oncogenic (high-risk) types have the potential to progress to invasive carcinoma [2]. Cervical cytology screening and HPV testing are not recommended in this population. Albeit screening guidelines published in 2006 established that HPV test should not be used in women under 21 years of age [3]; in our setting routine cervical cytology screening and HPV testing are commonly performed in this population. The aim of this study was to evaluate the frequency of testing and how a positive HPV test result impacted initial clinical management of patients with first time ASC-US diagnosis

Objectives

Methods

Results

Discussion

Conclusion