Abstract
Rates of acquisition and clearance of cervical human papillomavirus (HPV) during a 3-year period in women 51 years of age were compared with rates in younger women to provide data on cervical screening for women >50 years of age. Paired, cytologically negative, archived cervical smears taken 3 years apart from 710 women in Nottingham, United Kingdom, were retrieved and tested for HPV infection with polymerase chain reaction (PCR) with GP5+/6+ primers. Seventy-one (21.3%) of 333 women 51 years of age who were HPV negative at baseline were positive 3 years later. This percentage was higher than the corresponding acquisition rates among women 21 (15.2%), 31 (14.1%), and 41 (13.3%) years of age, although these differences were not significant. This retrospective study shows that HPV-negative women >50 years of age can acquire HPV and, therefore, require cervical screening.
Highlights
Rates of acquisition and clearance of cervical human papillomavirus (HPV) during a 3-year period in women 51 years of age were compared with rates in younger women to provide data on cervical screening for women >50 years of age
Our study found a high 3-year rate of HPV acquisition rate in women 51 years of age at baseline
Differences in HPV acquisition with age were not statistically significant, this rate was at least as high as that observed among younger women
Summary
Rates of acquisition and clearance of cervical human papillomavirus (HPV) during a 3-year period in women 51 years of age were compared with rates in younger women to provide data on cervical screening for women >50 years of age. In studies from Brazil and Colombia, an incidence of high-risk (carcinogenic) HPV of ≈5% per year was observed among women >35 years of age [7,8]; recent data from Costa Rica showed that the rate of high-risk HPV acquisition during a 5-year interval decreased slightly with increasing age [9] All these studies were conducted in areas where the risk of cervical cancer is considered to be high. A mathematic modeling study based on the UK screening population estimated that not providing screening for HPV-negative women at age 50 would save as much as 25% of resources for smear tests and 18% for colposcopies; the savings would be accompanied by an increase in the incidence of invasive cancers of ≈2/100,000 women annually [15] These estimates would be more accurate if the risk of acquiring high-risk HPV infection at these ages was known. This approach allowed us to estimate rates of HPV persistence and clearance during the same 3-year interval for women whose baseline smears were HPV positive
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