Abstract
Human papillomavirus (HPV) is the causative agent of cervical cancer (CC), the second most common cause of cancer deaths in Venezuela. Early detection and prompt treatment of precancerous lesions prevent up to 80% of CC cases. In Venezuela, difficult access to CC screening means that the disease is detected at advanced stages, especially in more vulnerable indigenous populations. The aim of the study was to detect precancerous cervical lesions and HPV infection in 60 women who attended the gynaecology service at the Maniapure Outpatient Clinic in Bolivar State, Venezuela. The study was carried out to detect precancerous cervical lesions using visual inspection with acetic acid (VIA), the Schiller test and conventional cytology (Pap testing). HPV detection and typing were carried out using the polymerase chain reaction. 58.3% of the women in the study belonged to the Eñepa indigenous community and 41.7% were white Creole women. The Schiller test showed irregularities in the staining of the exocervical epithelium in 8.33% of the patients, suggesting HPV infection. VIA was positive for 10.0% of the women. In the cytopathology report, 81.67% tested negative for intraepithelial lesions. The overall frequency of HPV detection was 35.0%. HPV infection was detected in 45.71% of the Eñepa women and 20.0% of the Creole women. 71.43% of the women had a high-risk single HPV infection. The percentage of viral infection was lower in the Creole patients than in the indigenous population; therefore, CC screening programmes in the latter population need to be improved.
Highlights
Cervical cancer (CC) is the second most frequent cause of malignancy and death in women around the world, preceded only by breast cancer [1, 2]
Each patient was screened for precancerous cervical lesions using the tests proposed by WHO: visual inspection with acetic acid (VIA), conventional cytology (Pap testing) and molecular detection of human papillomavirus (HPV)
Of the 60 women who participated in the study, 100% accepted the conditions of informed consent for the detection of precancerous lesions of the cervix, through VIA, the Schiller test, conventional cytology (Pap test) and molecular detection of HPV infection, 58.3% (35/60) belonged to the indigenous community of Eñepa and 41.7% (25/60) were Creole women from the region of Maniapure, Bolivar state
Summary
Cervical cancer (CC) is the second most frequent cause of malignancy and death in women around the world, preceded only by breast cancer [1, 2]. In 2012, the standardized incidence and mortality rates for CC per 100,000 women in Venezuela were 27.35 and 11.80, respectively, making it the second leading cause of cancer deaths among Venezuelan women [4]. The causative agent of CC is human papillomavirus (HPV), the most common sexually transmitted viral infection worldwide [5]. It is estimated that more than 290 million women around the world are infected with this virus. Estimates of HPV prevalence vary from 14% to more than 90%, with developing countries being the hardest hit [3, 5]
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