Abstract
Since the implementation of the cervical cancer screening program in Lithuania in 2004, cervical cancer incidence rates have stabilized during a 4-year period: in 2006 and 2007, 508 and 485 new cases, respectively, were diagnosed. Human papillomavirus (HPV) infection is one of the main risk factors for cervical cancer and development of intraepithelial lesions. However, not only HPV, but also HPV type, is a very important factor for malignant transformation. Cervical intraepithelial lesions with HPV 16 and 18 more frequently progress to cancer. To date, in Lithuania, studies only on HPV prevalence and risk factors have been carried out, and less attention has been paid to the identification of HPV types. The aim of this study was to identify the most common HPV types in women with various cytological lesions. A total of 246 women with various cytological lesions (atypical squamous cells of undetermined significance [ASCUS], low-grade squamous intraepithelial lesion [LSIL], and high-grade squamous intraepithelial lesion [HSIL]) were included into the study. All the women were screened for HPV infections followed by HPV typing for types 6, 11, 16, 18, 31, 33, 45, and 59. Polymerase chain reaction was used. Less than half (45.5%) of women with cytological lesions were infected with HPV. The highest prevalence of HPV was detected in women with HSILs (62.1%) and CIN2 (86.7%). HPV typing revealed that the most frequent type was HPV 16 (64.3%); HPV 18 and HPV 33 accounted for 5.4% and 4.5% of cases, respectively. Based on cytologic diagnosis, HPV 16 was more frequently found in women with HSILs than women with ASCUS (77.8% vs. 50.0%). The prevalence of HPV infection in women with cytological lesions was 45.5%. The highest prevalence of HPV was detected in women with HSILs (cytologic investigation) and CIN2 (histologic investigation). HPV 16 is the most common type in women with various cervical intraepithelial lesions.
Highlights
Morbidity and mortality rates for cervical cancer in Lithuania have been increasing during the last decades and have even exceeded the mean respective European rates
Results of Human papillomavirus (HPV) typing HPV typing showed that the majority (64.3%) of the women were infected with HPV type 16
Even 75 women were infected with this type of virus, and three of them had a double infection, i.e., with HPV types 16/ 18, 16/31, or 16/59
Summary
Morbidity and mortality rates for cervical cancer in Lithuania have been increasing during the last decades and have even exceeded the mean respective European rates. It is noteworthy that the mean morbidity rates for cervical cancer in the European Union countries are 11.9 cases per 100 000 female population [1]. The rise in the morbidity rates for cervical cancer in Lithuania has begun since 1992: in 1998–1999, 17.4 cases were registered per 100 000 women, and in 2004, the figure reached 31.1 cases.After the initiation of the cervical cancer screening program in 2004, the morbidity rates stabilized in 2008, and even decreasing trends were observed. It is noteworthy that in the second half of 2004, at the initiation of the cervical cancer screening program, more cases of precancerous cervical pathologies were diagnosed than before. The prevalence of HPV infection varies across different geographic
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