Prevalence Of Abnormal Cervical Cytology Research Articles

Human Papillomavirus Infection and Cervical Dysplasia in a Subset of Arab American Women.

Background: With limited health data on Arab Americans (AAs), we sought to describe the health-seeking behaviors, prevalence of abnormal cervical cytology and high-risk human papillomavirus (HPV) serotypes, and the relationship with socioeconomic factors among a subset of AA women.Methods: Retrospective observational cohort study of women undergoing routine cancer screening at the Arab-American Center for Economic and Social Services clinic. Data collected included demographics, tobacco use, gross monthly income, prior Papanicolaou (Pap) smear history, and results of cervical cytology and high-risk HPV testing.Results: Of 430 women, 74 (17%) reported that they had never had a Pap smear. Three hundred eighty-eight (90%) women had cervical cytology interpreted as “negative for intraepithelial lesion,” the remaining 42 (10%) women had abnormal results. Thirteen (3%) women reported prior abnormal Pap smear, which was significantly associated with additional abnormal Pap smear on multivariable analyses (odds ratio 65.46; 95% confidence interval [CI] 17.01–338.62; p < 0.001). One hundred twenty-five (29%) women were tested for high-risk HPV serotypes; 106 (91%) had negative results, 4 (3%) were positive for HPV-16, 7 (6%) were positive for other high-risk serotypes, and 8 results were not recorded. A negative HPV screen was significantly associated with a negative Pap smear (Fisher's exact test p = 0.006). There was no significant association between abnormal cervical cytology and evaluated socioeconomic factors.Conclusions: Additional population based-studies to determine cervical dysplasia/cancer and HPV prevalence in women of Middle Eastern descent are needed.

“PREVALENCE OF ABNORMAL CERVICAL CYTOLOGY IN ANTENATAL WOMEN BY LIQUID BASED CYTOLOGY IN A TERTIARY CARE HOSPITAL IN NORTH INDIA”

Background: This study aimed to know the prevalence of abnormal cervical cytology in pregnant women by liquid-based cytology (LBC). Materials and Methods : Cross sectional study done at a tertiary care hospital in between August 2017 to January 2019.Six hundred pregnant women attending the OPD at their rst visit were enrolled and after taking consent, history and clinical examination , subjected to cervical cancer screening by LBC. Result: Out of 600 samples, 10 samples (1.67%) were unsatisfactory for evaluation due to low cellularity. Among 590 samples, only 2 reported as LSIL(Low grade squamous intraepithelial lesion) and 588 reported as NILM (Negative for intraepithelial lesion or malignancy). Inammation of varying degree, mild, moderate and dense was reported in 58.65%, 24.92% and 16.44% respectively. Infection was reported in 3.73% and Candida. Discussion: prevalence of abnormal cervical cytology among pregnant women in region was low but screening for cancer cervix should be done for all pregnant women, adverse pregnancy outcomes like premature rupture of membranes, preterm birth and low birth weight.

Current status of cervical cytology during pregnancy in Japan

In Japan, uterine cancer screening during pregnancy is subsidized by public funds. We examined the current status of the results of cervical cytology conducted during pregnancy in Japan. We requested 2,293 obstetrical facilities to provide information on cervical cytology in pregnant women who delivered between October 2018 and March 2019. A total of 1,292 obstetrical facilities responded, with valid information on a total of 238,743 women. The implementation rate of cervical cytology during pregnancy was 86.8% in Japan. The prevalence of abnormal cervical cytology during pregnancy was 3.3% in total and 4.9% using a spatula/brush with liquid-based cytology (LBC). The prevalence of positive high-risk human papillomavirus (HPV) in teenagers with atypical squamous cells of undetermined significance (ASC-US) was significantly higher than women of other ages (p < 0.01). Because HPV vaccine coverage has dropped to less than 1% in Japan, a further study with various conditions will be needed to improve the accuracy of cervical cancer screening during pregnancy.

Study of Prevalence of Abnormal Cervical Cytology in Al-Shatby Maternity University Hospital

Introduction: Cervical cancer is the most common cause of preventable cancer related deaths; cervical cancer has a long pervasive phase (cervical dysplasia); the prevalence of cervical dysplasia varies according to the socioeconomic characteristics and geographic areas of the population studied. Low-grade lesions regress spontaneously in a significant number of patients, while high grade lesions will progress to an invasive cancer if left untreated. Cervical cancer screening is an important component of the World Health Organization (WHO) strategy for combating cervical cancer. The incidence and prevalence of cervical cancer has reduced remarkably over the last three decades in developed countries where there are effective, well-coordinated screening programs, and treatment of cervical dysplasia, while in developing countries it has been increasing and has constituted major health problems among women where there are no well-coordinated and effective screening programs, also resources are very low and no insurance can cover this programs. Aim of the work: The aim is to assess the prevalence of abnormal cervical cytology in Al Shatby Maternity University Hospital patients using Pap smear. Materials and methods: Inclusion criteria: 1) Married woman from 3 years or more; 2) Women age from 21 to age 65 years. Exclusion criteria: 1) Previously known cervical cancer patient; 2) Virgin females; 3) Woman with active vaginal bleeding. Results: 83% of patients were -ve intraepithelial neoplasia {37.7% was normal cytology and 45.3% was inflammatory}. 17% was +ve intraepithelial neoplasia (abnormal cytology), {11.1% ASCUS, 2.9% LSIL, 1.3% HSIL, 1.1% ASC-H, 0.3% AGS-NO, 0.3% AGS-Favour Neoplastic}. Prevalence of abnormal cervical cytology in age group less than30 years was 8.4% which is lower than prevalence in the middle age group which was 19.9%. Prevalence of abnormal cervical cytology in women with normal vaginal delivery was higher than those with caesarean delivery. 39.8% of our patients were passive and active smokers 61.2% of their Pap smear was abnormal cytology. 78.9% of abnormal cytology was among patients from low socioeconomic class (rural areas). Abnormal cervical cytology in patients with high parity was 69% which is higher than abnormality found in lower parity. 60.2% of abnormal cervical cytology was in patients who became sexually active before age of 20 years. Prevalence of abnormal cervical cytology was higher in patients with multiple sexual partners (56.5%) than patients with single sexual partner (13.3%). Conclusion: Cervical cytology remains the gold standard for cervical cancer screening and the use of Bethesda system is a simple and accurate method for diagnosis and management of cases with abnormal cervical cytology.

Abnormal cervical cytology amongst women infected with human immunodeficiency virus in Limpopo province, South Africa.

BackgroundCervical cancer remains the major public problem worldwide and the most common gynaecological malignancy in the developing world, particularly in sub-Saharan Africa.AimTo determine the prevalence of abnormal cervical cytology amongst women with and without human immunodeficiency virus (HIV) and examine the association between HIV and histological grading.SettingThe study was conducted in Limpopo province, which is the northernmost province of South Africa. The province has five district municipalities with one tertiary, five regional and thirty four district hospitals.MethodsWe retrospectively reviewed cervical cancer cases in Limpopo province (LP) of South Africa, using data collected routinely by the National Health Laboratory Services (NHLS). The data on smears submitted for cytology between 2013 and 2015 were extracted from the Central Data Warehouse (CDW) database.ResultsA total of 84 466 women were screened for cervical cytology smears. Their mean age was 39.8 ± 13.6 years, with range from 15 to 113 years; 77.2% were in the age group 30 years and older and 19.6% had an abnormal cervical cytology result. Overall, 46.4% of the women screened for cervical cancer were HIV infected. A significantly higher proportion of HIV-positive women had abnormal cytology than HIV-negative women (31.8% vs. 9.2%).ConclusionThe prevalence of abnormal cytology amongst HIV-positive women is relatively high, and the risk appears to be significantly greater in all age groups. This finding highlights the need to ascertain HIV status of all women presenting with cervical cancer.

Post coital bleeding is a risk for cervical cell abnormality

Postcoital bleeding is a worrying, for both women and health care provider. This study aimed to evaluate the prevalence of abnormal cervical cytology among patient with PCB in the private outpatient care setting, and to identify risk-factors for cervical pathology among these patients. A cross sectional study of 90 patients presented to the privet clinic, during the period 1st feb-1st Des. 2019. Inclusion criteria include married women presented with post coital bleeding, non-pregnant, all patients undergo Pap Smear Cytology. The commonest age presented with PCB was 40-44 years old 22(24.4%), followed by (45-49) years and (25-29) years 18(20%). Those aged ≥40 years 44(48.9%), and those aged ≤34 34(37.8%). The mean parity was 4.7±2.8, hormonal contraception was commonly used by those with PCB followed by intra uterine contraceptive device (IUCD), 30(33.3%), 18(20) respectively. Most of the patient were House wives 78(86.7%), The physical examination show that most patient had cervical erosion 68(75.5%), followed by healthy cervix in 12(13.3%), while suspicious features was found among 6(6.7%), Moderate and sever dysplasia was found more among those aged ≥40 years 10(22.7%), while it was 4(8.7%) among those aged &lt; 40 years. there is higher prevalence of High-grade squamous intraepithelial lesions among females with PCB, and non- significant difference among those aged less or more than 40 years. Therefore it’s important to examine any patient complaining of PCB with PAP smear cytology and colposcopy examination.

426. Prevalence of Human Papilloma Virus, Anal, and Cervical Dysplasia in Transgender Persons: A Systematic Review of the Literature

BackgroundHuman papilloma virus (HPV) is the most common sexually transmitted infection (STI) in the United States (US) and is associated with the development of cervical and anal dysplasia; however, little is known about the epidemiology of HPV in transgender persons. The objective of this study was to conduct a systematic review of the literature to evaluate the existing epidemiologic data on HPV infection prevalence as well as anal and cervical dysplasia in transgender persons.MethodsThe PubMed and Scopus databases were queried using the keyword “transgender” in combination with one of the following: PAP, cervical cancer, anogenital warts. The search generated 86 articles, when accounting for duplicates across searches. We included original research articles published from January 1969 to March 2019. Excluded were non-English articles, studies that did not have HPV or cytology testing data, and studies that did not have disaggregated transgender data.ResultsIn total, 13 articles were included in the review, of which 9 focused on transgender women (TW), 3 on transgender men (TM), and 1 on both TW and TM. HPV DNA testing was performed in 10 studies, with 7 of those offering prevalence data for specific HPV genotypes. Overall, HPV prevalence in TW ranged from 15%-97.4%, with High Risk-HPV (HR-HPV) prevalence ranging from 13%-82.5%. Anal cytology data for TW was presented in 2 studies, both of which cited a 42% prevalence of abnormal cytology. Cervical or vaginal cytology was evaluated in 4 articles, 3 of which involved TM and 1 of which involved TW with neovaginas. Among TM, the prevalence of abnormal cervical cytology ranged from 6%-42%.ConclusionOur review highlights the lack of HPV research and the high variability of the existing data about the transgender population. Further study is needed to better understand not only the epidemiology of HPV and resultant dysplastic sequelae, but also to inform the development of transgender sensitive diagnostic methods for this infection. The diverse genital anatomy represented in the transgender community as well as the gender dysphoria these patient’s experience during testing pose myriad diagnostic challenges that will need to be considered in the development of screening and diagnostic practices.Disclosures All authors: No reported disclosures.

The Trend of Abnormal Cervical Cytology Among Iranian Women During Recent Years from 2013 to 2016

BackgroundCervical cancer is one of the common cancers in developing countries, which has a high rate of mortality. This study aimed to evaluate the prevalence of abnormal cervical cytology among Iranian women.MethodsIn this cross-sectional study, cervical cytological results of 137,484 Iranian women, who were screened for cervical cancer in Tehran and 12 other provinces of Iran from 2013 to 2016, were investigated. The Pap smear was prepared by a liquid-based method and evaluated by a pathologist.ResultsThe overall prevalence of abnormal cervical cytology in the studied population was 3%. The mean age of the population was 35.77 ± 9.6. In this study, the prevalence of abnormal cytology in 2013, 2014, 2015, and 2016 was 2.10%, 2.68%, 3.47%, and 3.60%, respectively. The rate of the abnormal Pap smear has increased over the years, and this trend has been statistically significant (P<0.001). In this population, atypical squamous cells of undetermined significance (ASCUS) cytology was the most common abnormal Pap smear (1.96%).ConclusionIn this study, the prevalence of abnormal cervical cytology has been significantly increased in Iran in recent years. This increase requires careful monitoring of general education programs, strict cervical cancer screening, and routine vaccination against HPV infection.

A Descriptive Review of the Community-Based Cervical Cancer Screening Programme at the Singapore Cancer Society

Background: Cervical cancer is the fourth common malignancy in women worldwide and clinical Papanicolaou (Pap) smear test is a relatively inexpensive yet efficacious screening method for the detection of precancerous or cancerous lesions. Aim: Herein, we sought to quantify the incidence and prevalence of abnormal cervical cytology in asymptomatic women who underwent routine Papanicolaou test screening at the community-based clinical setting of our Singapore Cancer Society's Multi-Service Centre. Methods: This retrospective study reviewed a total of 15,195 reports of cervical Pap smears performed from January 2015 to December 2017 to delineate epithelial abnormalities. Additionally, a descriptive cross-sectional analysis was carried out on the corroborative demographic and clinical data retrieved from the relevant case notes. Results: The mean age of women recruited for screening in this period was 49.0 ± 11.1 years. A total of 623 (4.1%) were identified with abnormal Papanicolaou test results viz., i. atypical squamous/glandular cells of undetermined significance (n=592; 3.9%), ii. low/high grade squamous intraepithelial lesions (n=28; 0.18%) and iii. high grade squamous intraepithelial lesion, suspicious of squamous cell carcinoma/adenocarcinoma (n=3; 0.02%). Clinical history in the latter two cohorts (n=31; 0.2%) revealed first sexual encounter at age ≤ 20 years (54.8%), ≥ 2 sexual partners (38.7%) or abnormal vaginal discharge (29.0%). An 80.6% and 6.5% had undergone Papanicolaou test or HPV - human papillomavirus - vaccination in the past. History of smoking, long-term contraceptive use and treatment of STI(s) were reported by 22.6%, 3.2% and 6.5% respectively. Conclusion: Cervical cancer originates in the transformation zone of the uterine cervix and screening for abnormal cytology is the cornerstone in early detection. The low percentage of epithelial cell abnormality identified in this large population sampling over three years confirms that routine Papanicolaou test testing would suffice as a cost-effective screening approach to detect precancerous cervical lesions. Where imperative, necessary follow-up on unsatisfactory Papanicolaou test result(s), HPV genotyping and/or due referral procedures would significantly aid in reducing the cervical cancer burden for women in the susceptible age range.

Religious Gathering as a Tool for Collaborative Cervical Cancer Prevention: Report From Nigeria

Background and context: Cervical cancer is the second most common cancer and a leading cause of mortality affecting Nigerian women. There is prevalent ignorance about the disease and reduced access to screening services in Nigeria due to a variety of reasons. Many religious leaders often view cancer as evil, thus perpetuating a culture of fear and denial. Religious events have been used to promote health awareness and access to preventive services in Nigeria, but not usually for cancer screening. A cancer survivor might use a religious event to provide a strong avenue for improving cancer awareness and access to screening. Aim: Report describes a successful collaborative integration of cervical cancer screening into a religious event led by a breast cancer survivor. Strategy/Tactics: The 2018 Annual Women's Gospel Forum at Susanna Homes was used by a cancer survivor to teach women about cervical cancer and early diagnosis. Information was circulated among the Church of Christ fellowship in southern Nigeria. Program/Policy process: A medical team (gynecologist and pathologist) provided free cancer screening to consenting women using Papanicolaou test VIA simultaneously, with Pap preceding VIA. All smears were handled according to standard protocol and the findings were classified using the Bethesda system for reporting Papanicolaou test. Participants were taught about cervical cancer, counseled on screening and follow-up care prior to consent. Data were analyzed using descriptive statistics. Outcomes: Seventy-nine women at the event consented to the screening. The average participant was aged 51 years, but 90.6% (58/64) were above 30 years. Most (92.4%; 73/79) women were negative for squamous intraepithelial lesions (SILs), and six women had a low grade squamous intraepithelial lesion (LSIL). The prevalence of abnormal cervical cytology in this outreach was 7.6% (6/79), and mostly affected women aged 61-60 years. Table 1 describes the Papanicolaou test results. The result of VIA was recorded as positive or negative. What was learned: Participants provided positive feedback regarding integrating cervical cancer screening into a religious event, as it improved access and addressed ignorance. Leadership by a cancer survivor helped demystify the disease and encouraged women to be screened. Having a pathologist on site improved slides quality and reporting turn-around time. Project shows that collaboration between clinicians and religious leaders can improve cancer prevention. More physicians should be trained to provide these services and collaborate with community/religious organizations to provide screening outside of the clinical setting.[Table: see text]

Cervical Cancer Detection between Conventional and Liquid Based Cervical Cytology: a 6-Year Experience in Northern Bangkok Thailand

Objectives:To determine the prevalence of abnormal Papanicolaou (Pap) smear, cervical intraepithelial neoplasia (CIN) 2 or higher and cancer between conventional Pap smear (CPP) and liquid based Pap smear (LBP).Methods:This retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2011 and December 2016. Data was collected from medical records of participants who attended for cervical cancer screening test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for detecting CIN 2 or higher were evaluated by using the most severity of histopathology reports.Results:A total of 28,564 cases were recruited. Prevalence of abnormal Pap smear from CPP and LBP were 4.8 % (1,092/22,552) and 5.7 % (345/6,012), respectively. Percentage of unsatisfactory smears in CPP (52.3%) was higher than LBP (40.5%). From CPP and LBP, cervical cancer percentages were 0.2 and 0.1, respectively. Sensitivity, specificity, PPV, NPV and accuracy of CPP and LBP for detection cancer were 42.5 vs 26.1%, 99.9 vs 100.0%, 69.8vs 75.0%, 99.7 vs 100.0 % and 99.7 vs 99.7%, respectively.Conclusion:Prevalence of abnormal cervical cytology and cancer from CPP and LBP were 4.8/0.2 and 5.7/0.1 percent, respectively. Unsatisfactory smear of LBP was less than CPP. Sensitivity, specificity, PPV, NPV and accuracy of CPP and LBP for detection CIN 2 or higher and cancer were comparable.

Prevalence of Cervical Intraepithelial Lesion in Relation to HIV Status in Uyo Akwa Ibom State, Nigeria

Aim: The interaction between HPV and HIV infections is important in the development of cervical cancer especially where HIV prevalence is high and HPV vaccine coverage is low. This study was carried out to determine the prevalence of cervical intraepithelial lesions in relation to HIV status among women in Uyo, Akwa Ibom State. Methodology: A total of 235 HIV negative women (HNW) and 231 HIV positive women(HPW) between the ages of 18-60 years were recruited and screened using conventional Pap smear in the cytology clinic of University of Uyo Teaching Hospital. The results were classified according to the 2001 Bethesda System of classification. Result: Majority of the study participants were between the ages of 25 years and 36 years . 95.1% of the HNW and 89.3% of the HPW were negative for Squamous Intraepithelial Lesions (SILs). The prevalence of abnormal cervical cytology was more than two times higher in the cases than in the controls (10.6% vs 4.9%, p<0.05). The frequency for all categories of SILs was higher in the HPW. Conclusion: This result supports the inclusion of cervical cancer screening in the routine care of women living with HIV/AIDS in this region.

Prevalence of Abnormal Pap Smear in Women Undergoing Liver Transplantation [15E

INTRODUCTION: Female patients being evaluated for liver transplantation (LT) routinely undergo a gynecologic exam including cervical cancer screening. The prevalence of cervical cytologic abnormalities in this high risk population is unknown. Our study determines prevalence of cervical cytologic abnormalities, HPV positive status, and risk factors for abnormal cervical screening for this population. METHODS: With Institutional review board approval, we reviewed 375 charts of women undergoing evaluation for LT from 2008‒2013 at Mayo Clinic Florida. We recorded demographics, Pap smear results, High risk HPV positive results, and co-morbid conditions. Univariate analysis was done to determine risk factors. We compared the result of the LT group to the general female population getting cervical cancer screening during the same time period. RESULTS: 37 of 375 (9.86%) LT patients had abnormal Pap smear, compared to 1784 of 26118 (6.83%) of the general population patients (p &lt; 0.01). Among LT patients with cervical cytologic abnormalities, 40.5% were ASCUS, HPV positive (64.8% for non-LT patients), 29.7% were LSIL (28.1% for non-LT patients), 5.4% were HSIL (6.7% for non-LT patients) and 24.3% were cytology negative with HPV positive (0.2% for non-LT patients, p &lt; 0.05). Younger age and presence of hypertension were associated with higher risk of having an abnormal cervical cytology or positive HPV status among LT patients. CONCLUSION: Patients undergoing evaluation for LT have increased prevalence of abnormal cervical cytology, or a positive High risk HPV test. Gynecologic surveillance for this high risk population is recommended.

Introduction of liquid‐based cytology and human papillomavirus testing in cervical cancer screening in Luxembourg

In 2014, liquid-based cytology with HPV triage replaced conventional cytology. The aim of our study was to compare conventional and liquid-based cytology (LBC), estimate the prevalence of abnormal cervical cytology and high risk HPV (hrHPV) infection and their correlation, among screened women in Luxembourg. Between the first January 2013 and 31st December 2015, 315,868 cervical samples from 150,815 women (mean age 42.2years) were investigated by the national cytology laboratory. Slides were prepared and screened according to European Guidelines. All cytological results were classified according to the Bethesda 2001 system terminology. The prevalence of abnormal cervical lesions was as follows: atypical squamous cells of undetermined significance (ASC-US), 1.3%; low-grade squamous intraepithelial lesion (LSIL), 1.9%; high-grade squamous intraepithelial lesion (HSIL), 0.4%. The detection rate of cytological lesions was significantly higher with LBC than with conventional cytology. Based on 11,838 samples with concomitant cytology and HPV testing, hrHPV was detected in 9.5, 45.3, 70.0, and 92.6% of women with negative cytology, ASC-US, LSIL, and HSIL, respectively. More cervical lesions were identified using LBC compared to conventional cytology. HrHPV infection was correlated with the severity of intraepithelial lesions. The current findings provide important information to evaluate the prevention of cervical cancer in Luxembourg and for monitoring the future impact of HPV vaccination. Diagn. Cytopathol. 2017;45:384-390. © 2017 Wiley Periodicals, Inc.

Prevalence of abnormal cervical cytology and its relation with age and parity

This screening study was carried out in Gynae Unit II, Sir Ganga Ram Hospital, Lahore. The aim of study was to find out prevalence of abnormal pap smears and its correlation to age &amp; parity so that we can formulate a policy to screen at risk population with Utilization of minimum resources in our setup. Role of Pap smear in detection of cervical pre-malignant &amp; malignant lesions can not be over emphasized. The Cervical smears of 310 women have been evaluated. The frequency of mild to severe cervical intraepithelial neoplasia was found to be 8% while smear positive for malignant cells was in 0.9% of cases. This study reveals 41-60 years of age and Para three and above a high risk group for Cervical Intraepithelial Neoplasia (CIN) and cytology positive for malignant cells. In view of the expenditure involved and technical constraints in mass screening, an approach of selective screening of high risk population could be an effective strategy for control of carcinoma of cervix in developing countries like ours. 524-5+7+F Bushra Zahid-Department of Obstetrics &amp; Gynaecology, Sir Ganga Ram Hospital/Fatima Jinnah Medical College, Lahore Nuzhat Khawaja-Department of Obstetrics &amp; Gynaecology, Sir Ganga Ram Hospital/Fatima Jinnah Medical College, Lahore+np_khawaja@hotmail.com Rakhshanda Tayyeb-Department of Obstetrics &amp; Gynaecology, Sir Ganga Ram Hospital/Fatima Jinnah Medical College, Lahore

Spousal migration and human papillomavirus infection among women in rural western Nepal.

In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal. Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status. In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration. Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age.

Prevalence of Abnormal Cervical Cytology among Postnatal Clinic Attendees at the University of Calabar Teaching Hospital, Nigeria

Background: Carcinoma of the uterine cervix is a deadly disease, but it is preventable. Cervical cytology especially at postnatal visit can lead to its early detection and prompt treatment. Methods: This was a prospective cross sectional study of postnatal women to determine the prevalence of abnormal cervical cytology and their socio-demographic characteristics. Patients were recruited from the antenatal clinic and counseled on the need for postnatal cervical smear. Only those who consented and met the inclusion criteria were followed up in the postnatal clinic. Institutional ethical clearance was also obtained. Researcher administered questionnaire was used to collect the socio-demographic features while Aye’s spatula and endocervical brush were used to collect specimen from the ectocervix and endocervix respectively and smeared on individually labeled glass slides. The samples were treated using the conventional Papanicolaou staining method and reported using the Bethesda system. Researcher-administered questionnaire generated data as well as results of cytology were analyzed using Epi-Info version 3.5.1.0 (CDC Atlanta USA 2008). Colposcopy was done for smear positive patients. Results: There were 100 women screened. Three percent had low grade squamous intraepithelial lesion. There were no abnormal findings from the Colposcopy of the three patients. Ninety-five percent of the women had no prior knowledge of cervical cancer and Pap smear. Two percent of the women had a family history of cervical cancer and both patients died of the disease due to lack of facilities for treatment. Conclusions: Cervical cancer is a preventable disease but women of the sub-region are under-screened. Postnatal Pap smear is a necessary tool in its early diagnosis and treatment.

Abnormal uterine cervical cytology in a large tertiary hospital in Bangkok metropolis: Prevalence, management, and outcomes.

To determine the prevalence of abnormal cervical cytology, management, and association with clinical significant histopathology including cervical intraepithelial neoplasia II or adenocarcinoma in situ and more severe lesions. Women with abnormal cervical cytology from January 2005 to December 2009 were identified from the archives of Department of Anatomical Pathology and Department of Obstetrics and Gynecology. Demographic data, type of abnormal cytology, management, and their associated histopathology were collected. During the study period: 2533/54,179 women (4.7%) had abnormal cervical Pap test. Squamous lesions were more common than glandular lesions: 2309 (4.3%) compared to 224 (0.4%). Atypical squamous cell (ASC) was most commonly found (1449 or 2.7%), whereas low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intra-epithelial lesion (HSIL), or squamous cell carcinoma (SCC) were found in 648 (1.2%) and 212 (0.4%), respectively. Among abnormal glandular cytology, atypical glandular cell (AGC) was most commonly found (199 women or 0.4%) whereas adenocarcinoma and endometrial cell in woman aged >40 year were found in only 14 (0.02%) and 11 women (0.02%), respectively. Majority (77.3%) underwent further investigations. We found that 13.0% of ASC, 20.3% of LSIL, and 78.7% of HSIL and SCC had clinical significant histopathology. In glandular abnormalities: 14.9% of AGC, 33.3% of women aged >40 years with endometrial cell, and 66.7% of adenocarcinoma were histologically proven to be of clinical significant. ASC was the most common abnormal cervical cytology. Cytology abnormalities of HSIL and SCC had the highest association with clinical significant histopathology.

Number of External Anogenital Warts is Associated with the Occurrence of Abnormal Cervical Cytology

Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. A total of 191 women were eligible, with a mean age of 27.0±8.9 years; and a mean body mass index of 20.6±8.9 kg/m2. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ≥ 5 was the only factor associated with LSIL+ (aOR 2.65, 95%CI 1.11-6.29, p 0.027). LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

High-Risk Cervical Human Papillomavirus Infections among Human Immunodeficiency Virus-Positive Women in the Bahamas

BackgroundHigh-risk (HR) HPV genotypes other than 16 and 18 have been detected in a significant proportion of immunocompromised females. We aim to evaluate the frequency of HR HPV genotypes in a population of HIV-positive Caribbean women.MethodsOne hundred sixty-seven consecutive, non-pregnant, HIV-positive females ≥18 years were recruited in this study. Each participant received a vaginal examination, PAP smear, and completed a questionnaire. DNA was extracted for HPV testing in 86 patients.ResultsMean age was 39.1 years for women positive for HR HPV and 43.1 years for women negative for HR HPV (P value = 0.040). 78% (130/167) of the women had HR HPV infections; the prevalence of abnormal cervical cytology was 38% among women who were HR HPV-positive compared to women who were HR HPV-negative (22%). Fifty-one percent of the 86 women with available genotype carried infections with HPV 16 and/or HPV 18; genotypes of unknown risk were also frequently observed. Women who had a CD4+ count of ≤200 had 7 times increased odds of carrying HR HPV infection in comparison to women with CD4+>200.ConclusionsHR HPV infections in HIV infected females may consist of more than just HPV 16 and 18, but also HPV 52 and 58. Further studies are needed to determine whether HPV 52 and 58 play a significant role in the development of cervical cytological abnormalities in HIV+ women.