Prevalence of cervical high-risk human papillomavirus and cytological abnormalities in elderly Turkish women

Yıl 2022, Cilt: 35 Sayı: 3, 288 - 292, 31.10.2022

Cem Yalcınkaya

https://doi.org/10.5472/marumj.1186851

Öz

Objective: Cervical cancer (CC) screening ends at the age of 65 in Turkey, as in many countries. However, about a quarter of CCs
occurs in women over the age of 65. Persistent high-risk human papillomavirus(HR-HPV) infection is the most important factor
leading to CC. In this study, we aimed to investigate the prevalence of cervical HR-HPV and cytological abnormalities in Turkish
women aged 65 and over.
Patients and Methods: A total of 467 women between the ages of 66-84 who were referred to the gynecology outpatient clinics for any
reason between January 2010 and December 2021 were included in the study. Pap smears (liquid-based) of patients were screened for
HPV DNA typing using the COBAS test system and evaluated cytopathologicaly.
Results: The mean age of women was 72.4 years. The prevalence of HR – HPV was 5.1% (n = 24), HPV-16 and HPV-18 subtypes
constituted 58.4% of all positive cases. The rate of cervical HR-HPV and cytological abnormalities were not statistically different
between age groups. Of the women with a positive HR-HPV test in Pap smear, cytological abnormalities were found to be more
frequent when compared to HR-HPV negatives (95.8%, n=23 vs 4.3%, n=19, p<0.00001).
Conclusion: We demonstrated a strong correlation between HR-HPV positivity and cytological abnormality in the elderly women
population. Age groups were not significantly different regarding the prevalence of HR-HPV and abnormal cytology. We also revealed
that the prevalence of HR-HPV and cytological abnormalities in the elderly population were not high enough to explain the second
peak of cervical cancer seen in older ages. More studies are needed to explain which testing methods should be used in the elderly
patient population.

Anahtar Kelimeler

Cervical high-risk human papillomavirus, Cytological abnormality, Elderly Turkish women

Kaynakça

• de Villiers EM. Cross-roads in the classification of papillomaviruses. Virology 2013;445:2-10. doi: 10.1016/j. virol.2013.04.023.
• Walboomers JM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999;189:12-9. doi: 10.1002/(SICI)1096- 9896(199909)189:1<12 :AID-PATH431>3.0.CO;2-F.
• Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of ıncidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209- 49. doi: 10.3322/caac.21660.
• Açikgöz A, Ergör G. Cervical cancer risk levels in Turkey and compliance to the national cervical cancer screening standard. Asian Pac J Cancer Prev 2011;12:923-7.
• Gultekin M, Karaca MZ, Kucukyildiz I, Dundar S, Keskinkilic B, Turkyilmaz M. Mega Hpv laboratories for cervical cancer control: Challenges and recommendations from a case study of Turkey. Papillomavirus Res 2019;7:118-122. doi: 10.1016/j. pvr.2019.03.002.
• Darlin L, Borgfeldt C, Widen E, Kannisto P. Elderly women above screening age diagnosed with cervical cancer have a worse prognosis. Anticancer Res 2014; 34: 5147–51.
• Beckman N, Waern M, Gustafson D, Skoog I. Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971- 2001. BMJ 2008;337(7662):a279. doi: 10.1136/bmj.a279.
• Hermansson RS, Olovsson M, Hoxell E, Lindström AK. HPV prevalence and HPV-related dysplasia in elderly women. PLoS One 2018;13:e0189300. doi: 10.1371/journal.pone.0189300.
• Meijer CJ, Berkhof J, Castle PE, et al. Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Int J Cancer 2009;124:516-20. doi: 10.1002/ijc.24010.
• Nayar R, Wilbur DC. The Pap Test and Bethesda 2014. “The reports of my demise have been greatly exaggerated.” (after a quotation from Mark Twain). Acta Cytol 2015;59(2):121-32. doi: 10.1159/000381842.
• Petignat P, Faltin D, Goffin F, Billieux MH, Stucki D, Sporri S, et al. Age-related performance of human papillomavirus testing used as an adjunct to cytology for cervical carcinoma screening in a population with a low incidence of cervical carcinoma. Cancer 2005;105:126-32. doi: 10.1002/cncr.21060.
• Ferenczy A, Gelfand MM, Franco E, Mansour N. Human papillomavirus infection in postmenopausal women with and without hormone therapy. Obstet Gynecol 1997;90:7-11. doi: 10.1016/S0029-7844(97)00217-2.
• You W, Li S, Du R, Zheng J, Shen A. Epidemiological study of high-risk human papillomavirus infection in subjects with abnormal cytological findings in cervical cancer screening. Exp Ther Med 2018;15:412-8. doi: 10.3892/etm.2017.5357.
• Andersen B, Christensen BS, Christensen J, Ejersbo D, Heje HN, Jochumsen KM, et al. HPV-prevalence in elderly women in Denmark. Gynecol Oncol 2019;154:118-23. doi: 10.1016/j. ygyno.2019.04.680.
• St-Martin G, Viborg PH, Andersen ABT, et al. Histological outcomes in HPV-screened elderly women in Denmark. PLoS One 2021 11;16:e0246902. doi: 10.1371/journal.pone.0246902.