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HPV prevalence and HPV-related dysplasia in elderly women
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Center for Clinical Research, Dalarna, Uppsala University, Uppsala, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Center for Clinical Research, Dalarna, Uppsala University, Uppsala, Sweden; Clinical Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-7407-9642
2018 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 1, article id e0189300Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: In Sweden, where screening ends at the age of 60, about 30% of the cervical cancer cases occur in women older than 60. The aim of the present study was to investigate the prevalence of HPV and cervical dysplasia in women of 60 years and above.

PATIENTS AND METHODS: From September 2013 until June 2015, 1051 women aged 60-89 years (mean 68 years) were sampled for an HPV test when attending an outpatient gynecology clinic. Women with positive results had a second HPV test and liquid based cytology (LBC), after 3.5 months on average. Those with a positive second HPV test were examined by colposcopy, and biopsy and a sample for LBC was obtained.

RESULTS: The prevalence of HPV was 4.1%, (95%CI 3.0-5.5, n = 43) at the first test, and at the second test 2.6% remained positive (95%CI 1.7-3.8, n = 27). The majority of women positive in both HPV tests, had dysplasia in histology, 81.5% (22/27) (4 CIN 2-0.4%, 18 CIN 1-1.7%). HPV-related dysplasia was found in 2.1%, (95%CI 1.3-3.2, n = 22) of the 1051 women. Four of the 22 women with positive HPV tests also had abnormal cytology, one ASCUS and three CIN 1. No cancer or glandular dysplasia was detected.

CONCLUSION: A significant proportion of elderly women were found to have a persistent cervical HPV infection. Among them there was a high prevalence of CIN diagnosed by histology. The HPV test showed high sensitivity and specificity in detecting CIN in elderly women, while cytology showed extremely low sensitivity.

Place, publisher, year, edition, pages
San Francisco, USA: Public Library of Science , 2018. Vol. 13, no 1, article id e0189300
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:oru:diva-64034DOI: 10.1371/journal.pone.0189300ISI: 000419689600008PubMedID: 29320507Scopus ID: 2-s2.0-85040338884OAI: oai:DiVA.org:oru-64034DiVA, id: diva2:1173589
Note

Funding Agency:

Center for Clinical Research, Dalarna, Sweden  CKFUU-506211

Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2021-06-14Bibliographically approved

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Lindström, Annika K.

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