High prevalence of human papillomavirus and cervical intraepithelial neoplasia in a young Australian STD population.

Two hundred and forty-five women consecutively attending a large city Sexually Transmitted Diseases (STD) Centre had routine cervical screening performed by both the Pap smear and, in addition, a Cervigram. The aim of this study was to determine the prevalence of HPV infection, CIN and cervical cancer in an STD population. The mean age of this group was 26 years with a range from 16 to 53 years. Colposcopy and biopsy revealed a prevalence for human papillomavirus (HPV) of 41%, and 20.4% for cervical intraepithelial neoplasia (CIN). No cases of cervical cancer were detected. The Pap smear detected HPV-associated change in 18% and CIN in 8.2%, therefore generally underestimating the true prevalence of HPV and CIN. Cervicography was positive in 44% of the total group, indicating either HPV-associated change or CIN. Current screening methods are therefore failing to detect significant amounts of HPV-associated change and CIN.