BACKGROUND: Millions of women in the United States receive cervical screening in sexually transmitted disease (STD), family planning, and primary care clinical settings. OBJECTIVE: To inform current cervical screening programs. DESIGN: Measurement of abnormal Papanicolaou (Pap) tests and high-risk human papillomavirus (HPV) infection among demographically diverse women who received routine cervical screening from January 2003 to December 2005 in the United States. SETTING: 26 STD, family planning, and primary care clinics in 6 U.S. cities. PATIENTS: 9657 women age 14 to 65 years receiving routine cervical screening. MEASUREMENTS: Pap test results and high-risk HPV prevalence by Hybrid Capture 2 assay (Digene, Gaithersburg, Maryland). RESULTS: Among 9657 patients, overall high-risk HPV prevalence by Hybrid Capture 2 testing was 23% (95% CI, 22% to 24%). Prevalence was highest among women age 14 to 19 years (35% [CI, 32% to 38%]) and lowest among women age 50 to 65 years (6% [CI, 4% to 8%]). Prevalence by clinic type (adjusted for age and city) ranged from 26% (CI, 24% to 29%) in STD clinics to 17% (CI, 16% to 20%) in primary care clinics. Women younger than 30 years of age whose Pap test showed atypical squamous cells of undetermined significance had a high-risk HPV prevalence of 53%; women 30 years of age or older with normal Pap tests had a 9% prevalence. Values did not vary substantially by clinic type. LIMITATION: Hybrid Capture 2 and Pap testing were noncentralized, and consent was required for enrollment. CONCLUSION: High-risk HPV was widespread among women receiving cervical screening in the United States. Many women 30 years of age or older with normal Pap tests would need follow-up if Hybrid Capture 2 testing is added to cytology screening.
BACKGROUND: Millions of women in the United States receive cervical screening in sexually transmitted disease (STD), family planning, and primary care clinical settings. OBJECTIVE: To inform current cervical screening programs. DESIGN: Measurement of abnormal Papanicolaou (Pap) tests and high-risk human papillomavirus (HPV) infection among demographically diverse women who received routine cervical screening from January 2003 to December 2005 in the United States. SETTING: 26 STD, family planning, and primary care clinics in 6 U.S. cities. PATIENTS: 9657 women age 14 to 65 years receiving routine cervical screening. MEASUREMENTS: Pap test results and high-risk HPV prevalence by Hybrid Capture 2 assay (Digene, Gaithersburg, Maryland). RESULTS: Among 9657 patients, overall high-risk HPV prevalence by Hybrid Capture 2 testing was 23% (95% CI, 22% to 24%). Prevalence was highest among women age 14 to 19 years (35% [CI, 32% to 38%]) and lowest among women age 50 to 65 years (6% [CI, 4% to 8%]). Prevalence by clinic type (adjusted for age and city) ranged from 26% (CI, 24% to 29%) in STD clinics to 17% (CI, 16% to 20%) in primary care clinics. Women younger than 30 years of age whose Pap test showed atypical squamous cells of undetermined significance had a high-risk HPV prevalence of 53%; women 30 years of age or older with normal Pap tests had a 9% prevalence. Values did not vary substantially by clinic type. LIMITATION: Hybrid Capture 2 and Pap testing were noncentralized, and consent was required for enrollment. CONCLUSION: High-risk HPV was widespread among women receiving cervical screening in the United States. Many women 30 years of age or older with normal Pap tests would need follow-up if Hybrid Capture 2 testing is added to cytology screening.
Authors: Grace A Alfonsi; S Deblina Datta; Theresa Mickiewicz; Laura A Koutsky; Khalil Ghanem; Michael Hagensee; Peter Kerndt; Katherine Hsu; Hillard Weinstock; Judith C Shlay Journal: Public Health Rep Date: 2011 May-Jun Impact factor: 2.792
Authors: Debbie Saslow; Diane Solomon; Herschel W Lawson; Maureen Killackey; Shalini L Kulasingam; Joanna Cain; Francisco A R Garcia; Ann T Moriarty; Alan G Waxman; David C Wilbur; Nicolas Wentzensen; Levi S Downs; Mark Spitzer; Anna-Barbara Moscicki; Eduardo L Franco; Mark H Stoler; Mark Schiffman; Philip E Castle; Evan R Myers Journal: CA Cancer J Clin Date: 2012-03-14 Impact factor: 508.702
Authors: Beth E Meyerson; M Aaron Sayegh; Alissa Davis; Janet N Arno; Gregory D Zimet; Ann M LeMonte; James A Williams; Lynn Barclay; Barbara Van Der Pol Journal: Am J Public Health Date: 2015-02-17 Impact factor: 9.308
Authors: Keren Lehavot; Jodie G Katon; Emily C Williams; Karin M Nelson; Carolyn M Gardella; Gayle E Reiber; Tracy L Simpson Journal: J Womens Health (Larchmt) Date: 2013-12-13 Impact factor: 2.681
Authors: Elissa Meites; Carol Lin; Elizabeth R Unger; Martin Steinau; Sonya Patel; Lauri E Markowitz; Susan Hariri Journal: Int J Cancer Date: 2013-03-13 Impact factor: 7.396
Authors: Patti E Gravitt; Anne F Rositch; Michelle I Silver; Morgan A Marks; Kathryn Chang; Anne E Burke; Raphael P Viscidi Journal: J Infect Dis Date: 2012-12-12 Impact factor: 5.226
Authors: Keimari Mendez; Josefina Romaguera; Ana P Ortiz; Mariel López; Martin Steinau; Elizabeth R Unger Journal: Int J Gynaecol Obstet Date: 2013-11-01 Impact factor: 3.561