Human papillomavirus infection. Frequency and association with cervical neoplasia in a young population.

One million, six hundred thirty-two thousand, eight hundred forty-seven women from two independent populations in the United States received cytologic screening during a two-year period. Condylomatous lesions (human papillomavirus [HPV] infections) were the most frequent cytologic abnormality in women in both the Planned Parenthood and private sector groups (prevalence rates of 18.6 to 19.0 in women between ages 15 to 19). The prevalence rates of mild-to-moderate dysplasia were also similar in both populations, with the highest frequencies being between ages 25 to 29. Severe dysplasia and carcinoma in situ were most frequent between ages 35 to 39. In both populations, women with condylomatous changes coexisting with dysplastic changes were about ten years younger, grade-for-grade of severity of the lesion, than women without evidence of HPV infection. Since HPV infection is believed to represent the soil from which neoplasm develops, both the frequency of condyloma and the occurrence of dysplasia and cancer in young women suggest that women should begin regular screening programs while in their teens or after they become sexually active.