1. Predictors of Human papillomavirus (HPV) persistence after treatment of high grade cervical lesions; does cervical cytology have any prognostic value in primary HPV screening?
- Author
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Babür Kaleli, Ayhan Atigan, Ilknur Kaleli, Tolga Guler, Elif Avsaroglu, Yeliz Arman Karakaya, and Derya Kilic
- Subjects
0301 basic medicine ,cancer patient ,Pathology ,retrospective study ,Conization ,Uterine Cervical Neoplasms ,loop electrosurgical excision procedure ,Logistic regression ,Persistence (computer science) ,Human papillomavirus type 18 ,0302 clinical medicine ,Human papillomavirus type 58 ,Cytology ,Human papillomavirus type 16 ,Human papillomavirus type 59 ,Human papillomavirus type 56 ,Papillomaviridae ,papillomavirus infection ,Human papillomavirus type 52 ,Human papillomavirus type 51 ,Univariate analysis ,medicine.diagnostic_test ,adult ,colposcopy ,HPV infection ,General Medicine ,Middle Aged ,cohort analysis ,Papanicolaou test ,female genital diseases and pregnancy complications ,persistent virus infection ,aged ,female ,priority journal ,risk factor ,Human papillomavirus type 68 ,030220 oncology & carcinogenesis ,cancer grading ,uterine cervix cytology ,cancer surgery ,Human papillomavirus type 66 ,electrosurgery ,mass screening ,Human papillomavirus ,medicine.medical_specialty ,premenopause ,patient referral ,university hospital ,Cervical intraepithelial neoplasia ,cancer prognosis ,Article ,uterine cervix carcinoma in situ ,Pathology and Forensic Medicine ,Persistence ,Human papillomavirus type 39 ,Wart virus ,03 medical and health sciences ,Human papillomavirus type 35 ,Internal medicine ,medicine ,Humans ,follow up ,Human papillomavirus type 31 ,human ,Pap test ,Human papillomavirus type 33 ,Retrospective Studies ,Vaginal Smears ,nonhuman ,business.industry ,Papillomavirus Infections ,disease association ,Retrospective cohort study ,Uterine Cervical Dysplasia ,medicine.disease ,independent variable ,major clinical study ,predictor variable ,uterine cervix conization ,030104 developmental biology ,age ,Human papillomavirus type 45 ,business ,viral clearance - Abstract
Objective: This study aimed to determine the factors associated with Human Papillomavirus (HPV) persistence in women undergoing cervical excision for pre-invasive lesions, after they have been referred from a primary HPV screening program. Methods: A retrospective study design involving patients who were treated at a Cervical Disease Screening and Treatment Unit, in a university hospital setting. After initial treatment, cervical HPV infection status was analyzed at the sixth month, first year and then subsequently after the second year. Results: Totally, 395 patients who were diagnosed with pre-invasive cervical lesions and who subsequently undergone cervical excision were identified. In the first-year visit after cervical excision, HPV 18 was cleared in almost all (95.8%) cases, followed by HPV 16 (69.9%) and other hrHPV types (65.6%). Available data documented that 88.6% of women reached clearance after the two-year follow-up. Univariate analysis revealed a significantly higher proportion of HPV clearance among women who were younger (p = 0.019), premenopausal (p = 0.002), and who had been found to have a negative cytology result on their initial Pap test (p = 0.018). However, only cervical cytology result remained as the independent predictor of HPV persistence on a multivariate logistic regression (OR 0.43; 95% CI 0.21–0.87; p = 0.019). Conclusions: A low risk of HPV persistence was found among every HPV genotype in women undergoing cervical excision for pre-invasive cervical lesions. Initial cervical cytology result was the only independent predictor of HPV clearance during surveillance, which indicates the prognostic value of Pap test in primary HPV screening. © 2020 Elsevier Inc.
- Published
- 2020
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