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. 2018 Jan 10;13(1):e0189300.
doi: 10.1371/journal.pone.0189300. eCollection 2018.

HPV prevalence and HPV-related dysplasia in elderly women

Ruth S Hermansson  1   2 , Matts Olovsson  1 , Emelie Hoxell  3 , Annika K Lindström  1   3   4
Affiliations

HPV prevalence and HPV-related dysplasia in elderly women

Ruth S Hermansson et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Age distribution of women sampled for the analysis of HPV (n = 1051).
Fig 2
Fig 2. Flow chart showing study design and HPV and dysplasia occurrence (n = 1051).
Fig 3
Fig 3. HPV types at first HPV test (n = 43, 3 women had multiple HPV infection).
Fig 4
Fig 4. HPV types at second HPV test compared with the first HPV test (n = 43).
Fig 5
Fig 5. HPV types at first HPV test in women with benign histology vs. dysplasia (n = 43, where 3 women had multiple infection).
See this image and copyright information in PMC

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