gms | German Medical Science

Introduction: Cervical cancer (CC) is the second most common cancer among women worldwide. The German Federal Ministry of Health and Social Security recommends CC screening for all women at the age of 20 years on basis of the Papanicolaou (PAP) smear. HPV testing and liquid based cytology (LBC) should not be integrated. A lot of epidemiological studies have demonstrated that HPV infections are a major risk factor for the development of invasive cervical cancer (ICC). At least 14 of the high risk (HR) subtypes are accepted to be oncogenic (F. X. Bosch, 2008). German Society of Gynecology and Obstetrics recommends integrating HPV testing into primary screening for women older than 30 years (AWMF 015/027). Most of the female population will get infected with HPV during their lifetime, but generally the infection is eliminated by the t-cell system. Persistent infections with certain HR HPV types (HPV 16, 18 and 45) seem to demonstrate a higher risk to develop CC (Bulk S, 2006).

Material/Methods: At enrollment two HPV DNA tests were performed. The FDA approved Hybrid ® Capture II test and the 16/18/45 Probe Set test (HC2T, PST; Qiagen, Hilden, Germany). A total of 586 women were recruited (109 women attending for routine cc screening/477 women with well-known cervical lesion and infections (eligibility criteria: hr+)). 31 were excluded due to history of conization or hysterectomy (25), pregnancy (2), age (1), hpv negativity (1) and lost-to follow up (3).

Results: The overall baseline prevalence for HPV 16, 18, 45 infections in the risk group is 65,47%. 13,76% of the control group were HC2T positive, respectively 8,25% were PST positive.

Discussion: Starting CC screening at the age of 30 seems to be difficult as 17 of the 68 histological verified severe cervical lesions arise in women <30 years. 86,36% of HSIL were PST positive and progressed to CIS.