Prevalence of high-risk human papillomavirus in an inner-city population with atypical squamous cells of undetermined significance

Gretchen L. Allen, Merieme M. Klobocista, Shannon Sugarman, Katie Gravel, Deborah Feldman, Peter F. Schnatz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective. To compare the prevalence of high-risk human papillomavirus (HPV) in patients with atypical squamous cells of undetermined significance (ASCUS) cytology in an inner-city clinic and a private office population to determine if HPV screening is useful in either group before colposcopy. Methods. After an institutional review board approval at Hartford Hospital, we reviewed the charts of patients with ASCUS cytology and high-risk HPV DNA who were seen at the Community Health Services, Inc. in Hartford, CT (clinic patients), between January 1, 2000, and July 1, 2004, and at a private practice site in Hartford, CT (private patients), between January 1, 2004, and December 31, 2004. All charts were reviewed for demographic information, history of sexually transmitted diseases, tobacco, alcohol, and other drug use. A power analysis indicated that 32 patients would be needed in each group for a p < .05 with 80% confidence. Results. A total of 257 patient's charts were reviewed: 79 clinic charts and 178 private office charts. Three patients were eliminated due to a lack of HPV testing. High-risk HPV was identified in 94.9% of the clinic patients and 45.5% of the private patients. The populations were statistically different with regard to history of chlamydia (26.6% of clinic patients and 6.2% of private office patients; p < .0001), gonorrhea (11.4% clinic patients and 1.1% of private patients; p = .0005), and trichomonas (7.6% of clinic patients and 0% of private office patients; p = .0007). The prevalence of herpes simplex virus in clinic patients was 2.5%, whereas it was present in 6.2% of private patients (p = .35). Tobacco use was significantly higher in clinic patients (31.6% of clinic patients and 15.2% of private patients; p = .009). Conclusions. In our study, 94.9% of the women in the clinic population with an ASCUS cytology had high-risk HPV compared with a rate of 45.5% in the private patients studied. Because most clinic patients with ASCUS have high-risk HPV, it is reasonable to defer reflex testing for HPV in these high-risk patients and proceed straight to colposcopy.

Original languageEnglish (US)
Pages (from-to)63-65
Number of pages3
JournalJournal of Lower Genital Tract Disease
Volume13
Issue number2
DOIs
StatePublished - Apr 2009
Externally publishedYes

Fingerprint

Population
Atypical Squamous Cells of the Cervix
Cell Biology
Colposcopy
Trichomonas
Community Health Services
Chlamydia
Gonorrhea
Private Practice
Research Ethics Committees
Tobacco Use
Simplexvirus
Sexually Transmitted Diseases
Tobacco
Reflex
Alcohols
Demography
DNA

Keywords

  • Atypical squamous cells of undetermined significance (ASCUS)
  • Cervical cytology
  • Dysplasia
  • Human papillomavirus (HPV)
  • Pap smears

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Prevalence of high-risk human papillomavirus in an inner-city population with atypical squamous cells of undetermined significance. / Allen, Gretchen L.; Klobocista, Merieme M.; Sugarman, Shannon; Gravel, Katie; Feldman, Deborah; Schnatz, Peter F.

In: Journal of Lower Genital Tract Disease, Vol. 13, No. 2, 04.2009, p. 63-65.

Research output: Contribution to journalArticle

Allen, Gretchen L. ; Klobocista, Merieme M. ; Sugarman, Shannon ; Gravel, Katie ; Feldman, Deborah ; Schnatz, Peter F. / Prevalence of high-risk human papillomavirus in an inner-city population with atypical squamous cells of undetermined significance. In: Journal of Lower Genital Tract Disease. 2009 ; Vol. 13, No. 2. pp. 63-65.
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AU - Gravel, Katie

AU - Feldman, Deborah

AU - Schnatz, Peter F.

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N2 - Objective. To compare the prevalence of high-risk human papillomavirus (HPV) in patients with atypical squamous cells of undetermined significance (ASCUS) cytology in an inner-city clinic and a private office population to determine if HPV screening is useful in either group before colposcopy. Methods. After an institutional review board approval at Hartford Hospital, we reviewed the charts of patients with ASCUS cytology and high-risk HPV DNA who were seen at the Community Health Services, Inc. in Hartford, CT (clinic patients), between January 1, 2000, and July 1, 2004, and at a private practice site in Hartford, CT (private patients), between January 1, 2004, and December 31, 2004. All charts were reviewed for demographic information, history of sexually transmitted diseases, tobacco, alcohol, and other drug use. A power analysis indicated that 32 patients would be needed in each group for a p < .05 with 80% confidence. Results. A total of 257 patient's charts were reviewed: 79 clinic charts and 178 private office charts. Three patients were eliminated due to a lack of HPV testing. High-risk HPV was identified in 94.9% of the clinic patients and 45.5% of the private patients. The populations were statistically different with regard to history of chlamydia (26.6% of clinic patients and 6.2% of private office patients; p < .0001), gonorrhea (11.4% clinic patients and 1.1% of private patients; p = .0005), and trichomonas (7.6% of clinic patients and 0% of private office patients; p = .0007). The prevalence of herpes simplex virus in clinic patients was 2.5%, whereas it was present in 6.2% of private patients (p = .35). Tobacco use was significantly higher in clinic patients (31.6% of clinic patients and 15.2% of private patients; p = .009). Conclusions. In our study, 94.9% of the women in the clinic population with an ASCUS cytology had high-risk HPV compared with a rate of 45.5% in the private patients studied. Because most clinic patients with ASCUS have high-risk HPV, it is reasonable to defer reflex testing for HPV in these high-risk patients and proceed straight to colposcopy.

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