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Is human papillomavirus associated with cervical neoplasia in the elderly?

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Abstract

There have been no studies in the United States of human papillomavirus (HPV) in elderly women. This paper presents cross-sectional data on HPV and cervical neoplasia among 232 women age 65 or more. HPV deoxyribonucleic acid (DNA) testing was performed using a modified dot-blot hybridization technique. The prevalence of HPV DNA positivity was 3.5% (95% confidence interval (CI) 0.9%, 6.0%). There were six cases of histologic cervical neoplasia. The crude odds ratio for cervical neoplasia among HPV DNA positives was 18.3 (95% CI 2.8, 120.3). The adjusted odds, controlling for age, prior screening history, current sexual activity, and past contraception use, were 12.2 (95% CI 1.2, 122.9). Ever having had a Papanicolaou smear was protective, and there was a trend for the odds of having neoplasia to increase with age. Additional studies with larger samples of elderly women are needed. If confirmed, the results suggest that, independent of past screening, HPV may increase the risk of having cervical neoplasia for elderly women.

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      More than 75% of women older than 65 years have never had a cervical cancer screening.108 High-risk types of human papillomavirus (HPV) are found in 93% to 100% of squamous cell carcinomas of the cervix.109–111 It has been believed that exposure to an oncogenic strain of HPV during the second or third decade of life may gradually progress to invasive cancer over 10 to 15 years.

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    This work was supported in part by National Institute on Aging Academic Award K08 AG00471, National Cancer Institute Grant R03 CA51614-01, Enid Ancell Clinical Studies Award, Memorial Sloan-Kettering Cancer Center, and the Society of Memorial Sloan-Kettering Cancer Center (Dr. Mandelblatt).

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