ABSTRACT
OBJECTIVE: Persistence of human papillomavirus (HPV) is associated with an increased risk of developing cervical SIL and cancer in young women. Because this association in older, postmenopausal age women has received little attention, we evaluated persistence of HPV among women in this age group. METHODS: Women (n=105) ages 45-64 were examined annually for 7 years to evaluate HPV in cervical cytologic specimens. PCR, dot blot hybridization and DNA sequencing were used to detect HPV types. RESULTS: The cumulative prevalence of HPV was 34%, and 24% had HPV high-risk oncogenic types which are associated with genital cancers. The most common oncogenic types were HPV-16 (72%) and HPV-31 (16%). The persistence rate of HPV infection was 16%. No specific risk factors were associated with repeat viral positivity. CONCLUSION: Postmenopausal women are infected with persistent oncogenic HPV at a substantial rate, supporting the need for continued screening in postmenopausal women to detect preneoplastic genital lesions.
Subject(s)
Papillomaviridae/isolation & purification , Papillomavirus Infections/epidemiology , Tumor Virus Infections/epidemiology , Age Factors , Aged , DNA, Viral/analysis , Estrogen Replacement Therapy , Female , Humans , Iowa/epidemiology , Middle Aged , Papillomaviridae/genetics , Papillomavirus Infections/pathology , Papillomavirus Infections/prevention & control , Papillomavirus Infections/virology , Polymerase Chain Reaction , Postmenopause , Prevalence , Randomized Controlled Trials as Topic , Risk Factors , Tumor Virus Infections/pathology , Tumor Virus Infections/prevention & control , Tumor Virus Infections/virology , Vaginal Smears/statistics & numerical dataABSTRACT
Two hundred twelve women with histories of spontaneous second-trimester abortions or early preterm births (less than 34 weeks) were evaluated with hysterography in the nonpregnant state. The canal:cannula (C:CN) ratio, a representation of the width of the upper cervical canal, was related to the clinical characterization of the early delivery. Narrow canals were associated with bleeding or premature rupture of the membranes (PROM) preceding preterm labor. Wide canals were found in association with the clinical diagnosis of cervical incompetence. Those patients in whom preterm labor occurred in the absence of preceding bleeding or PROM had intermediate values. The results of two tests of cervical compliance, Hegar dilator passage and catheter balloon traction, were concordant and varied with the C:CN ratio.
