Atypical squamous cells of undetermined significance: human papillomavirus testing in adolescents.
OBJECTIVE
To estimate the age-stratified prevalence of oncogenic human papillomavirus (HPV) infection and to evaluate risk factors for HPV acquisition among women with atypical squamous cells of undetermined significance (ASC-US).


METHODS
This was a chart review of all women with ASC-US smears who underwent oncogenic HPV testing between July 2002 and February 2004. To be eligible, HPV DNA results had to be available. Data extracted from charts included demographic information as well as certain patient characteristics historically associated with HPV acquisition or carriage.


RESULTS
Of 527 eligible women with ASC-US, 357 (68%, 95% confidence interval [CI] 64-72%) tested positive for oncogenic HPV. As compared with women who tested negative, this population was significantly younger and less likely to be married. When stratified by age, 77% of the women aged younger than 20 years were positive for high-risk subtypes, compared with 58% of women aged older than 25 years (P < .01). In the multivariate analysis, young age (relative risk [RR] 1.30, 95% CI 1.14.-1.49), current smoking (RR 1.14, 95% CI 1.03-1.25) and a history of chlamydial infection (RR 1.20, 95% CI 1.09-1.32) were associated with an increased likelihood of HPV infection, while oral contraceptive use (RR 0.86, 95% CI 0.72-1.03) had a marginal protective effect. The protective effect of oral contraceptives was most pronounced among adolescent women (RR 0.57, 95% CI 0.31-1.03).


CONCLUSIONS
Given that the rate of oncogenic HPV infection approached 80% in our population of adolescent women with ASC-US, the usefulness of HPV testing in this age group requires further investigation.


METHODS
II-3.
Boardman
Lori A
LA
Department of Obstetrics and Gynecology, Women and Infants' Hospital of Rhode Island, Brown Medical School, Providence, Rhode Island 02905, USA. lboardman@wihri.org
Stanko
Cara
C
Weitzen
Sherry
S
Sung
C James
CJ
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D004847:Epithelial Cells / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D008499:Medical Records; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012237:Rhode Island / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D014626:Vaginal Smears / Q000706:statistics & numerical data*