The prevalence of HR-HPV DNA in ASC-US Pap smears: A military population study.
OBJECTIVE
To determine the prevalence of HR-HPV DNA in ASC-US Pap smears following implementation of the Bethesda 2001 classification system.


METHODS
A computer database of Pap smears obtained within Department of the Army medical facilities was queried for the study period August 2002 to June 2004. All ASC-US Pap smears that underwent reflex testing for HR-HPV DNA were included. Additional clinical and demographic data were obtained from facilities within the US northeast region to evaluate the differences in ASC-US and SIL rates between the current and former Bethesda classification systems.


RESULTS
550,000 Pap smears were collected during the study period. The HR-HPV prevalence was 40.8% (95% confidence interval [CI] = 40.3 to 41.3) among 40,870 patients with ASC-US Pap smears. Within the northeast region, the HR-HPV prevalence in ASC-US Pap smears decreased from 61.2% (95% CI = 57.4 to 64.8%) in patients 18-22 years old to 24.9% (95% CI = 23.1 to 26.8%) in patients age 29 and older. When comparing the two classification systems, significant increases in both ASC-H and SIL and decreases in ASC-US were appreciated after the institution of Bethesda system 2001.


CONCLUSIONS
In our large, diverse cohort, the implementation of the Bethesda II system has resulted in a decrease in ASC-US Pap smear results. Additionally, the prevalence of HR-HPV in the ASC-US population was 40.8%, significantly lower than the rate noted in the ALTS trial under the Bethesda I classification system.
Stany
Michael P
MP
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Building 2, Walter Reed Army Medical Center, 6900 Georgia Ave., NW, Washington, DC 20307, USA.
Bidus
Michael A
MA
Reed
Elizabeth J
EJ
Kaplan
Keith J
KJ
McHale
Michael T
MT
Rose
G Scott
GS
Elkas
John C
JC
D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D008889:Military Personnel; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D002577:Uterine Cervical Diseases / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears
D004279:DNA, Viral