title: The prevalence of HR-HPV DNA in ASC-US Pap smears: A military population study.
abstract: 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.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Building 2, Walter Reed Army Medical Center, 6900 Georgia Ave., NW, Washington, DC 20307, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Stany
authors.forename: Michael A
authors.initials: MA
authors.lastname: Bidus
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Reed
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Kaplan
authors.forename: Michael T
authors.initials: MT
authors.lastname: McHale
authors.forename: G Scott
authors.initials: GS
authors.lastname: Rose
authors.forename: John C
authors.initials: JC
authors.lastname: Elkas
mesh_terms: 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
chemical_list: D004279:DNA, Viral