title: Population-based frequency assessment of HPV-induced lesions in patients with borderline Pap tests in the Emilia-Romagna Region: the PATER study.
abstract: BACKGROUND
  The PATER study assessed the frequency of high-risk (HR) and low-risk (LR) human papillomavirus (HPV) in HPV-induced lesions in patients with borderline cytology.
  
  
  METHODS
  This retrospective observational cohort study was designed to evaluate ASCUS patients detected through a local cervical cancer screening programme and referred to the Department of Gynaecology and Obstetrics at the S. Orsola-Malpighi University Hospital in Bologna, in the period between January 2000 and December 2007.
  
  
  RESULTS
  In 1047 patients aged 38.4 ± 9.6 years (range 23-65 years), 34.8% (n = 364) was positive for HR- or LR-HPV DNA. The mean age of women with HPV infection was significantly lower compared with the negative group (36.8 ± 9.4 versus 39.3 ± 9.6 years; p < 0.001). Overall, 357 (34.1%) women had cervical lesions: 279 (26.6%) had CIN1, 18 (1.7%) CIN2, and 60 (5.7%) CIN3+. HR-HPV genotype was detected in 83.3%, and 91.5% of patients with CIN2 and CIN3+ respectively. Among the 124 CIN1 HPV-positive women, 8.9% harboured LR-HPV genotypes, 80.6% HR-HPV and 10.5% a combination of HR- and LR-HPV. HPV-6 and 11 accounted for 19.4% of all HPV-positive CIN1 lesions.
  
  
  CONCLUSIONS
  Our study suggest that: in ASCUS patients over 40 years there is a low risk of positivity for HPV infection; the HPV DNA testing in patients with CIN3+ and a mean age close to 40 years is highly sensitive (98.3%) and acceptably specific (75.5%); the frequency of LR-HPV (alone or in combination with HR) in ASCUS cytology is not negligible. A tetravalent-based HPV vaccination alongside the screening programme would provide considerable clinical, organizational, and economic benefits.
authors.affiliation: Department of Gynaecology and Obstetrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Costa
authors.forename: S
authors.initials: S
authors.lastname: Venturoli
authors.forename: F S
authors.initials: FS
authors.lastname: Mennini
authors.forename: A
authors.initials: A
authors.lastname: Marcellusi
authors.forename: M
authors.initials: M
authors.lastname: Pesaresi
authors.forename: E
authors.initials: E
authors.lastname: Leo
authors.forename: A
authors.initials: A
authors.lastname: Falasca
authors.forename: E
authors.initials: E
authors.lastname: Marra
authors.forename: M
authors.initials: M
authors.lastname: Cricca
authors.forename: D
authors.initials: D
authors.lastname: Santini
authors.forename: M
authors.initials: M
authors.lastname: Zerbini
authors.forename: G
authors.initials: G
authors.lastname: Pelusi
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D015331:Cohort Studies; D005260:Female; D005843:Geography; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006515:Hepatitis B virus / Q000502:physiology; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D011153:Population; D012016:Reference Values; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D014626:Vaginal Smears / Q000592:standards / Q000706:statistics & numerical data*; D055815:Young Adult