High prevalence of abnormal cervical smears in a hospital cohort of French women beyond the upper age limit screening program.
OBJECTIVE
To determine the prevalence of cytological abnormalities and high risk Human PapillomaVirus (hrHPV) in cervical smears from French women aged over 65 years who attended the referent Gynecology Clinic of the Besançon University Hospital.


METHODS
Between 2002 and 2012, 796 French women aged 66-99 years were cotested for cytology and hrHPV by Hybrid Capture 2 (hc2). hc2-positive cases were subjected to real time PCR for specific HPV 16/18/45 genotyping. Women with normal Pap smears and positive for hrHPV were followed-up every 12 months.


RESULTS
Cytological abnormalities were detected in more than 30% of women and cervical cancers (CC) in 2.9% of women. Benign lesions were more frequent in women aged 66-75 years while (pre)-malignant lesions were preferentially found in women over 76. The prevalence of hrHPV was 22.7%. HPV 16 was the most frequent (23.8%), followed by HPV 45 (7.7%) and HPV 18 (3.9%). The rate of hrHPV increased with the lesion severity and HPV 16 was identified in 50% of CC. Among the followed-up women, those who developed CIN3 were HPV16 positive at study entry.


CONCLUSIONS
The study provides important estimates of the prevalence of cervical abnormalities and hrHPV positivity in a French hospital based-population over 65. Findings suggest to consider this high risk population in regards to cervical cancer.
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France. Electronic address: alexandra.luquain@orange.fr.
Alexandra
A
Luquain
Laboratoire de Biologie Cellulaire et Génétique Moléculaire, Faculté des Sciences, Université Ibn Zohr, Agadir, Maroc; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France. Electronic address: essaadabelglaiaa@gmail.com.
Essaada
E
Belglaiaa
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France. Electronic address: david.guenat@univ-fcomte.fr.
David
D
Guenat
Université Bourgogne Franche-Comté, F-25000 Besançon, France. Electronic address: sindy.vrecko@edu.univ-fcomte.fr.
Sindy
S
Vrecko
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France. Electronic address: didier.riethmuller@univ-fcomte.fr.
Didier
D
Riethmuller
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France. Electronic address: severine.valmary@univ-fcomte.fr.
Séverine
S
Valmary-Degano
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France. Electronic address: ibedgedjian@chu-besancon.fr.
Isabelle
I
Bedgedjian
Laboratoire de Biologie Cellulaire et Génétique Moléculaire, Faculté des Sciences, Université Ibn Zohr, Agadir, Maroc. Electronic address: s.chouham@uiz.ac.ma.
Said
S
Chouham
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France. Electronic address: jean_luc.pretet@univ-fcomte.fr.
Jean-Luc
JL
Prétet
Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France. Electronic address: christiane.mougin@univ-fcomte.fr.
Christiane
C
Mougin
D000368:Aged; D000369:Aged, 80 and over; D004268:DNA-Binding Proteins; D055088:Early Detection of Cancer; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006760:Hospitalization; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008403:Mass Screening / Q000379:methods; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology
D004268:DNA-Binding Proteins; C556015:PARPBP protein, human
Cervical cancer; HPV 16; Pap smears; Women aged over 65; hrHPV