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Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1650
Efraim SIEGLER 1, 5, Karin SHARIR 1, Ofer LAVIE 1,3, Pninit SAKED-MISAN 2, Lena MACHULKI 1, Ron AUSLENDER 1, 3, Yakir SEGEV 1, 3
1 Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel; 2 Serology and Virology Laboratory, Carmel Medical Center, Haifa, Israel; 3 Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
BACKGROUND: Human Papilloma Virus (HPV) is classified as biologic carcinogen causing cervical cancer. Our aim was to identify all the HPV types responsible for cervical cancer and pre-cervical cancer in Israel.
METHODS: This study included 226 women, diagnosed with CIN 2-3 and 115 women diagnosed with cervical cancer, and tested for all HPV typing during the period of January 2006 to May 2013.
RESULTS: HPV was detected in 92.9% of women with CIN 2-3 and HPV–HR was detected in 85.8% of them. In women with cervical cancer HPV was positive in 96.5%, HPV–HR detected in 93%. In the CIN 2-3 group the most common HPV types were 16 (42%), 31 (8.8%) and 18 (4.9%) and in the cancer group HPV 16 (57.4%), 45 (9.6%), and 18(7.8%). Multiple HPV types were seen in 12.8% of CIN 2-3 group but only in 0.9% of cancer group. The chief complaint led to cancer diagnosis was post menopause bleeding (27%),while abnormal Pap test lead to CIN 2-3 diagnosis in 75.2% of the women. Only 22.6% of women diagnosed with cancer were diagnosed due to abnormal Pap test and 76.9% of them were diagnosed at stage I, as compared to women diagnosed with cancer because of bleeding or abnormal mass, of them 57.1 % were diagnosed at stage I (p<0.07).
CONCLUSIONS: High risk HPV types were found in 93% of cancer group and 85.8% of CIN 2-3 group, and LR-HPV was detected in 3.5% and 7.1% of women with cervical cancer and CIN 2-3 respectively. The most common HPV types in cervical cancer women were 16, 45 and 18. Women diagnosed with cancer because abnormal Pap test were in earlier stage compared to women diagnosed because of complains. Including LR-HPV types in screening HPV can increase the sensitivity of the test.