High-risk Human Papillomavirus Infection in Low Risk Women: Incidence, Patient Characteristics, and Clinical Meaning for Cervical Cancer

Objective: To investigate the incidence of high-risk human papillomavirus (HPV) infection and its clinical meaning. Methods: Total 28,339 women attending our hospital for routine gynecologic care underwent Papanicolaou test (PAP test) and high-risk HPV tests. Biopsies were taken from some women and their results were compared. Results: The prevalence of high-risk HPV infection is 24.15%. And the women aged 20-29 years had the highest prevalence (32.3%) compared to 30-70 years (P<0.05). Of the 28,339 women, 1369 (4.83%) had positive PAP test (ASCUS, LSIL, HSIL). Of the 1369 PAP-positive patients, only 16 (1.17%) were negative for HPV test. Of the 1353 patients positive on both tests, 510 (37.7%) had lesions higher than CINII on histology. Of the 1,611 patients who underwent biopsies, 350 underwent the loop electrical excision procedure, with 339 (96%) being positive for HPV test, including 16 with CINI, 48 with CINII/III, 74 with CIS, and 16 with cervical cancer. HPV test had a positive predictive value of 40.7% and a negative predictive value of 100% for higher than CINII. Conclusion: Although HPV test has a burden of cost, considering its high negative predictive value, HPV test should be considered for more useful screening test.