Objectives: Little is known about the epidemiology of human papillomavirus (HPV) in Italy before the age of 25. At the European Institute of Oncology, a prospective observational study on cervical HPV infection in 18-year-old women undergoing quadrivalent HPV vaccination is ongoing.
Methods: At the first visit before vaccination, all the young women answered an epidemiological questionnaire, and then, the presence of high-risk HPV (hrHPV) was tested. Samples positive for hrHPV were genotyped. Liquid-based cytology was done only to women declaring not to be virgins. Any positivity at cytology or HPV testing was completed with colposcopy and eventually biopsies.
Results: Seven hundred and thirty women were enrolled. Two hundred sixty-six women were virgins; 7 (2.6%) of these resulted positive to hrHPV: 1 had HPV16 and CP6108, whereas the other 6 resulted negative at genotyping. Of the 464 nonvirgins, 61 (13.1%) were HPV positive: 19 had HPV16, 4 were positive to HPV18 with other hrHPVs, 25 to other hrHPVs, 7 to low-risk HPV, whereas 13 resulted negative at genotyping. HPV positivity was significantly associated to both smoking and having more than 3 partners. Cervical cytology was negative in 433 cases (93.3%), ASC-US in 10 cases (2.2%), low-grade squamous intraepithelial lesion in 20 cases (4.3%), and ASC-H in 1 case (0.2%). No CIN2+ was identified.
Conclusions: Overall, we found a low positivity to HPV in this population; however, the rate of HPV positivity was significantly related to smoking and sexual life. The cytology result low-grade squamous intraepithelial lesion was more frequent than in the screening population, whereas no CIN2+ was identified, confirming the indication to avoid screening at this age.
Low positivity rate of human papillomavirus (HPV) infection in 18-year-old women represents a target for catch-up programs, improving HPV vaccine coverage and encouraging healthy behaviors and HPV vaccination.
1Preventive Gynaecology Unit, 2Laboratory Medicine Unit, and 3Diagnostic Cytology Unit, European Institute of Oncology, Milan, Italy
Reprint requests to: Sarah Igidbashian, MD, Preventive Gynaecology Unit, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy. E-mail: firstname.lastname@example.org
Conflict of interest statement: M.S. was consultant for Qiagen, Sanofi Pasteur, GSK, Roche Diagnostics, MTM, Innogenetics. The other authors have nothing to disclose.
IRB Status: This study was approved by the IEO ethics committee.