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Human papillomavirus and cervical dysplasia in Nunavut: prelude to a screening strategy
Sylvia M Healey1, KristanJ Aronson, Yang Mao
1Health Protection Unit, Department of Health, Government of Nunavut, Iqaluit, Nunavut, Canada. shealey@cov.nu.ca
Objectives:
To determine the prevalence of oncogenic human papillomavirus' (HPV) in Nunavut and to assess the association between HPV and squamous intraepithelial lesions (SIL) as a prelude to planning a better screening strategy.
Study Design:
A cross-sectional study was conducted on the Pap-screened populations in 19 communities in Nunavut, Canada. SIL was determined using Liquid-based cytology, and HPV testing was done using the Hybrid Capture II assay.
Results:
Prevalence of oncogenic HPVs in 1,290 women ages 13-79 was 26% and of Cervical Dysplasia was 7.2%. Over 90% of women with SIL had positive HPV tests. Over 75% of women who were HPV positive but SIL negative were under 30 years of age.
Conclusion:
Consideration should be given to using liquid-based cytology for Pap testing. Also consider concurrent HPV testing in those over 30 years old and reflex testing of HPV in those under 30 years old with a positive HPV test.