Prevalence of cervical high-risk human papillomavirus and cytological abnormalities in elderly Turkish women

Objective: Cervical cancer (CC) screening ends at the age of 65 in Turkey, as in many countries. However, about a quarter of CCs occurs in women over the age of 65. Persistent high-risk human papillomavirus(HR-HPV) infection is the most important factor leading to CC. In this study, we aimed to investigate the prevalence of cervical HR-HPV and cytological abnormalities in Turkish women aged 65 and over. Patients and Methods: A total of 467 women between the ages of 66-84 who were referred to the gynecology outpatient clinics for any reason between January 2010 and December 2021 were included in the study. Pap smears (liquid-based) of patients were screened for HPV DNA typing using the COBAS test system and evaluated cytopathologicaly. Results: The mean age of women was 72.4 years. The prevalence of HR - HPV was 5.1% (n = 24), HPV-16 and HPV-18 subtypes constituted 58.4% of all positive cases. The rate of cervical HR-HPV and cytological abnormalities were not statistically different between age groups. Of the women with a positive HR-HPV test in Pap smear, cytological abnormalities were found to be more frequent when compared to HR-HPV negatives (95.8%, n=23 vs 4.3%, n=19, p<0.00001). Conclusion: We demonstrated a strong correlation between HR-HPV positivity and cytological abnormality in the elderly women population. Age groups were not significantly different regarding the prevalence of HR-HPV and abnormal cytology. We also revealed that the prevalence of HR-HPV and cytological abnormalities in the elderly population were not high enough to explain the second peak of cervical cancer seen in older ages. More studies are needed to explain which testing methods should be used in the elderly patient population.