Human papillomavirus and cervical dysplasia in Nunavut: prelude to a screening strategy

Abstract

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.

Key Words:

• papillomavirus
• Papanicolaou test
• cervix neoplasms
• screening
• Inuit