Women Over 55 Lack HPV Risk Markers


VANCOUVER, B.C. — There's no easy way to identify older women whose risk for human papillomavirus infection is low, so physicians should continue cervical screening unless the woman has tested negative consistently for the virus, Concepcion Diaz-Arrastia, M.D., and her associates advised in a poster presentation at the 22nd International Papillomavirus Conference.

Nineteen (11%) of 176 women older than 55 years tested positive for infection with high-risk or intermediate-risk types of the human papillomavirus (HPV) in a prospective, longitudinal study, they reported at the conference, sponsored by the University of California, San Francisco.

“High-risk HPV infection is not restricted to young women,” said Dr. Diaz-Arrastia of the University of Texas, Galveston, and her associates.

All the women completed a detailed medical and sexual history form and underwent a pelvic exam that included a liquid-based cervical sample and HPV test. The study found no clear social markers of risk for HPV infection in this group of older women, whose mean age was 67 years. “'Low risk' may be more difficult to establish in this age group,” the investigators concluded.

More than a third of the HPV-positive women said they had been sexually inactive for more than the past 5 years. There were no significant differences between the HPV-positive and HPV-negative women in terms of the traditional social risk factors for cervical neoplasia, including a history of first sexual activity before age 16, number of sexual partners in their lifetimes, presence of other sexually transmitted disease, history of sexual abuse, or smoking habits.

Pap smear results also did not correlate with risk for HPV infection. In the HPV-positive group, two women had atypical squamous cells of undetermined significance (ASC-US), and one woman had low-grade squamous intraepithelial lesions (LSIL). In the HPV-negative group, Pap results showed ASC-US in five women and LSIL in one woman. Stratified by race, 4% of 113 Hispanic women were HPV positive, as were 23% of 43 non-Hispanic white women and 25% of 20 African American women, the investigators reported.

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