HPV Epidemic - Early
Pap Smears Recommended
By Brenda C. Coleman
Associated Press
CHICAGO (AP) - Suburban and rural white New England schoolgirls had strikingly high rates of cervical cell abnormalities, which are often caused by a sexually transmitted virus and can lead to cancer, a study found.
The findings argue for early Pap-smear screening of all sexually active girls, not just those who live in inner cities and belong to minority groups, where such high rates have been found before, the researchers said.
The study, led by Sharon M. Mount of the University of Vermont, was published in the March issue of Pediatrics.
Past studies indicate human papillomavirus, or HPV, is the most common sexually transmitted virus in the United States, affecting 13 percent to 46 percent of young women, researchers said.
Among U.S. adolescent girls, about one-third are sexually active by ninth grade and about two-thirds by 12th grade, putting them at high risk for catching HPV, which is well known to cause cervical cell changes that can lead to cancer, the researchers said. Abnormal cells revealed by Pap smears can be removed before they become malignant.
The researchers reviewed 10,296 Pap smear diagnoses made over a one-year period for females ages 10 to 19 in suburban and rural Maine, New Hampshire and Vermont. Almost all were white and were patients at family planning clinics, private doctors' offices, student health clinics and hospitals.
The researchers found 3.8 percent of the Pap smears showed cell abnormalities of the type that might later develop into cancer, and 14.6 percent of the smears bore evidence of infection. The smears did not reveal the proportion of infections caused by HPV. No cancers were found.
"This high rate of abnormal Pap smear results of both an infectious and precancerous nature in this population may reflect a high level of sexual activity among adolescent girls," the researchers said.
Among 10 to 14 year olds, seven cases of precancerous changes were found in a total of 378 Pap smears, the researchers said.
An accompanying editorial by experts at Harvard Medical School praised the study for contributing valuable data about "strikingly high" rates of cell abnormalities in females that many might consider low-risk.
"A primarily white and rural or suburban population might be expected to have rates of abnormal Pap smears lower than a population of urban women of mixed race and ethnicity," the editorial said.