High prevalence of abnormal cervical cytology in young women with genital warts

1. High prevalence of abnormal cervical cytology in young women with genital warts Chenchit Chayachinda, Manopchai Thammakhantho, Chanon Nuengton, Amphan Chalermchockcharoenkit, Isarin Thanabunyawat Gynecolologic Infectious Disease and Female STD Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 10700 Genital warts and cervical intra-epithelial neoplasia (CIN) are both associated with human papillomavirus (HPV) infection. Although the etiologic HPV types are different, the occurrence of genital warts may be a marker of a relative deficiency in immune response that can be a factor for cervical intra-epithelial lesion. From literature review, only few studies have been conducted to explore this issue but all of them showed a significant association. Methods habits such as smoking, multiple sex partners and condom usage refusal usually come along. These factors increase oncogenic human papillomavirus (HPV) exposure. The malignant transformation of cervix takes 10-15 years resulting in the higher prevalence in the older women. The present study demonstrated that such transformation was strikingly faster among young women who had genital warts. Comparison to older women with syphilis was aimed to illustrate how huge the interaction of different HPV-related diseases was. This can be explained by the individual’s probable relative immunodeficiency toward HPV and the co-infection of the non-oncogenic and oncogenic HPV infection5. This retrospective cohort study included 600 women with either genital warts or syphilis who attended Siriraj Female STD Clinic from 2007-2011. Exclusion criteria were pregnancy, HIV infection, known case of cervical cancer or genital warts, rape case and being a commercial sex worker. Eligible subjects were 104 women with late latent syphilis and 293 women with genital warts. The diagnosis of cervical intraepithelial neoplasia was based on liquid-based Pap smear, colposcopy and/or biopsy. Loop electrical excisional procedure (LEEP) was performed when Results Conclusion The high prevalence of LSIL+ among young women with genital warts supports the relation among diseases causing by different HPV types. Table 3: Abnormal cervical cytology References 1. Handley J, Lawther H, Homer T, Maw R, Dinsmore W. Ten year follow-up study of women presenting to a genitourinary medicine clinic with anogenital warts. Int J STD AIDS. 1992; 3(1): 28-32 2. Li J, Rousseau MC, Franco EL, Ferenczy A. Is colposcopy warranted in women with external anogenital warts?. Journal of lower genital tract disease. 2003; 7(1): 22-28 3. Sadan O et al. Occurrence of cervical intraepithelial neoplasia in generally healthy women with exophytic valvar condyloma acuminata. Infectious diseases in Obstetrics and Gynecology. 2005; 13(3): 141-3 4. Milojkovic M, Milojkovic D, Russo M, Vakan BV. High squamoua intra-epithelail lesion and cancer of lower genital tract in women with anogenital warts. Arch Gyenol Obster. 2011:284: 453-7 5.Ball SLR et al. Analyses of Human papillomavirus genotypes and viral loads in anogenital warts. J Med Virol. 2011; 83: 1345-50 Table 1: Literature review on prevalences of abnormal cervical- cytology in women with genital warts Table 2: Characteristics of the participants Objectives Women with genital warts had 9 times higher prevalence of LSIL+ than ones with late latent syphilis had (18.1% vs 1.9%, p < 0.05). Age, body mass index (BMI) and number of sex partners revealed significant difference. Table 4: Loop electrical escisional procedure (LEEP) results To compare the prevalence of low grade squamous intra-epithelial lesions and more (LSIL+), as well as its associated factors, between women with genital warts and ones with syphilis. Discussion Sexually transmitted infection is one of the risk factors of cervical cancer development because other social