RESUMEN
BACKGROUND: In Chile, cervical cancer (CC) is the second leading cause of death from malignancy in women. The main causal agent of cervical cancer is the human papillomavirus (HPV). This virus is the most common sexually transmitted infection among sexually active youth. An early onset of sexual life increases the chances of HPV infection; this may involve a possible early development of cervical intraepithelial neoplasia and CC, creating a major public health problem. OBJECTIVE: To present HPV frequency in women under the age of 25, treated in the CC screening program and their follow-up after histopathological diagnosis. METHODS: 173 cervical samples were genotyped by polymerase chain reaction and non-radioactive reverse hybridization (line blot). RESULTS: The overall frequency of HPV was 84.8%. HPV16 was the most prevalent. In 12.1% of women the cervical lesion persisted or progressed. 28.9% of women had irregular follow-up; in this group, 88% were HPV(+) and 52% had no record of Pap smear in the past 3 years. DISCUSSION: The results reaffirm the usefulness of complementing the Pap and HPV detection as a primary screening tool in sexually active women. They also suggest the possibility of extending the age coverage of the national screening program.
Asunto(s)
ADN Viral/análisis , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Neoplasias del Cuello Uterino/virología , Adolescente , Chile , Femenino , Genotipo , Humanos , Tamizaje Masivo/métodos , Prueba de Papanicolaou , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Reacción en Cadena de la Polimerasa , Neoplasias del Cuello Uterino/prevención & control , Adulto JovenRESUMEN
Background: In Chile, cervical cancer (CC) is the second leading cause of death from malignancy in women. The main causal agent of cervical cancer is the human papillomavirus (HPV). This virus is the most common sexually transmitted infection among sexually active youth. An early onset of sexual life increases the chances of HPV infection; this may involve a possible early development of cervical intraepithelial neoplasia and CC, creating a major public health problem. Objective: To present HPV frequency in women under the age of 25, treated in the CC screening program and their follow-up after histopathological diagnosis. Methods: 173 cervical samples were genotyped by polymerase chain reaction and non-radioactive reverse hybridization (line blot). Results: The overall frequency of HPV was 84.8%. HPV16 was the most prevalent. In 12.1% of women the cervical lesion persisted or progressed. 28.9% of women had irregular follow-up; in this group, 88% were HPV(+) and 52% had no record of Pap smear in the past 3 years. Discussion: The results reaffirm the usefulness of complementing the Pap and HPV detection as a primary screening tool in sexually active women. They also suggest the possibility of extending the age coverage of the national screening program.
Introducción: En Chile, el cáncer cérvico-uterino (CCU) es la segunda causa de muerte por neoplasias malignas en la mujer. El principal agente causal es el virus papiloma humano (VPH), descrito como la infección de transmisión sexual más frecuente entre jóvenes sexualmente activas. El comienzo precoz de la vida sexual incrementa las posibilidades de infección con VPH; esto puede implicar un eventual desarrollo prematuro de neoplasia intraepitelial cervical y CCU, creando un importante problema de salud pública. Objetivo: Presentar la frecuencia del VPH en mujeres bajo 25 años de edad, participantes del programa de CCU y su seguimiento post-lesión. Material y Métodos: Se genotipificaron 173 muestras cervicales, mediante reacción de polimerasa en cadena e hibridación no radioactiva (reverse line blot). Resultados: La frecuencia global del VPH fue 84,8%. El genotipo más frecuente fue VPH16. En 12,3% la lesión cervical persistió o evolucionó a una mayor. Se encontró 28,9% de mujeres con seguimiento post-lesión irregular; en este grupo, 88% fue VPH (+) y 52% no tuvo registro de Papanicolaou en los últimos tres años. Discusión: Los resultados obtenidos reafirman la utilidad de complementar el Papanicolaou con detección del VPH como herramienta de tamizaje primario en mujeres sexualmente activas. Además sugieren la posibilidad de ampliar la edad de cobertura del programa de tamizaje.