Pre-vaccination prevalence of high-risk human papillomaviruses (HPV) in women from Kosovo and their related sociodemographic characteristics.

OBJECTIVES: Kosovo's current health care system does not support organized nationwide cervical cancer screening and human papillomavirus (HPV) vaccination programs. To date, no reliable data are available on cervical cancer incidence and mortality in Kosovo, or on high-risk HPV (HR-HPV) prevalence and HPV type distribution. Our aim is to determinate the pre-vaccination prevalence and distribution of HR-HPVs and to assesses the associations between sociodemographic characteristics and increased risk of HPV infection in women from Kosovo. MATERIAL AND METHODS: Detection of HR-HPV DNA in cytologically evaluated cervical smears was performed using a clinically validated Abbott RealTime High Risk HPV test, Roche Linear Array HPV Genotyping Test, HPV52 type-specific real-time PCR and an in-house GP5+/GP6+/68 PCR. RESULTS: The crude overall prevalence of any of the HR-HPVs was estimated at 13.1% (26/199; 95% confidence interval (CI): 9.1-18.5%), with HPV16 being the most common type (7/26, 26.9%), followed by HPV31 and HPV51, each detected in 4/26 (15.4%) cervical specimens, HPV18, detected in 3/26 (11.5%) specimens, HPV52 and HPV66, each detected in 2/26 (7.7%) specimens, and HPV33, HPV45, HPV56, and HPV58, each detected in a single (3.9%) specimen. Women over 40 (OR = 0.36), older than 18 at sexual debut (odds ratio (OR) = 0.28), those that had delivered at least one child (OR = 0.32), and those that had a history of pregnancy termination (OR = 0.39) were at lower risk for HPV infection. CONCLUSION: Because more than 70% of cervical precancerous lesions could have been prevented in Kosovo using nationwide HPV-based cervical cancer screening and HPV vaccination, it is of outmost importance to implement both programs in the national health care system as soon as possible.

Colposcopy and cytodiagnosis in the prevention of cervical malignancies.

BACKGROUND: Worldwide, cervical cancer is the fifth most frequent malignant disease in women, ranking third, after endometrial and ovarian cancer, among malignant diseases of the female genitalia. Sexual activity early in adolescence and promiscuity have been confirmed as risk factors. The aim of this study was to establish the value of cytology, colposcopy, and pathohistology in the prevention of cervical malignancies. METHODOLOGY: The study population comprised 750 patients hospitalized for different reasons in whom cervical alterations were noted on speculum examination or who showed typical clinical symptomatology, performed at the Obstetric-Gynecologic Clinic in Prishtina, Kosovo during the period between January 2008 and January 2009. RESULTS: The symptomatology of the patients with pathological cervices varied, with 272 of the 750 patients (36.27%) showing clinical symptoms. Atypical epithelial changes, noted during colposcopy, were more frequent in patients 31-40 years of age (60 patients, 32.09%) and 41-50 years of age (59 patients, 31.55%). In addition to material collected during colposcopic examination, biopsy material (direct biopsy) was obtained from 117 patients. Histopathological findings from both sources were noted: 19 cases (16.24%) of cervical dysplasia at different stages, six cases (5.13%) of carcinoma in situ, and three cases (2.56%) of invasive carcinoma. CONCLUSIONS: The correct clinical evaluation of cervical epithelial alterations enables a prompt diagnosis and the timely implementation of appropriate therapeutic measures.