Prevalence of Human Papillomavirus Genotypes and Abnormal Pap Smears Among Women in the Military Health System

• Published in: Journal of community health 2018-06, Vol.43 (3), p.441-447
• Main Authors: Daly, Christopher M., Hansen, Shana L., Kwon, Paul O., Roberts, Timothy A.
• Format: Article
• Language: English
• Subjects: Adult; Cervical cancer; Community and Environmental Psychology; Cross-Sectional Studies; Demographics; Demography; Ethics; Female; Females; Genotypes; Genotyping; Health Promotion and Disease Prevention; Health Services; Human papillomavirus; Humans; Immunization; Infections; Medicine; Medicine & Public Health; Military; Military Personnel - statistics & numerical data; ORIGINAL PAPER; Pap smear; Papanicolaou Test; Papillomaviridae - isolation & purification; Papillomavirus Infections - diagnosis; Papillomavirus Infections - epidemiology; Pathology; Prevalence; Regression analysis; Retrospective Studies; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - virology; Statistical analysis; Statistical methods; STD; United States; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - virology; Vaginal Smears - statistics & numerical data; Womens health
• ISSN: 0094-5145; 1573-3610
• DOI: 10.1007/s10900-017-0447-z

Human papillomavirus infection (HPV) is the most common sexually transmitted infection among United States Military Servicemembers, and present in the majority of cervical cancers. Many of these infections are preventable, but HPV immunization is not mandatory during military service. The objective of this study was to examine the prevalence of vaccinepreventable cervical disease among women enrolled in the San Antonio Military Health System. This is a retrospective cross-sectional study of Pap smear results and HPV genotyping data among Military Servicewomen and beneficiaries. Simple descriptive statistics and logistic regression were used to assess the association between demographics, cervical pathology and high-risk HPV (hrHPV) infection. Pap smears were obtained by 16.9% of women and cervical pathology was present in 28.8% of samples. Compared to the 25–34 year group, 35–44 year-olds were more likely to have an abnormal Pap smear (OR 1.25, CI 1.05–1.50). Of the samples tested, 10.5% were positive for hrHPV. Adjusted multivariable analysis revealed that hrHPV infection was more likely among the 23–34 year group when compared to 35–44 (OR 0.50, CI 0.38–0.67), 45–54 (0.40. CI 0.28–0.59) and 55–65 year groups (0.46, CI 0.30–0.71). Active Duty Servicewomen were more likely to test positive for hrHPV when compared to Active Duty Family Members (OR 0.59, CI 0.45–0.79) and Retiree Family Members (OR 0.59, CI 0.41–0.83). Younger women and Active Duty Servicewomen are significantly more likely to have cervical infection with hrHPV. Future studies should assess the cost-effectiveness of mandatory HPV immunization for military members.