Preliminary findings: older women can have high-risk HPV strains.(Gynecology)

LAKE BUENA VISTA, FLA. -- Preliminary findings suggest that older women, even those who are not sexually active, can be infected with the high-risk strains of human papillomavirus associated with cervical cancer, Dr. Concepcion Diaz-Arrastia reported at a meeting of the American Society for Colposcopy and Cervical Pathology.

Furthermore, in the study there were no identifiable medical or social factors for human papillomavirus (HPV) infection that might help predict risk for cancer. "Low risk" therefore may be difficult to establish in this age group, suggesting that older women should continue to be considered at risk and should receive cervical cancer screening unless they have persistently tested negative for HPV infection, Dr. Diaz-Arrastia said.

Population-based studies have shown HPV infection to have a bimodal age distribution, peaking first in the early 20s and then again at age 55, perhaps because of reactivation.

An initial study in Costa Rica found that cervical HPV DNA detected in women aged 65 years and older was primarily of the low risk, non-cancer causing types (J. Natl. Cancer Inst. 92[6]:464-74, 2000).

A subsequent study in Mexico, however, provided the first evidence that infections with the high-risk types of HPV also were found in up to 23% of women aged 65 and older (Int. J. Cancer. 91[3]:412-20, 2001).

Now, in a prospective cohort study that has thus far enrolled 63 women aged 55-86 years, 21% were HPV positive for the high-risk types, said Dr. Diaz-Arrastia of the University of Texas, Galveston.

Women in the study filled out a questionnaire detailing their medical and social history and underwent a pelvic examination that included a liquid-based cervical sample and a Hybrid Capture II HPV test. Among the women who were HPV positive, 44% reported no sexual activity for more than 5 years.