An Alarming Evidence Of Increased HPV Infection In Cervical Smear In Iraqi Patients

Background: Cervical cancer is one of the common cancers among women worldwide, with increasing incidence. This study was designed to assess the role of cervical cytology in detecting the various cervical lesions predisposed to cervical cancer with the special emphasis on squamous intraepithelial lesions (SIL) and to predict the prevalence of these lesions and their association with Human papilloma virus (HPV). Patients and methods: This study enrolled 3500 women aged 17 years and above, presented with cervical lesions and attended for cytological evaluation of cervical smears. The data was retrieved from the archives of these patients for the period from January 2017 to December 2021.  All results were classified according to Bethesda system (2014) and statistically analyzed. Results:  the cytological examinations revealed that 91.7% of the submitted cases were negative for intraepithelial lesion or malignancy (NILM). Abnormal cellular changes were reported in 8.3% of the cases; Low-grade squamous intraepithelial lesion was the most common abnormality representing 4.7%, while High-grade squamous intraepithelial lesion constituted 0.5% of the total cases. A HPV-DNA test was done to 220 cases; 52 cases (23.6%) were positive, most of them (73%) were of low-risk genotypes while high risk genotypes were reported in 27% of the cases. Conclusion: the cervical squamous abnormality has formed a low prevalence rate while HPV-DNA test has been detected in a considerable proportion of Iraqi patients. This fact discloses alarming evidence of a growing problem in the population that needs to introduce a screening program for early diagnosis of precancerous cervical lesions.