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

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Abstract

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 vaccine-preventable 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.

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Acknowledgements

Defense Health Agency-Immunization Health Branch grant proposal ID IHB-16-08. All work was completed per WRAIR (Walter Reed Army Institute of Research) Protocol #2307 and paid to WRAIR institution. All work done on this manuscript was completed by Active Duty Servicemembers and no funds were required for this AIM of the protocol.

Disclaimer

Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense. The investigators have adhered to the policies for protection of human subjects as prescribed in AR 70–25.

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  1. Christopher M. Daly

    Present address: Adolescent Medicine, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96589, USA

Authors and Affiliations

  1. Adolescent Medicine, Joint Base San Antonio/Lackland AFB, San Antonio, TX, USA

    Christopher M. Daly, Shana L. Hansen & Timothy A. Roberts

  2. Walter Reed Army Institute of Research, Silver Spring, MD, USA

    Paul O. Kwon

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Correspondence to Christopher M. Daly.

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Daly, C.M., Hansen, S.L., Kwon, P.O. et al. Prevalence of Human Papillomavirus Genotypes and Abnormal Pap Smears Among Women in the Military Health System. J Community Health 43, 441–447 (2018). https://doi.org/10.1007/s10900-017-0447-z

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  • DOI: https://doi.org/10.1007/s10900-017-0447-z

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