Human Papillomavirus and Abnormal Pap Test Results in Vietnamese-American Women: A Pilot Case-Control Study

Abstract
To evaluate the relationship between abnormal Pap test results and human papillomavirus (HPV) in Vietnamese-American women, who have the highest cervical cancer incidence in the United States. In 2001, we obtained specimens from 117 Vietnamese women, 24 with abnormal Pap test results including atypical squamous cells of undetermined significance (cases) and 93 with normal Pap test results (controls), as classified by the 1991 Bethesda System. We used L1 consensus primers MY09/MY11 to perform HPV polymerase chain reaction analysis and type-specific probes to perform genotyping. Thirteen cases (54%) and 6 controls (6%) were HPV positive (p < .001). Ten of 24 cases (42%) and 0 controls (0%) had high-risk HPV types (16, 18, 45, 53, 56, or 66; p < .001). High-risk HPV types were significantly associated with increasing severity of Pap test results. Compared with those with normal Pap test results, Vietnamese-American women with abnormal Pap test results were more likely to have high-risk HPV types. Higher cervical cancer incidence among these women is likely the result of less frequent Pap screening rates and not different biology.