Cervical cancer screening program based on HPV testing and conventional Papanicolaou cytology for jail inmates

To assess the validity of Human Papillomavirus (HPV) testing in a group of women at high risk for developing cervical cancer, a screening intervention was applied to a population of jail inmates in Rome, Italy. This cross-sectional study provided also new insights on the risk factors and on the HPV genotype distribution. Methods: We have invited 350 inmates to the preliminary stage of the screening program and 98 inmates decided to participate to the study and filled out a questionnaire for the history of attendance to previous cervical screening and for the known risk factors for cervical malignancies. HPV DNA test, conventional Pap smear and HPV genotyping were performed. Results: The percentage of women with High Risk (HR) HPV positivity were 19.3%. The inmates with LSIL/ HSIL status showed a significantly higher prevalence of HR-HPV positivity (100% vs. 16.3%; p < 0.001) and of multiple HPV types (60% vs. 1.2%; p < 0.001) compared to women with normal/ASCUS Pap smear. HPV16 was the predominant genotype in either single or multiple infections. Conclusions: The results indicated that HPV DNA-based approach is a strategy useful for incarcerated women which do not have the opportunity or the social and cultural environment to receive preventive care