Acta medica academica · 2026
Cervical Cytology and Age in HPV-Infected Women in North Macedonia: A Cross-Sectional Study.
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Shabani Vjollca, Reçi Mije, Veselievska Stojkovska Vesna
Аннотация
OBJECTIVE: HPV infection is a key etiological factor in cervical epithelial alterations and neoplasia. Its prevalence and cytological impact vary with age, co-infections, and screening practices. This study investigated the association between HPV infection, age, and cervical cytological findings in women from North Macedonia.
MATERIALS AND METHODS: This cross-sectional study included 300 women aged 26-66 years, who were screened over a 13-month period (June 2023-July 2024). The participants were divided into two age groups (26-36 and 37-66 years). All participants underwent Pap testing, HPV screening, and microbiological evaluation. Ordinal regression analysis was used to examine the associations between age, microbial factors, and HPV positivity.
RESULTS: HPV prevalence was higher in the 37-66 group (12.33%) than in the 26-36 group (6.0%). However, younger age showed a stronger statistical association with HPV positivity (OR=2.10; P<0.1). Cytological abnormalities, particularly LSIL/CIN I, were more prevalent in HPV-positive participants. The use of conventional Pap smears was associated with lower HPV detection (OR=0.16; P<0.05). Co-infection with Candida spp. and atrophic inflammation were inversely associated with HPV positivity.
CONCLUSION: This study confirmed the association between HPV infection and cytological changes, particularly in younger age groups. These results highlight the importance of age-tailored screening approaches and support the continued use of conventional Pap smears as cost-effective tools. Integrating virological and microbiological assessments may further refine cervical cancer prevention strategies, particularly in transitional healthcare systems across the Western Balkans.
MATERIALS AND METHODS: This cross-sectional study included 300 women aged 26-66 years, who were screened over a 13-month period (June 2023-July 2024). The participants were divided into two age groups (26-36 and 37-66 years). All participants underwent Pap testing, HPV screening, and microbiological evaluation. Ordinal regression analysis was used to examine the associations between age, microbial factors, and HPV positivity.
RESULTS: HPV prevalence was higher in the 37-66 group (12.33%) than in the 26-36 group (6.0%). However, younger age showed a stronger statistical association with HPV positivity (OR=2.10; P<0.1). Cytological abnormalities, particularly LSIL/CIN I, were more prevalent in HPV-positive participants. The use of conventional Pap smears was associated with lower HPV detection (OR=0.16; P<0.05). Co-infection with Candida spp. and atrophic inflammation were inversely associated with HPV positivity.
CONCLUSION: This study confirmed the association between HPV infection and cytological changes, particularly in younger age groups. These results highlight the importance of age-tailored screening approaches and support the continued use of conventional Pap smears as cost-effective tools. Integrating virological and microbiological assessments may further refine cervical cancer prevention strategies, particularly in transitional healthcare systems across the Western Balkans.