1528 - Prevalence of Human Papillomavirus Infection and Cervical Intra-Epithelial Lesions in A Subset of Arab American Women in Southeast Michigan

Background: The Pap smear is a screening examination that detects abnormal cervical cells and may be paired with human papillomavirus (HPV) testing in order to detect high-risk, oncogenic HPV strains. The incidence of cervical cancer varies among groups due to racial and ethnic disparities, and 80% of cases occur in developing countries. Mortality rates for cervical cancer in the Middle East are disproportionately higher when compared to developed countries. Our study aims to assess the prevalence of HPV and cervical cancer among a subset of Arab-American women in southeast Michigan.

Methods: The study is a retrospective chart review of women who presented for routine cancer screening as part of the Breast and Cervical Cancer Control Program (BCCCP), at the Arab-American Center for Economic and Social Services Clinic in southeast Michigan between 2003-2019. Paper charts were reviewed for information such as age, date of birth, monthly income, tobacco use, cervix-related gynecological examination performance, cervical cytology results, and HPV testing results. Women between the ages of 21 and 65 were included. In instances where cytology was performed, results and details of high-risk HPV testing were documented. In instances where high-risk HPV testing was performed, negative results were documented as such, and positive results were documented as either positive for HPV 16, 18, or other high-risk strains, or unknown if serotype testing was not available.

Results: A total of 464 charts from the BCCCP program were reviewed. All women included were uninsured and had immigrated from Middle Eastern countries, including Yemen and Lebanon. The average age of the women was 48.3 years. Of 464 women, 6% (n=28) of women declined to have a Pap smear. 85 women reported they had never had a Pap smear. Of the 436 women who did undergo Pap smear, 42 women (9.6%) had an abnormal pap smear. The remaining results are summarized in Table 1.Table 1


Conclusion: Our study results show a trend toward HPV serotype 16 and other serotypes compared to HPV serotype 18 in Arab-American women who recently immigrated to the United States. However, this needs to be studied on a larger cohort of patients to determine if these serotypes are more common among this ethnicity compared to the general population.