Prevalence of Cervical Abnormalities by PAP Test and HPV-16 Genotyping in Owerri Municipal LGA, Nigeria

Abstract

Background: Cervical cancer remains the second most common cancer among women in Nigeria. Although the Papanicolaou (PAP) test is available, human papillomavirus (HPV) genotyping is not routinely performed in Owerri Municipal. No data are available on their combined impact. Aim: To evaluate the prevalence of cervical abnormalities using the PAP test and to characterise HPV types in Owerri Municipal LGA. Place and Duration of Study: Federal University Teaching Hospital Owerri and HI-TECH Diagnostic Laboratories, Owerri Municipal, Imo State, between January and June 2024. Methodology: This cross-sectional study included 113 women aged 25–65 years. Sociodemographic data and knowledge, attitude and perception (KAP) were assessed using an interviewer-administered questionnaire. Cervical smears were collected, stained using the Papanicolaou technique and reported according to the Bethesda System. Positive samples underwent DNA extraction and polymerase chain reaction testing for HPV-16 and HPV-18. Data were analysed using SPSS version 25 and the chi-square test, with p < 0.05. Results: The mean age was 33.35 years, and 96.5% of participants had tertiary education. Overall, 67.3% were unaware of PAP/HPV testing. Previous PAP screening and HPV testing were reported by 20.4% and 8.8%, respectively, while 0.9% reported HPV vaccination. PAP results were negative for intraepithelial lesion or malignancy (NILM) in 111 participants (98.2%), while squamous cell carcinoma was reported in two (1.8%). HPV-16 was detected in both PAP-positive cases (2/2; 100%), whereas HPV-18 was not detected. Significant associations were reported for the age group 46–55 years (p = 0.006) and parity of 3–5 children (p = 0.009). Conclusion: The prevalence of abnormal cytological findings was 1.8%, with HPV-16 detected in both PAP-positive specimens. Poor awareness and low uptake limit screening. Co-testing is recommended.