Asian Paciic Journal of Cancer Prevention, Vol 15, 2014 2245 DOI:http://dx.doi.org/10.7314/APJCP.2014.15.5.2245 HPV DNA in Routine Cervical Scraping Samples in Malaysia Asian Pac J Cancer Prev, 15 (5), 2245-2249 Introduction Incidence of cervical cancer in developing countries is common where its accounts for 15% of female cancers with a risk of 1.5% at age below 65 years old (Parkin and Bray, 2006). As for developed countries, cervical cancer accounts for only 3.6% of new cancers, with a cumulative risk of 0.8% (<65 years) (Parkin and Bray, 2006). Cancer of the cervix was the third most common cancer among women and ifth most common cancer in the entire general population of Malaysia (NCR, 2011). There are about 9 million women eligible to be screened [age 22-60 years] for cervical cancer and the presence of abnormal smears in routine cervical scrapings cytology accounts to 4-7%. Cervical cancer incidence rate increased after 30 years old and peaks at ages 65-69 years. Currently, though there is no national screening program available, around 30-40% coverage is achieved by opportunistic screening. HPV infection is now a well-established causal agent in the development of a variety of epithelial lesions, 1 Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, 2 Unit of Haematology, Cancer Research Center, Institute for Medical Research, Kuala Lumpur, Malaysia *For correspondence: hayatikb@usm.my Abstract Background: Human papillomavirus is a well-established cause of the development of a variety of epithelial lesions in the cervix. However, as yet, incorporation of HPV testing into cervical cancer screening either as an adjunct or stand alone test is limited due to its cost. We therefore here ascertained the presence and type speciicity of human papilloma virus (HPV) DNA in routine cervical scrapings. Materials and Methods: Cervical scrapings were collected from women attending clinics for routine Pap smear screening. HPV-DNA was detected by PCR using MY09/11 and GP5+/GP6+ primer sets and genotyping was accomplished by cycle-sequencing. Results: A total of 635 women were recruited into the study with mean±SD age of 43±10.5 years. Of these 92.6% (588/635) were reported as within normal limits (WNL) on cytology. The presence of HPV infection detected by nested MY/GP+-PCR was 4.4% (28/635). The overall prevalence of high-risk HPV (HR-HPV) in abnormal Pap smears was 53.8% (7/13). HPVs were also seen in 3.1% (18/588) of smears reported as WNL by cytology and 5.9% (2/34) in smears unsatisfactory for evaluation. Conclusions: The overall percentage of HPV positivity in routine cervical screening samples is comparable with abnormal indings in cytology. Conventional Pap smear ‘missed’ a few samples. Since HPV testing is expensive, our results may provide valuable information for strategising implementation of effective cervical cancer screening in a country with limited resources like Malaysia. If Pap smear coverage could be improved, HPV testing could be used as an adjunct method on cases with ambiguous diagnoses. Keywords: HPV-DNA detection - cytology - PCR - cervical cancer screening - developing country RESEARCH ARTICLE Detection of Human Papillomavirus DNA in Routine Cervical Scraping Samples: Use for a National Cervical Cancer Screening Program in a Developing Nation Norodiyah Othman 1,2 , Nor Hayati Othman 1 * which range in severity from benign warts to invasive cervical cancer (Carter et al., 2011). More than 90% of invasive cervical cancer specimens contain HPV-DNA with approximately 5% may be unrelated to HPV infection (Janicek and Averette, 2001; Bhatla et al., 2008). HPV prevalence among countries may vary considerably across studies. This is due to the insuficient degree of geographical coverage and sample size, diversity in the techniques used for HPV detection and different methods used for estimating HPV type-speciic prevalence (Bosch et al., 2008; Giuliano et al., 2008). The adjusted global prevalence of HPV infection was 10.4% (Burchell et al., 2006). The overall HPV-DNA prevalence in invasive cervical cancer is 96%, based on pooled analysis of 12 studies (Clifford et al., 2006b). The prevalence of HPV types that cause cervical cancer are; HPV-16 (53.5%), -18 (17.2%), -45 (6.7%), -31 (2.9%), -33 (2.6%), and other high-risk types; -52, -58, -35, -59, -56, -39, -51, -73, -68 and -66 (15-20%) (Clifford et al., 2006a). Complete data is not yet available on HPV burden in