Pap Smear Results of Victorian Teenagers, 1980–1987

EDITORIAL COMMENT: There are times when appraisal of the medical literature seems as difficult as that of articles in the lay press — whose story do you believe? This careful paper reporting a large series of patients is reassuring — there is no epidemic of human papillomavirus in Victorian teenagers since the prevalence in the last decade has remained at about 5%. For cervical intraepithelial neoplasia the figures are less reassuring but not alarming. Next we must ask our cytologists to provide similar comparative data for the other age groups in Victoria. Certainly this paper would indicate that the pessimism of the colposcopists due to investigation of patients referred to them is not the last word on human papillomavirus infection. Summary: Pap smears reported by the Victorian Cytology (Gynaecological) Service between 1980 and 1987 for teenagers show a profile of abnormality which is similar to that for women for all ages. More than 90% of the cytology reports have consistently been reported as normal or showing minor benign abnormalities only. No evidence of an increasing rate of infection with human papillomavirus is apparent, with the infection rate as determined cytologically being constant at around 4% to 5% during 1981 to 1987. Some increase in the proportion of women having associated changes of CIN is apparent. No case of invasive cancer in teenagers has yet been confirmed. These data suggest that the teenagers in Victoria who are having Pap smears reported by the Victorian Cytology (Gynaecological) Service are not a high risk group for cervical cancer during their teenage years, but may be a high risk group during later years.