Frequency of human papillomavirus in endometrial polyp cases treated in Dicle University Faculty of Medicine gynecology clinic: 5-year retrospective analysis

Introduction and Aim: Endometrial polyps (EP) are benign endometrial lesions commonly observed in perimenopausal women, with a prevalence of 20-25%. The etiology of EPs remains unclear. Human Papillomavirus (HPV), one of the most widespread sexually transmitted pathogens globally, continues to show an increasing prevalence. This study aimed to determine the prevalence of HPV in patients diagnosed with EP, evaluate their Pap smear results, and identify the factors influencing these outcomes. Additionally, it sought to contribute to the limited literature on the malignancy risk of EPs and their potential association with HPV. Materials and Methods: This retrospective and cross-sectional study included 811 women diagnosed with EP between January 1, 2019, and August 1, 2024, at the Gynecology and Obstetrics Department of Dicle University Faculty of Medicine. The demographic and clinical characteristics of the patients, including age, body mass index (BMI), gravidity, parity, use of hormone replacement therapy, and tamoxifen, were evaluated. HPV DNA and Pap smear results were also analyzed in detail. Statistical analyses were conducted using SPSS version 27.0. Results: The mean age of the patients was 46.3 years, and the mean BMI was 27.05. Among the patients diagnosed with EP, 4.8% were HPV positive, while 95.3% had benign Pap smear results. The EP specimens were obtained via curettage in 71.9% of the patients and hysteroscopic polypectomy in 28.1%. Hypertension, diabetes mellitus, and infertility were diagnosed in 11.7%, 6.7%, and 11.8% of the patients, respectively. Additionally, 5.5% of the patients were using tamoxifen, and 7.4% were receiving hormone replacement therapy. There was no significant association between HPV positivity and age, BMI, gravidity, or parity. Pap smear results revealed that benign rates were lower and low-grade squamous intraepithelial lesion (LGSIL) rates were higher in patients receiving hormone replacement therapy. All HPV-positive patients were diagnosed with LGSIL. Furthermore, benign Pap smear rates were lower among patients using tamoxifen. Conclusion and Recommendations: The detection of HPV positivity suggests that HPV may play a significant role in the etiology of these lesions. Additionally, a significant association between HPV positivity and Pap smear results was identified. To better understand the potential effects of HPV on endometrial polyps, further prospective studies with larger and more diverse patient groups are required. This study provides valuable contributions to the literature on the relationship between HPV and endometrial polyps. Keywords: HPV, Endometrial polyp, Pap smear, Curettage, Hysteroscopy