Trends in Inflammatory Status of the Vaginal Flora as Established in the Dutch National Screening Program for Cervical Cancer Over the Last Decade

Objective To describe recent trends in the prevalence of cytologic patterns of the vaginal flora (koilocytosis, Trichomonas, dysbacteriosis, Candida, Gardnerella, Actinomyces, Chlamydia trachomatis) over the last decade. Study Design From 1996 to 2005 >500,000 cervical smears were screened in the context of the Dutch national screening program on a 5-year basis. Data from the first screening period were compared with those of the second screening period. Results Prevalences differed from 34.8 for dysbacteriosis to 0.2 for C trachomatis. Bacterial imbalance (dysbacteriosis, unequivocal Gardnerella and Trichomonas) showed a decline in all age groups. Cases of human papillomavirus (HPV)―related koilocytosis have dramatically increased among young women (30 and 35 years). Conclusion Bacterial imbalance of the vaginal flora has significantly decreased during the past decade in all age cohorts. Campaigns on consciousness of vaginal hygiene might have contributed to this amazing effect. We ought to be concerned about the increase in HPV-related koilocytosis.