Human papillomavirus genotype-specific risks for cervical intraepithelial lesions

Area of Science:

• Gynecology
• Oncology
• Virology

Background:

• Prevalence of different human papillomavirus (HPV) genotypes is evolving following HPV vaccination initiatives.
• Understanding HPV type-specific risks is crucial for optimizing cervical cancer screening strategies.
• Cervical cancer screening relies on accurate detection and risk assessment associated with HPV genotypes.

Purpose of the Study:

• To estimate HPV type-specific prevalence, odds ratios (OR), and positive predictive values (PPV) for cervical cytological abnormalities.
• To analyze the performance of HPV genotypes in relation to high-grade cytology before the widespread HPV vaccination era.
• To inform future cervical cancer screening protocols in the context of changing HPV genotype landscapes.

Main Methods:

• Analysis of 41 different HPV genotypes in cervical samples from 8351 women aged 18-51 years.
• Data collected from a population-based sample prior to the HPV vaccination era (Study V501-033; NCT01077856).
• Statistical estimation of prevalence, OR, and PPV for various HPV genotype groups and cytological abnormalities.

Main Results:

• HPV16 prevalence was 4.9% with an OR of 11.9 for high-grade cytology.
• Nonavalent vaccine HPV types (16,18,31,33,45,52,58) showed a combined prevalence of 14.4% and an OR of 23.7.
• HPV types in screening but not vaccinated against (35,39,51,56,59,66,68) had a prevalence of 8.5% and an OR of 2.9; non-carcinogenic types had a prevalence of 11.8% and an OR of 1.5.

Conclusions:

• HPV screening tests may be more effective post-vaccination if focused on nonavalent vaccine HPV types.
• Screening for all 14 high-risk HPV types may lead to an imbalanced ratio of harms to benefits.
• Type-specific HPV prevalence and risk data are essential for refining cervical cancer screening guidelines.