Multi-site HPV infection in women with cervical intraepithelial neoplasia: an exploratory analysis

Human papillomavirus (HPV) positivity is associated with cervical, oropharyngeal, and anal cancers. There is insufficient published evidence regarding the effectiveness of obtaining oropharyngeal and anal swabs from patients with cervical HPV positivity to detect potential pathologies. Our aim was to analyze the feasibility of this potential screening protocol in a pilot group.

In this cross-sectional exploratory analysis, women diagnosed with cervical intraepithelial neoplasia (CIN) grades 1, 2, or 3 were recruited. In order to evaluate HPV infection beyond the cervix, oropharyngeal and anal swab samples from HPV-positive women presenting to the obstetrics and gynecology clinic with histopathologically confirmed CIN were collected.

A total of 30 women who provided informed consent were included in this pilot study. HPV 16 was the predominant cervical HPV type across all CIN grades (46.7% of cases), but HPV genotype did not significantly correlate with the severity of CIN lesions (p=0.786). No statistically significant association was found between cervical and anal HPV infections (p=0.427). Oral HPV positivity was rare (6.7%) and similarly showed no significant correlation with cervical HPV infection (p=0.499).

These findings provide preliminary data on the effectiveness of multi-site HPV screening in this population. Future larger-scale studies are needed to determine whether detecting extra-cervical HPV in women with cervical HPV positivity will influence clinical management decisions.