Extended HPV Genotyping for Risk Stratification in Cervical Screening: A Population-based Study

Area of Science:

• Oncology
• Virology
• Public Health

Background:

• Limited population-based data exist for extended HPV genotyping in cervical cancer screening risk stratification.
• Routine screening relies on accurate methods to identify women at high risk for cervical cancer.

Purpose of the Study:

• To evaluate the association between oncogenic risk categories from extended HPV genotyping and cervical screening outcomes.
• To assess the utility of HPV genotyping for risk stratification in a large population-based cohort.

Main Methods:

• Retrospective analysis of HPV, cytology, and histology data from 448,394 screened women (October 2021-September 2023).
• Classification of high-risk HPV genotypes into high (HOT), moderate (MOT), and low (LOT) oncogenic risk categories.
• Comparison of cytologic and histologic outcomes across risk categories, including calculation of positive predictive values (PPVs) for CIN2+ and CIN3+.

Main Results:

• Overall HPV prevalence was 8.6%, with HOT, MOT, and LOT genotypes comprising 35.5%, 24.0%, and 40.5% of infections, respectively.
• Significant differences in cytologic severity (p<.0001) and histologic disease severity were observed across risk categories.
• HOT genotypes were associated with 68.8% of CIN3+ diagnoses, with category-level CIN3+ PPVs of 23.0% for HOT, 14.6% for MOT, and 5.5% for LOT.

Conclusions:

• Extended HPV genotyping demonstrates a clear gradient of oncogenic risk.
• Low-oncogenic risk HPV infections are associated with markedly lower rates of high-grade cervical disease.
• Findings support the implementation of risk-stratified clinical management in cervical cancer screening programs using extended HPV genotyping.