What Are the Current HPV Types Contributing to Cervical High-Grade Squamous Intraepithelial Lesions, Adenocarcinoma In Situ, and Early Cervical Cancer?

Abstract

Objectives: To determine the prevalence of human papillomavirus (HPV) types by genotyping high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ (AIS), and early-stage invasive cervical cancer (ICC) in patients who have been exposed or are naïve to the HPV vaccine.

Methods: This was a cross-sectional study. All patients over the age of 18 years who presented to the colposcopy clinic with HSIL, AIS, or ICC who were expected to undergo a cervical biopsy, loop electrosurgical excisional procedure, or cone biopsy were eligible and approached for informed consent. HPV typing was performed to identify the causative HPV types.

Results: Between November 2016 and May 2023, 113 patients (34 vaccinated with at least 1 dose, and 79 non-vaccinated) consented to this study. The median ages at coitarche and study entry were 18 (range 14-37) and 34 (range 24-66) years, respectively. Only 3 patients were vaccinated prior to coitarche. Histology was as follows: HSIL = 97, AIS = 9, HSIL and AIS = 2, squamous cell carcinoma = 4, and 1 patient with adenocarcinoma. The causative HPV type was 16 or 18 in 59% of the vaccinated group and in 66% of the non-vaccinated group. Most vaccinated patients (74%) reported receiving 2-3 doses of HPV vaccine.

Conclusions: In our cohort, the distribution of causative HPV 16 and 18 in patients presenting with HSIL/AIS/ICC was similar between vaccine-naïve and vaccinated patients. This data suggests cervical screening guidelines should not differentiate between "vaccinated" and "non-vaccinated" women without further details of their vaccination.

Keywords: HPV type; HPV vaccination; HSIL; early cervical cancer.