J Cancer 2020; 11(20):6157-6167. doi:10.7150/jca.48357

Research Paper

Type-specific Distribution of Cervical hrHPV Infection and the Association with Cytological and Histological Results in a Large Population-based Cervical Cancer Screening Program: Baseline and 3-year Longitudinal Data

Fangbin Song1,2, Hui Du1,2✉, Aimin Xiao1,2, Chun Wang1,2, Xia Huang1,2, Zhihong Liu1,2, Meifang Zhao3, Hongjian Men3, Ruifang Wu1,2✉

1. Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, PR China
2. Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen 518036, Guangdong, PR China
3. Buji Street Family Planning Service Center, Buji Street, Longgang District, Shenzhen 518129, PR China

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Citation:
Song F, Du H, Xiao A, Wang C, Huang X, Liu Z, Zhao M, Men H, Wu R. Type-specific Distribution of Cervical hrHPV Infection and the Association with Cytological and Histological Results in a Large Population-based Cervical Cancer Screening Program: Baseline and 3-year Longitudinal Data. J Cancer 2020; 11(20):6157-6167. doi:10.7150/jca.48357. Available from https://www.jcancer.org/v11p6157.htm

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Abstract

Objectives: This study aimed to describe the study design, and to analyze the type-specific distribution of cervical high-risk human papillomavirus (hrHPV) infection and its association with cytological and histological results in a large population-based screening program in Buji Street, Shenzhen, China.

Methods: A total of 10,186 women aged 21-70 years were co-tested by Cobas4800 HPV assay and liquid-based cytology. Women were referred to colposcopy by virtue of being HPV16/18-positive, Other hrHPV-positive/ cytology ≥ASCUS, or HPV-negative/ cytology ≥LSIL. Three-year histological follow-up data were recorded.

Results: The overall prevalence of hrHPV infection was 11.1%; among them, the highest type was Other hrHPV (8.9%), followed by HPV16 (1.6%) and HPV18 (0.6%). Moreover, the prevalence of hrHPV and that of HPV16 increased with cytological severity (Ptrend <0.001). In the baseline phase, 106 women had cervical intraepithelial neoplasia 2/3 (CIN2/3) and six had cervical cancers. During 3-year follow-up, 12 cases of CIN2/3 and no cancers were identified. For HPV16-positive women with normal cytology, the baseline risks of CIN2/3 or worse (CIN2+/CIN3+) were 15.5% (7.0-23.9%) and 4.2% (1.4-8.5%) respectively. For Other hrHPV-positive women with normal cytology, the cumulative 3-year risks of CIN2+/CIN3+ were 3.1% (1.0-5.2%) and 0.7% (0.3-2.1%) respectively. Strikingly, 75.8% (322/425) of abnormal cytology and 50.9% (29/57) HSIL cytology were attributed to Other hrHPV infection in HPV-positive women. Similarly, Other hrHPV infection led to large proportions of CIN2 (62.7%) and CIN3+ (43.9%) over 3-year follow-up.

Conclusions: The co-testing modality is a feasible, effective and safe option for cervical cancer screening in urban population. Great importance should also be attached to 'genotypes excluding HPV16/18' and separate detection of each genotype when considering screening and vaccination strategy.

Keywords: Human papillomavirus, genotype, cytology, cervical cancer screening, vaccination