Cervical Screening in North Sardinia (Italy): Genotype Distribution and Prevalence of HPV among Women with ASC-US Cytology

Abstract

The assessment of human papillomavirus (HPV) genotype dynamics could support the adoption of more tailored preventive actions against cervical cancer. The aim of the study was to describe the prevalence of HPV infection, HPV genotype distribution, and the epidemiological characteristics of women with ASC-US cytology since the introduction of HPV-DNA testing in Sardinia (Italy), (March 2016–December 2020). Specimens were tested by RT-PCR for 14 high-risk HPV genotypes. A total of 1186 patients were enrolled, with a median (IQR) age of 41 (38–48) years. Of these women, 48.1% were positive for at least one HPV genotype; 311 (26.2%) women were vaccinated with a median (IQR) age of 38 (30/47) years. The percentage of prevalence of HPV-16, -31, -66, -56, and -51 was 36.3%, 18.7%, 11.9%, 11.4% and 10.7%, respectively. The highest prevalence of infection was found in women aged <41 years, and single women. Moreover, women aged >41 years (OR: 0.51, 95% CI: 0.31–0.86; p-value: 0.01), having parity (OR: 0.57, 95% CI: 0.34–0.96, p-value: 0.04), and higher educational level (OR: 0.39, 95% CI: 0.18–0.87; p-value: 0.02) were associated with a lower CIN2+ risk. We did not find a significant difference in terms of prevalence of HPV-16 infection between vaccinated and non-vaccinated (18.3% vs. 17.1%; p-value < 0.001). Our results support the adoption of nonavalent HPV-vaccine to prevent the most prevalent infections caused by HPV-16 and -31 genotypes and underscore the need of surveillance to implement tailored vaccination programs and preventive strategies.

Prevalence of human papilloma virus (HPV) genotypes between outpatients males and females referred to seven laboratories in Tehran, Iran

“…Fourth, the above-mentioned HPV prevalence among outpatients could not have mirrored the real HPV epidemiology among general population. According to recent studies on the clinical progression of cervical lesions in women and the importance of this issue, there is a need for deeper and more complete studies in the future that could be the starting point for such studies in the future in the Iranian female population [ 45 – 47 ].…”

Extended HPV typing test performed better predict value for CIN2+ among elderly women in China

“…Among women with ASC-US cytology in Italy, the top three HPV genotypes were HPV16, HPV31, and HPV66, respectively. ( Muresu et al, 2022 ) Our study discovered that the most prevalent HPV genotypes in the entire cohort were HPV 52, 16 and 53 ( Table 3 ). The result was similar, but not identical to those of other researches.…”

Preliminary Results of Feasibility and Acceptability of Self-Collection for Cervical Screening in Italian Women

“…The overall positivity found in our cohort probably reflects the wide variability in the prevalence of HPV infection reported in the literature, which is related to demographic (i.e., age), clinical (i.e., cytology and histology examinations) and microbiological (i.e., HPV detection method, type of specimens) variables [28]. The lack of information relative to cytology analysis does not allow for a comparison of the prevalence of HPV infection in our cohort with those reported previously in women with ASCUS cytology (~48% of HPV-positive rate) [27]. Further studies and larger sample sizes may clarify our results and plan appropriate preventive strategies to reach non-adherent women, who accounted for a relevant percentage in our cohort study (>60%), and to supply the consistent delay and reduction in screening participation (from 76% in 2019 to 40% in 2020), mainly attributable to the recent COVID-19 pandemic.…”