Abstract
BackgroundInfection with human papillomaviruses (HPVs) can cause benign and malignant tumours in the anogenital tract and the oropharynx both in men and women. The aim of the presented study was to investigate cervical, anal, and oral HPV-detection rates among women referred to colposcopy for abnormal Cervical Cancer (CaCx) screening results and assess the concordance of HPV-types among these anatomical sites.MethodsWomen referred to colposcopy at a single centre due to abnormal cytology, conducted for CaCx screening, were subjected to cervical Liquid-based Cytology (LBC) smear testing, anal and oral sampling. Routine colposcopy consisted in multiple biopsies and/or Endocervical Curettage (ECC). HPV-detection was performed by PCR genotyping in all three anatomical sites. In high-risk (hr) HPV-DNA positive samples either from anal canal or oral cavity, anal LBC cytology and anoscopy were performed, or oral cavity examination respectively. Descriptive statistics was used for the analysis of HPV-detection rates and phi-coefficient for the determination of HPV-positivity concordance between the anatomical sites.ResultsOut of 118 referred women, hr. HPV-DNA was detected in 65 (55.1%), 64 (54.2%) and 3 (2.5%) at cervix, anal canal and oral cavity respectively while low-risk HPV-DNA was detected in 14 (11.9%) and 11 (9.3%) at cervix and anal canal respectively. The phi-coefficient for cervix/anal canal was 0.392 for HPV16, 0.658 for HPV31, 0.758 for HPV33, − 0.12 for HPV45, 0.415 for HPV52 and 0.473 for HPV58. All values were statistically significant (p < 0.001).ConclusionsThe results suggest that most HPV-types, high-risk and low-risk, detected in the cervix of women with prevalent cervical dysplasia, correlate with the ones detected in their anal canal. This particularly applies for the HPV-types included in the nonavalent HPV-vaccine (HPVs 6/11/16/18/31/33/45/52/58).
Highlights
Infection with human papillomaviruses (HPVs) can cause benign and malignant tumours in the anogenital tract and the oropharynx both in men and women
Participants & sampling The presented analysis was conducted on samples collected from 118 women referred to the Colposcopy/Cervical Pathology Clinic of the 2nd Department of Obstetrics/Gynaecology (Hippokration Hospital, Medical Faculty Aristotle University of Thessaloniki (AUTh), Greece) for either an abnormal Pap-test screening result or for follow-up testing after surgical treatment for highgrade cervical intraepithelial lesion (CIN) between January 2015 and November 2016
It has been hypothesized that HPV could be a carcinogenic factor for anal as well as oropharyngeal cancer, apart from cervical, for which it is known to be a necessary condition, since hr-HPV is detected in 99.7% of all cervical cancer cases worldwide [1]
Summary
Infection with human papillomaviruses (HPVs) can cause benign and malignant tumours in the anogenital tract and the oropharynx both in men and women. The aim of the presented study was to investigate cervical, anal, and oral HPV-detection rates among women referred to colposcopy for abnormal Cervical Cancer (CaCx) screening results and assess the concordance of HPV-types among these anatomical sites. Persistent infection with high-risk human papillomaviruses (HPVs) is necessary, but not sufficient, for the development of Cervical Cancer (CaCx) [1,2,3]. HPV has been detected in other anatomical sites like the anus and the oral cavity and has been associated to some extent to anal and oropharyngeal cancer respectively [4,5,6,7]. It has been reported that anal HPV-infection is more common in men or women who already have a genital HPV-infection suggesting HPV-type concordance in genitalia and anus [11,12,13,14]
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