The prevalence of HPV types in women with CIN 2-3 or cervical cancer in Haifa district, Israel.

Abstract

Human papilloma virus (HPV) is classified as a biologic carcinogen causing cervical cancer. Our aim was to identify all the HPV types responsible for cervical cancer and pre-cervical cancer in Israel. This study included 226 women, diagnosed with cervical intraepithelial neoplasia (CIN) 2-3 and 115 women diagnosed with cervical cancer, and tested for all HPV typing during the period of January 2006 to May 2013. HPV was detected in 92.9% of women with CIN 2-3 and high-risk HPV (HR-HPV) was detected in 85.8% of them. In women with cervical cancer, HPV was positive in 96.5%, HR-HPV detected in 93%. In the CIN 2-3 group the most common HPV types were 16 (42%), 31 (8.8%) and 18 (4.9%) and in the cancer group HPV 16 (57.4%), 45 (9.6%), and 18 (7.8%). Multiple HPV types were seen in 12.8% of CIN 2-3 group but only in 0.9% of cancer group. The chief complaint led to cancer diagnosis was post menopause bleeding (27%), while abnormal Papanicolaou (Pap) test lead to CIN 2-3 diagnosis in 75.2% of the women. Only 22.6% of women diagnosed with cancer were diagnosed due to abnormal Pap test and 76.9% of them were diagnosed at stage I, as compared to women diagnosed with cancer because of bleeding or abnormal mass, of them 57.1 % were diagnosed at stage I (P<0.07). HR-HPV types were found in 93% of cancer group and 85.8% of CIN 2-3 group, and low-risk HPV (LR-HPV) was detected in 3.5% and 7.1% of women with cervical cancer and CIN 2-3 respectively. The most common HPV types in cervical cancer women were 16, 45 and 18. Women diagnosed with cancer because abnormal Pap test were in earlier stage compared to women diagnosed because of complains. Including LR-HPV types in screening HPV can increase the sensitivity of the test.