Human Papillomavirus Positivity Research Articles

Comparison of the ScreenFire and Xpert HPV assays for the detection of human papillomavirus and cervical precancer among women living with HIV in Malawi

BackgroundThe World Health Organization recommends human papillomavirus (HPV) testing for primary cervical cancer screening, including among women living with HIV (WLWH). Low-and-middle-income countries account for 85% of the cervical cancer burden globally, yet have limited access to HPV-based screening, largely due to cost. This study aims to compare the performance of a rapid, isothermal amplification HPV assay (ScreenFire) to that of the Xpert HPV assay for the detection of HPV and cervical precancer among WLWH in Malawi.MethodsWe utilized stored self- and provider-collected specimens from a prospective cohort study of WLWH in Malawi from July 2020 to February 2022. Specimens were tested with both Xpert and ScreenFire HPV assays. The overall and within-channel non-hierarchical agreement between ScreenFire and Xpert was determined for both self- and provider-collected specimens. Hierarchical ScreenFire HPV positivity by channel was compared to Xpert for each histological diagnosis—cervical intraepithelial neoplasia grade 2 or worse (CIN2+) compared to <CIN2.Results315 matched self- and provider-collected specimens had valid results from both Xpert and ScreenFire testing and were included in analyses, of which 279 and 36 were HPV positive and HPV negative, respectively, on Xpert self-collection. Of the 315, 245 (78%) had normal pathology, 21 CIN1 (7%), 14 CIN2 (4%), and 35 CIN3 (11%). Of the 245 with normal pathology, 213 (87%) and 188 (77%) were HPV-positive on Xpert and ScreenFire self-collected specimens, respectively. Among provider-collected specimens, the assays had 80% agreement on overall HPV positivity (unweighted kappa 0.59, 95% 0.50–0.69). ScreenFire was HPV-positive in 90% of self-collected specimens that were HPV-positive on Xpert. Channel agreement between the assays was high for both self- and provider-collected specimens, but slightly lower for HPV18/45. In hierarchical analysis, ScreenFire demonstrated high concordance with Xpert testing for detecting CIN2+ cases in all channels, missing no HPV 16 or HPV 18/45 positive CIN2+ case that was positive on Xpert, in both self- and provider-collected specimens.ConclusionIn this study of stored specimens, the ScreenFire HPV assay performed well in the detection of HPV and CIN2+ among WLWH compared to the Xpert HPV assay. If supported by larger validation studies, ScreenFire could be an affordable alternative point-of-care HPV assay for use in LMICs.

Human Papillomavirus Genotype Distribution in a Hospital-based Single-Center Study

Background: Cervical cancer is reported as one of the most prevalent malignancies worldwide in women. There is a substantial connection between cervical diseases and infection with Human Papillomavirus (HPV), especially Types 16 and 18 of HPV. Objective: This study aimed to assess the HPV genotype distribution to determine its most common type at a referral hospital in Iran. Methods: This cross-sectional study was conducted on 400 women with positive HPV result tests who visited the gynecologic oncology clinic of Baqiyatallah Hospital from 2017-2021. Results: The average age of subjects was 37.46±9.75 years (range=19-74). About 167 (41.8%) of the patients were between 25 to 35 years. The analysis showed that 137 (34.2%) patients had only low-risk (LR) typing, 129 (32.2%) patients had only high-risk (HR) typing, and 134 (33.5%) patients had both HR and LR typing. The most frequent LR HPV types were HPV 6 (18.5%) and 11 (17%), and the most frequent HR HPV types were HPV-16 (14.7%), 52 (8.2%), 18, and 31 (6.5%). Conclusion: This study showed that the most frequent age category in both low- and HR HPVpositive women is the age 25 to 35 years. The second most common HR-HPV subtypes included HPV-52, not HPV-18, which indicates variations in HR-HPV subtypes in different populations and races and warrants further research.

Impact of Human Papillomavirus (HPV) Infection on the Treatment Outcome of Concomitant Chemoradiotherapy (CRT) in Cervical Cancer

Background: Human Papilloma Virus (HPV) infection and its persistence are responsible for the development of cervical cancer (CaCx). Chemoradiotherapy (CRT) is the only treatment option, especially in advanced stages. However, it is not influenced by the status of HPV infection. CRT controls cancer growth along with mild to severe adverse effects. Objective: The aim of this study was to assess the HPV-associated risk factors and correlate them with chemoradiation therapy (CRT) response in cervical cancer. Methods: The study was undertaken in 103 histologically positive CaCx patients. Anthrodemographic and obstetric characterizations were conducted by face-to-face interviews, and HPV testing was done by conventional PCR. All the patients received a 40-50Gy total effective dose using tele‑ and brachytherapy. The treatment response, survivorship and statistical analysis were made using GraphPad Prism 9 and SPSS (ver.25.0). Results: Out of 103 patients, 84% were HPV infected, and 16% CaCx were HPV-negative. Advanced age, lower-middle socioeconomic status (SES), illiteracy, and patients from rural backgrounds were significantly higher in CaCx patients with HPV infection. Multiparity, irregular menstrual cycle, poor menstrual hygiene, and use of contraception were significantly associated with HPV positivity. Patients with HPV infection showed a better clinical response (P =0.031), alive vital status (P =0.007), and 59 months of median survival (P &lt;0.001) with a poor hazard ratio (HR 0.29 at 95% CI). Conclusion: HPV-infected CaCx patients showed better response to definitive chemoradiation therapy compared to HPV-negative with a poor hazard ratio. Therefore, HPV testing can potentially stratify CaCx patients for more effective therapeutic regimens, treatment assessments and follow-ups.

HPV genotyping in clinical samples using long-read single-molecule real-time sequencing.

Human papillomavirus (HPV) genotyping is widely used, particularly in combination with high-risk (HR) HPV tests for cervical cancer screening. We developed a genotyping method using sequences of approximately 800 bp in the E6/E7 region obtained by PacBio single molecule real-time sequencing (SMRT) and evaluated its performance against MY09-11 L1 sequencing and after the APTIMA HPV genotyping assay. The levels of concordance of PacBio E6/E7 SMRT sequencing with MY09-11 L1 sequencing and APTIMA HPV genotyping were 100% and 90.8%, respectively. The sensitivity of PacBio E6/EA7 SMRT was slightly greater than that of L1 sequencing and, as expected, lower than that of HR-HPV tests. In the context of cervical cancer screening, PacBio E6/E7 SMRT is then best used after a positive HPV test. PacBio E6/E7 SMRT genotyping is an attractive alternative for HR and LR-HPV genotyping of clinical samples. PacBio SMRT sequencing provides unbiased genotyping and can detect multiple HPV infections and haplotypes within a genotype.

Urine high-risk human papillomavirus testing as an alternative to routine cervical screening: A comparative diagnostic accuracy study of two urine collection devices using a randomised study design trial.

To evaluate the sensitivity of human papillomavirus (HPV) tested urine to detect high-grade cervical precancer (cervical intraepithelial neoplasia grade 2+ [CIN2+]) using two urine collection devices. Randomised controlled trial. St Mary's Hospital, Manchester, UK. Colposcopy attendees with abnormal cervical screening; a total of 480 participants were randomised. Matched urine and cervical samples were available for 235 and 230 participants using a first-void urine (FVU)-collection device and standard pot, respectively. Urine was self-collected and mixed with preservative - randomised 1:1 to FVU-collection device (Novosanis Colli-pee® 10 mL with urine conservation medium [UCM]) or standard pot. Matched clinician-collected cervical samples were taken before colposcopy. HPV testing used Roche cobas® 8800. A questionnaire evaluated urine self-sampling acceptability. The primary outcome measured sensitivity of HPV-tested urine (FVU-collection device and standard pot) for CIN2+ detection. Secondary outcomes compared HPV-tested cervical and urine samples for CIN2+ and evaluated the acceptability of urine self-sampling. Urine HPV test sensitivity for CIN2+ was higher with the FVU-collection device (90.3%, 95% CI 83.7%-94.9%, 112/124) than the standard pot (73.4%, 95% CI 64.7%-80.9%, 91/124, p = 0.0005). The relative sensitivity of FVU-device-collected urine was 0.92 (95% CI 0.87-0.97, pMcN = 0.004) compared with cervical, considering that all women were referred after a positive cervical HPV test. Urine-based sampling was acceptable to colposcopy attendees. Testing of FVU-device-collected urine for HPV was superior to standard-pot-collected urine in colposcopy attendees and has promising sensitivity for CIN2+ detection. General population HPV testing of FVU-device-collected urine will establish its clinical performance and acceptability as an alternative to routine cervical screening.

Assessing Management of Abnormal Cervical Cancer Screening Results and Concordance with Guideline Recommendations in Three US Healthcare Settings.

Follow-up of abnormal results is essential to cervical cancer screening, but data on adherence to follow-up are limited. We describe patterns of follow-up after screening abnormalities and identify predictors of guideline-concordant follow-up. We identified the index screening abnormality (positive human papillomavirus [HPV] test or atypical squamous cells of undetermined significance [ASC-US] or more severe cytology) among women 25-65 years old at three U.S. healthcare systems during 2010-2019. We estimated the cumulative incidence of surveillance testing, colposcopy, or treatment after the index abnormality and initial colposcopy. Logistic regressions were fit to identify predictors of guideline-concordant follow-up according to contemporaneous guidelines. Among 43,007 patients with an index abnormality, the cumulative incidence of any follow-up was 49.6% by 4 years for those with ASC-US/HPV-negative and higher for abnormalities warranting immediate colposcopy. The 1-year cumulative incidence of any follow-up after colposcopy was 70% for patients with normal results or cervical intraepithelial neoplasia (CIN) I and 90% for patients with CIN II+. Rates of concordant follow-up after screening and colposcopy were 52% and 47%. Discordant follow-up was associated with factors including age, race/ethnicity, overweight/obese BMI, and specific types of public payor coverage or being uninsured. Adherence to recommended follow-up of cytologic and histopathologic abnormalities is inconsistent in clinical practice. Concordance was poor for mild abnormalities and improved, though suboptimal, for more severe abnormalities. There remain gaps in the cervical cancer screening process in clinical practice. Further work is needed to understand barriers to appropriate management of cervical abnormalities.

Nonlinear relationship between viral load and TCT in single/multiple HPV52 infection

PurposeTo determine the correlation between HPV (human papillomavirus) 52 viral load, multiple infections and ThinPrep cytology test (TCT), to inform clinical management of HPV52-positive women after cervical cancer screening.MethodsA total of 1,882 female patients who had positive quantitative HPV tests at Yuebei People's Hospital from January 2020 to December 2022, of whom 533 tested positive for HPV52. We excluded patients who combined HPV16 and/or HPV 18 positivity and whom HPV52 viral load could not be calculated. The final enrollment was 488 patients, including 400 NILM, 48 ASC-US, 28 LSIL and 12 HSIL. The HPV test is a quantitative multiplexed fluorescent PCR assay that provides both HPV genotyping and viral load.ResultsIn our study, there were differences in the median distribution of viral loads among various cytological class categories. The risk of TCT results (LSIL or worse) was increased with the increase of HPV52 viral load, for every LOG unit increase in HPV52 viral load, the risk increased by 26.6%. More importantly, we found a nonlinear relationship between HPV52 viral load and TCT results (LSIL or worse) in both single and multiple infections. When the viral load reaches a threshold, the risk of abnormal cytological results increases significantly.ConclusionHPV52 viral load is an independent risk factor for TCT results (LSIL or worse). The relationship between HPV52 viral load and TCT results (LSIL or worse) is not linear. Viral load may be used as a triage indicator for HPV52-positive patients, thus improving the post-screening clinical management of HPV52-positive women.

Navigating therapeutic strategies: HPV classification in head and neck cancer.

The World Health Organisation recognised human papillomavirus (HPV) as the cause of multiple cancers, including head and neck cancers. HPV is a double-stranded DNA virus, and its viral gene expression can be controlled after infection by cellular and viral promoters. In cancer cells, the HPV genome is detected as either integrated into the host genome, episomal (extrachromosomal), or a mixture of integrated and episomal. Viral integration requires the breakage of both viral and host DNA, and the integration rate correlates with the level of DNA damage. Interestingly, patients with HPV-positive head and neck cancers generally have a good prognosis except for a group of patients with fully integrated HPV who show worst clinical outcomes. Those patients present with lowered expression of viral genes and limited infiltration of cytotoxic T cells. An impediment to effective therapy applications in the clinic is the sole testing for HPV positivity without considering the HPV integration status. This review will discuss HPV integration as a potential determinant of response to therapies in head and neck cancers and highlight to the field a novel therapeutic avenue that would reduce the cancer burden and improve patient survival.

Human Papillomavirus Is Rare and Does Not Correlate with p16INK4A Expression in Non-Small-Cell Lung Cancer in a Jordanian Subpopulation.

Background and Objectives: Human papillomavirus (HPV) was previously investigated in lung cancer with wide inter-geographic discrepancies. p16INK4a has been used as a surrogate for detecting high-risk HPV (HR-HPV) in some cancer types. This study assessed the evidence of HPV in non-small-cell lung cancer (NSCLC) among Jordanian patients, investigated the expression of p16INK4a, and evaluated its prognostic value and association with HPV status. Materials and Methods: The archived samples of 100 patients were used. HPV DNA detection was performed by real-time polymerase chain reaction (RT-PCR). p16INK4a expression was assessed by immunohistochemistry (IHC). The Eighth American Joint Committee on Cancer protocol (AJCC) of head and neck cancer criteria were applied to evaluate p16INK4a positivity considering a moderate/strong nuclear/cytoplasmic expression intensity with a distribution in ≥75% of cells as positive. Results: HPV DNA was detected in 5% of NSCLC cases. Three positive cases showed HR-HPV subtypes (16, 18, 52), and two cases showed the probable HR-HPV 26 subtype. p16INK4a expression was positive in 20 (20%) NSCLC cases. None of the HPV-positive tumors were positive for p16INK4a expression. A statistically significant association was identified between p16INK4a expression and the pathological stage (p = 0.029) but not with other variables. No survival impact of p16INK4a expression was detected in NSCLC cases as a group; however, it showed a statistically significant association with overall survival (OS) in squamous cell carcinoma (SqCC) cases (p = 0.033). Conclusions: This is the first study to assess HPV and p16INK4a expression in a Jordanian population. HPV positivity is rare in NSCLC among a Jordanian subpopulation. P16 INK4a reliability as a surrogate marker for HPV infection in lung cancer must be revisited.

SCREENING FOR HUMAN PAPILLOMAVIRUS USING SELF-COLLECTED CERVICAL SAMPLES FROM WOMEN DEPRIVED OF LIBERTY IN THE STATE OF AMAZONAS, BRAZIL

Objective: The aim of the study was to identify the prevalence of human papillomavirus (HPV) infections using a self-collection device and also describe the frequency of P16INK4a overexpression in women deprived of liberty (WDL). Methods: This observational, cross-sectional, descriptive, analytical, and epidemiological study of the prevalence of HPV infection included 268 women deprived of liberty (WDL) in the state of Amazonas who performed self-collection using the Roche® HPV CTNG test. Patients with positive HPV results were submitted to a Pap smear in liquid medium, colposcopy, an immunocytochemistry evaluation using P16INK4a, and a biopsy, when necessary. Results: The age of the 268 women ranged from 19 to 64 years (mean±standard deviation: 33.5±9.1 years). HPV was detected in 66 (24.6%) women: 12 (4.5%) had HPV 16, 3 (1.1%) had HPV 18, 51 (19%) had other high-risk HPV genotypes, 21 (7.8%) had inconclusive results and 181 (67.5%) had negative results. Two women had a high-grade lesion and 13 had a low-grade lesion. Eight women showed alterations in their Pap smear and 32 (64%) presented overexpression of P16INK4a. Self-collection was well-accepted by 95.9% of the WDL. Conclusion: This study shows that the prevalence of HPV among the sample of WDL was high, that self-collection as a screening method was well-accepted and that the prison population has peculiar characteristics since there is a higher prevalence of other high-risk HPV genotypes.

2024 Updates to Cervical Cancer Screening in Canada

The landscape of cervical cancer screening in Canada is about to undergo a major shift from cytology-based screening to testing directly for the presence of high-risk strains of the human papilloma virus (HPV), the persistence of which is known to be a prerequisite for the development of almost all cases of cervical cancer. In 2018, the World Health Organization declared a call to action for the worldwide elimination of cervical cancer by 2040. Subsequently the Canadian Partnership Against Cancer (CPAC) released an action plan outlining the necessary steps for Canada to reach this goal. One of the 3 major priorities identified in the action plan is the transition to primary HPV testing. This transition from screening to testing represents a major shift in infrastructure and also a shift in mindset for clinicians, policymakers, and the public. To help guide this transition, CPAC has collaborated with the Gynecologic Oncology Society of Canada (GOC) and the Society of Canadian Colposcopists (SCC) to release two open-access, evidence‑based guidelines in June 2023. These guidelines address how to manage a positive HPV screening test, and colposcopy in the context of primary HPV‑screening. This paper will outline the evolution of cervical cancer screening in Canada along with the rationale behind the transition to HPV testing. Also included is a discussion on the broad recommendations from the 2023 CPAC/GOC/SCC guidelines, as well as recommendations for age and interval of screening and special populations. Readers of this article in e-journal format can access the Canadian Guideline on the Management of a Positive Human Papillomavirus Test and Guidance for Specific Populations here. Readers may also access the 2023 Canadian Colposcopy Guideline: A Risk-Based Approach to Management and Surveillance of Cervical Dysplasia here.

Investigation of Human Papillomavirus (HPV) Frequency and Genotype Analysis in Cervical Samples

Aim: Human Papillomaviruses (HPVs) are double-stranded DNA viruses belonging to the Papillomaviridae family. There is ample evidence demonstrating the association of Human Papillomavirus (HPV) with cervical carcinoma. This study aimed to investigate the presence of HPV DNA in cervical swab samples and determine the HPV genotypes in positive samples.&#x0D; Materials and Methods: The three-year results of cervical swab samples sent to the Medical Microbiology Laboratory of Afyonkarahisar Health Sciences University Faculty of Medicine Hospital for screening for HPV DNA presence between January 1, 2020, and December 31, 2022, were retrospectively evaluated in this study. HPV genotyping was performed using the cobas 4800 (cobas® x480) fully automated system (Roche Diagnostics, Indianapolis, USA) for extraction, and the samples were analyzed using the Real-time PCR (cobas® z 480) system following the manufacturer's instructions. &#x0D; Results: HPV-DNA was detected in 415 out of a total of 4960 patients (8.4%), while 4545 (91.6%) tested negative. Evaluation of HPV positivity revealed that the highest positivity rates were observed in HR-HPV at 68%, HPV 16 at 17.3%, and HPV 16 combined with HR-HPV at 8.2%. HPV-DNA positivity was highest at 38% in the 35-44 age group, while it was lowest at 3.4% in patients under 25 years old. &#x0D; Conclusion: Vaccination programs, alongside screening programs, will serve to restrict the spread of infection in at-risk populations and prevent HPV-related cancers. It is believed that nationwide HPV DNA screening studies and vaccination programs targeting HPV infections will be highly effective in reducing the prevalence of cervical cancer.

Role of Geminin as a Tool for Augmenting Accurate Diagnosis of Cervical Neoplasia.

To determine the role of geminin as a tool for differentiating various types of cervical intraepithelial neoplasia (CIN) and cervical carcinoma (CC). Seventy women newly diagnosed with CIN or CC undergoing cervical biopsy were included; their clinical profile, human papilloma virus (HPV) positivity, and colposcopy findings were noted, and biopsy tissue was analyzed for geminin content. On geminin immunohistochemistry, 100% of women with CIN3 and 96.29% of women with CC had geminin two plus or more. When analyzed as ordinal variables, there was a significant correlation (spearman's rho 0.35, p 0.01) between geminin and biopsy results (CIN1, CIN2, CIN3, and CC). Screening tests for cervical cancer, like conventional pap smears, liquid-based pap smears, and triaging with HPV, have limitations. It is important to be able to differentiate between high-grade lesions, invasive cancer, and low-grade lesions. The detection of geminin in these cells may aid in the confirmation of the diagnosis and ensure adequate treatment. Cervical intraepithelial lesions and carcinoma cervix demonstrated a correlation between increased geminin expression in CIN1 vs. CC and CIN2 vs. CC. Geminin may be a potential surrogate marker for higher-grade cervical lesions, and further research is needed to corroborate evidence in this direction.

Abstract 2297: Longitudinal monitoring of HPV circulating tumor DNA in cervical cancer

Abstract Introduction Detecting circulating tumor DNA (ctDNA) in the blood using minimally invasive techniques known as a "liquid biopsy", is gaining tremendous popularity in oncology research. Integration of human papillomavirus (HPV) DNA and the overexpression of the E6 and E7 oncogenes are crucial steps in the development of cervical cancer. We investigated the potential utility of HPV ctDNA as a biomarker for monitoring treatment outcomes in patients with cervical cancer. Material and Methods We use droplet digital PCR (ddPCR) to measure the amount of HPV16/18 ctDNA in plasma of cervical cancer patients. The HPV standard GP5+/6+ primers were used to determine HPV positivity in our patients. Specific primers were designed to amplify specifically the E6 oncogene of HPV16 and HPV18. Plasmid constructs were made using the PCR-purified products of HeLa and SiHa cell lines which would act as a positive control for the assay. HPV16 and 18 plasmids were serially diluted and then tested in qPCR as a template using different primer sets. Standard curves were made from the recombinant plasmids. This will serve as a positive control and will also provide a correlation between the sensitivity and specificity of qPCR vs ddPCR. Results and Discussions We hypothesize that our dPCR test will be able to detect minute quantities of HPV ctDNA in plasma of cervical cancer patients as ctDNA levels are expected to be decrease as treatment progresses. The assay sensitivity and specificity will be obtained by comparing results to QPCR. The study samples involve a tumor biopsy and a blood sample at the baseline prior to the therapy and serial blood sampling in different stages of treatment and follow-ups. These samples will also serve for treatment monitoring of these patients through ddPCR. Tumor samples are used to confirm the HPV status of patients using HPV-specific GP5+/GP6+ qPCR. We have recruited 75 cervical cancer patients with majority of them being squamous cell carcinoma and stage IIB disease. The qPCR results from tumor biopsy revealed HPV 16 was most prevalent (32/43), followed by HPV18 (6/43) and HPV 33(2/43). Conclusion we will now use Qiagen digital PCR system to understand HPV ctDNA levels in our patient cohort. we believe that our comprehensive sample collection after every treatment milestone and thorough follow-up for upto 2 years after diagnosis will allow us to study the utility of this sensitive test in monitoring disease and relapse. Citation Format: Preetiparna Parida, Krishna Sharan, Shirley Lewis, Rama Rao Damerla. Longitudinal monitoring of HPV circulating tumor DNA in cervical cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2297.

Long-Term Follow-Up Outcomes in Women with In Situ/Microinvasive Adenocarcinoma of the Uterine Cervix Undergoing Conservative Treatment-Cervical Adenocarcinoma Study Group Italian Society of Colposcopy and Cervico-Vaginal Pathology.

The present study aimed to assess long-term follow-up outcomes in women with in situ/microinvasive adenocarcinoma (AC) of the uterine cervix treated conservatively. Retrospective multi-institutional study including women with early glandular lesions and 5-year follow-up undergoing fertility-sparing treatment. Independent variables associated with recurrence were evaluated. Logistic regression analysis and Kaplan-Meier survival analysis with Logrank test were performed. Of 269 women diagnosed with in situ/microinvasive AC, 127 participants underwent conservative treatment. During follow-up, recurrences were found in nine women (7.1%). The only factor associated with recurrence during follow-up was positive high-risk Human Papillomavirus (hr-HPV) testing (odds ratio 6.21, confidence interval 1.47-26.08, p = 0.012). HPV positivity in follow-up showed a recurrence rate of 21.7% against 3.8% in patients who were HPV-negative (p = 0.002, Logrank test). Among women with negative high-risk HPV tests in follow-up, recurrences occurred in 20.0% of non-usual-type histology vs. 2.1% of usual-type cases (p = 0.005). HPV testing in follow-up is of pivotal importance in women with early glandular lesions undergoing conservative treatment, given its recurrence predictive value. However, women who are high-risk HPV-negative in follow-up with non-usual-type histopathology may represent a sub-population at increased risk of recurrences. Further studies should confirm these findings.

Human Papilloma Virus Typing as a Triage Tool for Women with Postcoital Bleeding: A Retrospective Cohort Study.

Objective: To investigate the performance of human papilloma virus (HPV) typing as a triage tool in the management of patients with postcoital bleeding (PCB). Methods: All patients referred for colposcopy at a cervical pathology clinic of a nationwide health insurance organization, due to PCB and had a preceding high-risk HPV (hrHPV) test between 2018 and 2020, were retrospectively located. Demographic and pathologic data were collected from electronic medical files. Sensitivity, specificity, and negative and positive predictive value of hrHPV test according to final pathology were calculated. Results: Three hundred ninety patients referred for colposcopy due to PCB with a preceding hrHPV test were located. HrHPV-positive patients were significantly younger (33.7 ± 10 vs. 37.2 ± 9, p < 0.006) with a higher proportion of nulliparous, nonmarried, and smokers compared with hrHPV-negative patients (75% vs. 47%, p < 0.001; 75.4% vs. 45.1%, p < 0.001; and 24.6% vs. 12.8%, p < 0.028, respectively). No case of high-grade cervical intraepithelial neoplasia (CIN2/3) was identified among hrHPV-negative patients. The sensitivity and NPV of the hrHPV test for high-grade cervical lesions were both 100%, decreasing to 36% and 95%, respectively, for any cervical dysplasia (CIN1/CIN2/CIN3). Adding cytology to HPV typing had a negligible effect on test performance. At univariate analysis, age, HPV vaccine status, nulliparity, and positive HPV typing were independently associated with cervical dysplasia. At multivariate analysis, only positive HPV typing remained significantly associated with cervical dysplasia (hazard ratio 2.75, confidence interval 1.1-6.5, p = 0.023). Conclusion: A negative HPV test even in the presence of PCB may rule out cervical dysplasia with extremely high accuracy and may save unnecessary colposcopies.

Long-Term Efficacy of Risk-Directed, De-Escalated Post-Operative Adjuvant Therapy for Surgically Resected Locally Advanced, Human Papillomavirus-Positive Oropharynx Squamous-Cell Carcinoma (HPV+ OPSCC): A Non-Randomized, Multi-Arm Phase 2 Trial

Long-Term Efficacy of Risk-Directed, De-Escalated Post-Operative Adjuvant Therapy for Surgically Resected Locally Advanced, Human Papillomavirus-Positive Oropharynx Squamous-Cell Carcinoma (HPV+ OPSCC): A Non-Randomized, Multi-Arm Phase 2 Trial

High incidence of HPV infection in minors with oral squamous cell carcinoma

BackgroundOral squamous cell carcinoma in minors is considered to be a distinct entity from OSCC in older patients, with an uncertain etiology. Human papillomavirus (HPV) infection may trigger the initiation and promote the progression of OSCC, but these roles have not been firmly established.We aimed to explore the correlation between HPV infection and the development of oral squamous cell carcinoma in minors and know the characteristics of OSCC in young patients more thoroughly.MethodFrom January 2013 to December 2022,6 cases of OSCC aged < 15 years were selected from the Department of Oral Pathology, Peking University School of Stomatology, Beijing, China. All cases underwent testing for high-risk HPV mRNA infection using the RNA scope technique, and immunohistochemical staining was performed to investigate the expression of p16, pan-cytokeratin (CK), CK5/6, CK7, CK8/18, epidermal growth factor receptor (EGFR), p53, and Ki-67. Furthermore, we reviewed the literature on OSCC in patients aged < 21 years.ConclusionsMinors OSCC is associated with HPV infection, and that p16 can serve as an immunohistochemical marker of HPV positivity.

Attitude toward human papillomavirus self-sampling and associated factors among Thai women undergoing colposcopy.

To compare attitudes toward self-sampling for human papillomavirus (HPV) testing before and after specimen collection in women undergoing colposcopy. The factors associated with the pre-sampling attitude were also studied. This prospective study enrolled women with abnormal cervical cytology and/or positive high-risk HPV who attended colposcopy clinics at 10 cancer centers in Thailand between October 2021 and May 2022. Prior to colposcopy, the attitudes of the women toward self-sampling were surveyed through a questionnaire. Written and verbal instructions for self-sampling were provided before the process and subsequent colposcopy. The attitudes toward self-sampling were reassessed after the actual self-sampling. Factors associated with the attitudes were analyzed. A total of 499 women were included in this study. The mean age was 39.28±11.36 years. A total of 85.3% were premenopausal, and 98.8% had sexual experience. With the full score of 45, the attitude score after self-sampling was significantly higher than the attitude score before self-sampling (39.69±5.16 vs. 37.76±5.71; P<0.001). On univariate analysis, the factors associated with attitude before HPV self-sampling were age, menopause, sexual activity, education level, income, knowledge regarding HPV, and prior HSIL histology. The remaining significant factor on multivariate analysis was sexual activity within the past year (B=0.105, 95% CI, 0.014-2.870; P=0.048). Attitudes toward self-sampling improved after the actual self-sampling process, as evidenced by higher attitude scores. Sexual activity was the only independent factor related to the attitude before self-sampling.

Evaluating Opt-In Vaginal Human Papillomavirus Self-Sampling: Participation Rates and Detection of High-Grade Lesions (CIN2+) among Unscreened Japanese Women Aged 30-39.

Cervical cancer incidence is increasing among Japanese women, which is partly attributed to low screening rates. This study examined the implementation of opt-in human papillomavirus (HPV) self-sampling among Japanese women aged 30-39 years who had not undergone cervical cancer screening, focusing on those requiring preconception care. The responses to the opt-in approach and effectiveness in detecting cervical squamous intraepithelial neoplasia 2 or worse (CIN2+) were evaluated. Participants used the Evalyn® Brush for self-sampling, with HPV testing conducted using the Cobas 4800 system (version 2.2.0). Out of 3489 eligible, unscreened women from four municipalities in Fukui Prefecture, only 10.6% (370/3489) requested the self-sampling kit. Of these, 77.3% (286/370) returned the kit (HPV testing rate: 8.2% (286/3489)). The HPV positivity rate was 13.7% (39/285), yet only 61.5% (24/39) of those with positive HPV results proceeded to cytology testing. Subsequently, three cases of CIN2+ were detected (10.5/1000). While this study demonstrated a reasonable kit return rate and indicated the capability of opt-in HPV self-sampling to detect CIN2+ cases in unscreened women, the low ordering rate of kits and suboptimal compliance for follow-up cytology testing highlight significant challenges. The findings suggest the need for more effective strategies to enhance participation in cervical cancer screening programs.