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Incorporating HPV 33 and cytology into HPV 16/18 screening may be feasible. A cross-sectional study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The distribution of human papillomavirus (HPV) varies geographically, and each country is making its screening and vaccination program. This study questioned the need for colposcopy for HPV types other than HPV 16 and 18, and the need for cytology incorporated into HPV testing.

Methods

1043 consecutive patients referred for colposcopy are included in this retrospective study. Logistic regression analysis, ANOVA, and Pearson’s correlation were used for statistical analysis. The value of p < 0.05 was considered statistically significant.

Results

HPV 16 was the most common HPV type referred, followed by HPV 18, 52, 51, and 31, respectively. HPV 16 tends to be positive in younger patients than other HPV types (p < 0.05). Only HPV 16 (OR: 1.41, 1.06–1.88 95% CI) and HPV 33 (OR: 2.23; 1.06–4.64 95% CI) (p < 0.05) had significant prediction for CIN 2 + lesions. In patients with only a cytological abnormality, cytological abnormality with single other high-risk (hr) HPV (without HPV 16 or 18) or double other hrHPV positivity but without HPV 16 and 18 infections, we detected 159 (19%) CIN 2 + lesions.

Conclusion

HPV 33 may be implemented in hrHPV screening protocols for direct colposcopy referral as well as HPV 16 and HPV 18 in specific regions. If we had opted for HPV-based screening only for HPV 16 and 18 without cytology, 19% of all CIN 2 + lesions would have been missed. HPV-based screening only with HPV 16 and 18 may not be feasible. Nonavalent vaccines should be considered for the vaccination of specific populations.

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Availability of data and material

Data supporting this study’s findings are available from the corresponding author (BT) upon reasonable request and with permission from the Institutional Review Board of Health Sciences University Samsun Research and Training Hospital.

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Funding

The author declares that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Gynecologic Oncology, Health Sciences University Samsun Research and Training Hospital, Samsun, Turkey

    Burak Tatar

  2. Department of Multidisciplinary Molecular Medicine, Health Sciences Institute, Ondokuz Mayıs University, Samsun, Turkey

    Burak Tatar

  3. Private Clinic, Samsun, Turkey

    Burak Tatar

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Contributions

As the only author, BT examined the patients, did the colposcopies, took records, applied to the ethics committee, and prepared the manuscript.

Corresponding author

Correspondence to Burak Tatar.

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The author has no relevant financial or non-financial interests to disclose.

Ethical statement

The work has been approved by Health Sciences University Samsun Research and Training Hospital Institutional Review Board (IRB) and Ethics Committee with the approval number TUEK 67-2019BADK/13-101.

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Tatar, B. Incorporating HPV 33 and cytology into HPV 16/18 screening may be feasible. A cross-sectional study. Arch Gynecol Obstet 308, 183–191 (2023). https://doi.org/10.1007/s00404-022-06876-8

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  • DOI: https://doi.org/10.1007/s00404-022-06876-8

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