To study the human papillomavirus (HPV) genotype distribution of cervical cancer (CxCa) and cervical intraepithelial neoplasia grade 2/3 (CIN2/3) in China and to evaluate cotesting of HPV and cytology in CxCa screening.
Patients with histopathologic CxCa and CIN 2/3 diagnoses reported between January 2012 and June 2016 and extended HPV genotype testing in the prior 6 months were documented in the institute. Available prior Papanicolaou (Pap) test results were also documented. Extended HPV genotype testing was performed using two China Food and Drug Administration-approved HPV tests.
CxCa and CIN 2/3 diagnoses and recent prior HPV test results were documented in 370 CxCa cases and 2774 CIN 2/3 cases. The high-risk (hr) HPV-positive rate was 88.4% for CxCa and 90.1% for CIN 2/3. Among 327 HPV-positive CxCa cases, the most common HPV types were HPV 16 (70.3%), 18 (7.0%), 58 (5.7%), 33 (4.1%), and 53 and 59 (1.9% each). Among 2499 hrHPV-positive CIN 2/3 cases, the most common HPV types were HPV 16 (53.3%), 58 (21.4%), 52 (11%), 33 (10.6%), and 18 (5.1%). 161 CxCa cases and 1094 CIN 2/3 cases also had available prior cotest results. Among cotested cases hrHPV-negative results were reported in 12.4% of CxCa and 10.1% of CIN 2/3 cases compared to cytology-negative results reported in 15.5% of CxCa and 4.3% of CIN 2/3.
HPV 16/18/59/39/45 genotypes were significantly more prevalent in CxCa cases than in CIN 2/3 cases, consistent with the more limited progressive potential of some CIN 2/3 lesions. Of CIN 2/3 and CxCa cases, 10% to 12% had recent negative hrHPV test results, pointing to a significant limitation of primary HPV screening.