Racial differences in HPV type 16 prevalence in women with ASCUS of the uterine cervix

Abstract

BackgroundUnderstanding racial influences on human papillomavirus (HPV) distribution in women with atypical squamous cells of undetermined significance (ASCUS) cytology via partial genotyping in a statewide population can inform HPV‐based prevention efforts.MethodsWomen aged 21 to 65 years with any cytology result and partial HPV genotyping for ASCUS triage between January 1, 2014, and December 31, 2017, were included. All women attended a Mississippi State Department of Health clinic. Age, race, cytopathologic, and HPV data were extracted from the electronic health record and analyzed. Cytologic specimens were processed with ThinPrep and HPV testing with the Cobas 4800 assay. HPV genotypes were evaluated in hierarchical categories. Chi‐square tests and multinomial logistic regression models evaluated associations between race and type prevalence.ResultsThere were 43,106 women who underwent cervical cancer screening with cytology and ASCUS triage. Of these, 34,363 (80.2%) had normal cytology, 4672 (10.9%) had ASCUS, 2683 (6.3%) had a low‐grade squamous intraepithelial lesion, and 633 (1.5%) had a high‐grade squamous intraepithelial lesion. Blacks represented 69.3% of the sample and had a higher proportion of HPV‐positive ASCUS (6.5%) in comparison with whites (5.6%). Blacks had significantly decreased odds of HPV‐16 (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.6‐0.9; P = .002) and significantly increased odds for 12 other types (OR, 1.37; 95% CI, 1.2‐1.5; P < .0001) in comparison with whites.ConclusionsIn a diverse population, significant differences in HPV genotypes are shown by race. Importantly, blacks with ASCUS are less likely to be positive for HPV‐16 in comparison with whites. Ongoing work is evaluating the individual genotype prevalence and genotype‐specific risk of precancer by race.

<p>The Triage Effectiveness of an Extended High-Risk Human Papillomavirus Genotyping Assay for Women with Cytology Showing Atypical Squamous Cells of Undetermined Significance in China</p>

“…However, the prevalence of HR-HPV among women with ASC-US was quite inconsistent in different studies. Although one study reported that the prevalence rate of HR-HPV among women with ASC-US was 41.7%, 23 another study reported a prevalence rate of 23%. 24 The prevalence rate of HR-HPV among patients with ASC-US was 47.6% in our research.…”

HPV E1 qPCR, a Low-Cost Alternative Assay to Roche Diagnostic Linear Array is Effective in Identifying Women at Risk for Developing Cervical Cancer

“…The reasons for those differences are unclear but could be due to factors such as differences in the HPV genotypes, viral load or the integration status of the HPVs that could vary by the severity of lesion status or by race. 27 , 33 , 34 Despite those differences, the NPV to exclude the possibility of having underlying CIN lesions caused by any HPV genotype, included or not included in HPV vaccines, was highly satisfactory (≥90%) in both AA and CA women. Therefore, the utilization of the HPV E1 assay as a tool for CC screening could be a cost-effective approach that applies to both vaccinated and unvaccinated populations comprised varying races or ethnicities in developed and underdeveloped countries.…”

ThinPrep cytologic test combined with HPV typing to evaluate the degree of cervical diseases and the relationship between HPV typing and the pathological results of patients with atypical squamous cells of undetermined significance: a diagnostic test

“…Studies have shown that among 18,574 women who underwent ASCUS HPV typing, the HPV positive rate was 10.9%, and the infection rate of women under 30 years old was the highest ( 20 ). Young women who have more sex may have more opportunities to cause cervical epithelial damage.…”