Women who test positive for certain high-risk human papillomavirus types but do not show any signs of cellular abnormality have an increased risk of developing cervical cancer, according to a new European study.
Researchers from Karolinska University Hospital and Institute in Sweden, working with teams from the USA, Slovenia, and Belgium, say their findings indicate how testing for HPV needs to be incorporated into screening programme.
The study, published in CANCER, examined 576 women with normal findings on liquid-based cytology of the cervix. They were followed for nine years and during that time, 92 developed high-grade pre-cancerous cervical changes and four women developed cervical cancer.
These 96 women (cases) were compared with 480 women with normal findings on follow-up cervical cytology and were matched by age. All 576 baseline cervical samples were tested retroactively for HPV.
The study teams found that a positive HPV finding was more common among the 96 women than among the controls. For women under 30 years, only HPV16 and HPV18 were present more often among cases than controls and were associated with an increased risk of pre-cancerous cervical changes and cervical cancer.
For women over 30, other HPV types in addition to HPV16 and HPV18 conferred significant risk.
Dr Sonia Andersson, principal investigator, said: “These findings can help in the ongoing development of guidelines for cervical cancer screening. They strongly indicate that testing for HPV needs to be incorporated into screening programs.
“Women younger than 30 with a positive HPV16 or HPV18 finding need to be closely followed, whereas other HPV types are much less likely to be associated with increased risk in these younger women. Among women above age 30, any HPV positive finding should be closely followed.”
Fröberg M, Östensson E, Belkic K et al. The impact of HPV status on development of high-grade cervical intraepithelial neoplasia in women negative for intraepithelial lesions or malignancy at baseline: 9-year Swedish nested case-control follow-up study. Cancer 10 December 2018; doi: 10.1002/cncr.31788
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