D3.533 - Prevalence of dysplasia and cervical cancer of papillomavirus origin in women of different age groups

Worldwide, and particularly in low- and middle-income countries, over 95% of the 660,000 annual cases of cervical cancer are caused by human papillomaviruses (HPV). In Ukraine the disease is most frequently diagnosed in women who avoid regular medical check-ups, a trend that has intensified, particularly in the current wartime conditions. It is known that HPV has a tropism for epithelial tissues of the skin and mucous membranes, where its DNA can persist for a long time and eventually contribute to malignant transformation. Twelve HPV types are believed to cause oncological diseases in humans, specifically types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59, which together account for 70% of all cases of cervical cancer.

Objective. To conduct a comparative study of human papillomavirus genotypes and their combined distribution in patients with cervical intraepithelial neoplasia and cervical cancer across different age groups.

A total of 88 patients aged 18 to 68 years with HPV infection were examined. To confirm the primary diagnosis and assess comorbid conditions, patients underwent clinical, general laboratory, cytological, histological (biopsy material), molecular-genetic examinations

The patients were divided into four age groups: group 1: 21 patients aged 18–25 years; group 2: 26 patients aged 26–42 years; group 3: 21 patients aged 43–55 years; group 4: 20 patients older than 55 years. Cervical intraepithelial neoplasia (CIN) was detected in 53.4% of patients  and cervical cancer (CC) in 46.6%. CIN  was most frequently diagnosed in women aged 26-42 years (36.2%), with its prevalence decreasing with age, reaching 17.0% in women over 55 years old. The risk of developing cervical cancer gradually increased with age, peaking at 43-55 years (29.3%), with the verification rate remaining the same in women over 55 years (29.3%). In CIN patients, eight highly oncogenic HPV genotypes were actively involved, while in CC patients, ten genotypes were identified, with HPV16 being the predominant strain (found in 44.0% of CIN cases and 38.1% of CC cases) and HPV18 also playing a significant role (22.0% in CIN cases and 16.7% in CC cases), both as single infections and in combination with other HPV genotypes. In most CIN cases across different age groups, a single HPV genotype was the primary causative factor: in 66.7% of cases among patients aged 18-25 years, 100% in the 26-42 age group, 77.8% in the 43-55 age group, and 50.0% in those over 55 years old. In CC patients, a single HPV genotype was identified as the causative factor in 16.7% of cases among women aged 18-25 years, 89.9% in the 26-42 age group, 66.9% in the 43-55 age group, and 50.0% in those over 55 years old. Combined HPV infections were characteristic of CC patients aged 18-25 years (83.3%) and were also observed in both CIN and CC patients over 55 years old (50%).Since HPV31, 33, 35, 39, 52, 58, and other types were detected in 25-45.4% of CIN patients and 20.0-49.9% of CC patients across different age groups, there is an urgent need to conduct diagnostic genotyping using an expanded HPV panel.

The findings have practical significance for determining treatment strategies and highlight the necessity of conducting diagnostic genotyping using an expanded HPV panel.