Prevalence of high-risk human papillomavirus types and cervical squamous intraepithelial lesions in women over 30 years of age in St. Petersburg, Russia

Background: Cytology-based screening has significantly decreased incidence of and mortality from cervical cancer. High sensitivity of high-risk human papillomavirus (hrHPV) test for the detection of high-grade cervical intraepithelial neoplasia (CIN) makes it a useful screening tool, especially in settings where cytology is not available or not quality assured. The study aimed to determine the prevalence of hrHPV and associated cervical lesions in Russian women over 30 years of age and to assess usefulness of HPV test for cervical screening in Russia.

Methods: Consecutive women aged 30-65 years (n=823) receiving routine gynaecological care, not pregnant and not treated for high-grade CIN, were recruited. Oncogenic HPV types were detected using Hybrid Capture 2 (HC2) assay and genotyped with direct DNA sequencing. Women with cytological abnormalities higher than atypical squamous cells of undetermined significance (ASCUS) and women positive for hrHPV were referred to colposcopy.

Results: HPV infection was present in 107 (13%) women. Cytological abnormalities were found in 81 (9.8%) patients, including 59 (7.2%) with ASCUS, 21 (2.5%) with low-grade squamous intraepithelial lesions (LSIL), and one (0.1%) with high-grade SIL. Only 11 (18.6%) patients with ASCUS were positive for hrHPV. Histological diagnoses were obtained for 63 women. Relative sensitivities and positive predictive values of the HPV test and cytology for the detection of high-grade CIN were 100% (6/6) and 9.5% (6/63), and 83.3% (5/6) and 27.8% (5/18), respectively. The most prevalent hrHPV types were 16 (3.9%), 31 (2.8%), 52 (1.7%), and 33 (1.3%). Cytological abnormalities and symptoms of a urogenital infection were strongly associated with hrHPV infection.

Conclusions: The study provides data on the prevalence of hrHPV types in association with cervical lesions, as well as on hrHPV determinants, in an unvaccinated population of Russian women. Our results indicate that HPV test might be a useful screening tool in Russia.