Prevalence and genotypes' distribution of human papillomavirus in invasive cervical cancer in Saudi Arabia

ObjectiveData concerning HPV infection in cervical cancer are globally lacking in Saudi Arabia. Therefore, the aim of this study was to assess HPV prevalence and genotypes' distribution in invasive cervical cancer in our patients to provide baseline information for screening and prevention.MethodsThe study included 100 paraffin-embedded cervical tumors. HPV genotyping was performed using the Linear Array kit (Roche Diagnostic) that enables the concomitant detection of 37 mucosal HPVs including 13 most common high-risk viruses.ResultsEighty-nine specimens were HPV-positive. Eleven different HPV genotypes were detected, 8 high risk (16, 18, 31, 39, 45, 51, 59, 73) and 3 low risk (6, 64, 70). Ten patients had double infections involving mainly HPV-16 and 18. The most common genotypes were 16 (65.2%), 31 (7.9%), 45 (6.7%), 18 (3.4%), and 73 (2.3%). However, by considering double infections, HPV-18 became the second most common genotype (10.1%). The patients' median age was significantly lower (P = 0.028) in HPV-16/18 infected group compared to other genotypes (44, range 32–76 vs. 49, range 38–67).ConclusionsEighty-nine percent of cervical cancers in Saudi Arabia were associated with HPV infection, and 78.7% (70/89) of HPV-positive tumors were infected with HPV-16/18, which caused the cancer to appear 5 years earlier than the combined HPV-negative and other HPV genotypes (P = 0.013).

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► HPV infection is present in 89% of cervical cancers in the Kingdom of Saudi Arabia.
► 11 HPV genotypes are detected (6, 16, 18, 31, 39, 45, 51, 59, 64, 70 and 73).
► 97.8% are infected with high-risk HPVs of which 78.7% HPV-16, HPV-18, or both.