Extended HPV Genotyping for Risk Stratification in Cervical Screening: A Population-based Study
Sigal Kfir, Yael Barkan, Efraim Siegler, Talish Razi, Ronen ArbelObjective:
Population-based data on extended HPV genotyping for risk stratification in routine cervical cancer screening are limited. We evaluated the association between oncogenic risk categories derived from extended HPV genotyping and cervical screening outcomes (cytology and histology) in a large population-based cohort (October 2021-September 2023).
Methods:
This retrospective observational study analyzed HPV results and corresponding cytology and histology from screened women between October 2021 and September 2023. High-risk HPV genotypes were classified into three mutually exclusive categories: high (HOT), moderate (MOT), and low (LOT), developed for the organizational framework of this particular study. Cytologic and histologic outcomes were compared across categories using chi-square tests, and PPVs for CIN2+ and CIN3+ were calculated.
Results:
Among 448,394 screened women, overall HPV prevalence was 8.6%. HOT, MOT, and LOT genotypes accounted for 35.5%, 24.0%, and 40.5% of HPV-positive infections, respectively. Cytologic severity differed significantly across oncogenic risk categories (
Conclusions:
Extended HPV genotyping was associated with a clear gradient of oncogenic risk; women with low-oncogenic risk infections demonstrated markedly lower rates of high-grade disease, supporting risk-stratified clinical management in cervical cancer screening programs.