A demographic and clinico pathological study of HPV associated cofactors in the pathogenesis of cervical cancer

Abstract

Aims: Cervical carcinogenesis is a multi-step process associated with refractory infection by highrisk human papillomavirus (HPV) types. Only a minority of HPV infected women develop cervical intraepithelial neoplasia (CIN) or cervical cancer, indicating that HPV infection is not the sole risk factor to induce cervical cancer. The present study aimed to identify the association of demographic and clinic pathological factors in persistent high risk HPV infections of cervix and progression to cervical cancer in East Indian women. Materials and Methods: Study subjects comprised 71 women with histologically proven cervical cancer, and 100 women with benign cervical lesions. The case group included HPV 16 +ve subjects with malignancy. Among subjects with benign lesions, 43 were HPV 16 +ve (intermediate group) and 57 were HPV – ve (control group). Demographic factors like age at diagnosis, age at first childbirth, parity, postmenopausal status, literacy, smoking and clinic pathological factors like type of cervical cancer and grading were correlated with HPV infections and cervical cancer. HPV status and HPV Type was confirmed by PCR based method, using specific primers. Results: There was significant association between HPV +ve individuals (both cases and intermediates) and increased parity, post menopause, increased age at diagnosis, decreased age at first childbirth, illiteracy and smoking. All individuals of the case group were HPV +ve, type 16 and most had poorly differentiated and stage III squamous cell carcinoma of the cervix. Conclusion: Our study suggests that demographic factors should be taken into account when screening for HPV infectivity and cervical cancer. © 2019 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by/4.0/)