Highest percentage of high-risk HPV found in 31-45 age group, says SRL Analysis on cervical cancer screening

New Delhi: A retrospective analysis of HPV (Human Papillomavirus) testing in Cervical Cancer Screening by SRL Diagnostics, has revealed that samples received from women from 31 to 45 years (47%) age group had the highest number of positive cases of high-risk HPV, and consequently a higher chance of developing cervical cancer.

This was followed by the percentage in women from the 16-30 years (30%) age group. More than 4,500 women were tested pan-India between 2014 and 2018 for High Risk HPV infection by using a global standard molecular method. Overall, 8% women showed high-risk HPV infection. However, there was no zonal variation observed for the prevalence of HPV across India.

Human Papilloma Virus (HPV) is a group of viruses that are extremely common worldwide. There are more than 100 types of HPV, of which at least 14 are cancer-causing (also known as high risk type). HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. Cervical cancer is caused by sexually acquired infection with certain types of HPV. Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions.

Cervical cancer (CC) ranks as the fourth most frequently diagnosed and the fourth leading cause of cancer death in women worldwide with an incidence rate of 6.6% and mortality rate of 7.5% according to GLOBOCAN 2018 reported by the International Agency for Research on Cancer (IARC). Cervical Cancer ranks second in incidence and mortality behind breast cancer in lower Human Development Index settings; however, it is the most commonly diagnosed cancer in 28 countries and the leading cause of cancer death in 42 countries, the vast majority of which are in Sub-Saharan Africa and South-Eastern Asia.

The tests utilized in the screening for cervical cancer are – Conventional Pap smear and Liquid-based Cytology (LBC) tests, Visual Inspection with Acetic Acid (VIA) and HPV testing for high-risk HPV types. In this analysis by SRL test data of high risk HPV detection in cervical smear samples was reported.

Elaborating further, Dr B R Das, Advisor and Mentor – R&D and Molecular Pathology, SRL Diagnostics said, “Cervical cancer is the second most common cancer in women living in less developed regions with an estimated 570 000 new cases (84% of the new cases worldwide).  In 2018, approximately 3,11,000 women died from cervical cancer; more than 85% of these deaths occurring in low- and middle-income countries. But cervical cancer is also the only cancer which is preventable if care is taken in the initial stage. Thus, the high mortality rate from cervical cancer globally could be reduced through a comprehensive approach that includes screening, early diagnosis and treatment programmes.”

PAP test is the most commonly used screening test, however PAP test is much more likely to miss precancerous cervical disease compared to HPV testing. Available data indicates HPV testing is more sensitive for detecting localized infection and marginally less sensitive for distant infection. Owing to these limitations, co-testing in women between 30 and 65 years is the preferred screening strategy recommended by most of the global medical associations. It is recommended to be performed every 5 years. Nevertheless experts believe that screening benefit of co-testing is largely driven by HPV testing and not cytology.

“Over the last few decades, cervical cancer incidence and mortality rates reportedly have been in decline in many populations worldwide. Aside from screening , these declines can be attributed to increasing average socioeconomic levels, and diminishing risk of persistent infection with high risk HPV, resulting from improvements in genital hygiene, reduced parity, and a declining prevalence of sexually transmitted disease.” added Dr Das.