Prognostic Impact of Human Papillomavirus Infection on Cervical Dysplasia, Cancer, and Patient Survival in Saudi Arabia: A 10-Year Retrospective Analysis

Abstract

AbstractCervical cancer is caused by persistent human papillomavirus (HPV) infection. However, HPV prevalence data and survival rates among HPV-infected women are scare in Saudi Arabia. This study assessed the prevalence of HPV genotypes in a 10 year time-frame. Cervical biopsy specimens underwent HPV detection, HPV viral load using qPCR, HPV genotyping, p16INK4a expression measurement using immunohistochemistry. Kaplan-Meier plots were constructed to analyze overall survival rates. Of the 316 cervical specimens examined, HPV was detected in 96 (30.4%); 37.3% had cervical cancer; 14.2% cervical intraepithelial neoplasia (CIN) III, 4.1% CIN II, and 17.0% CIN I. A significant association was found between HPV-16 viral load and disease progression (P < .001, Mann-Whitney U) and between HPV presence and cervical cancer (χ2, 56.78; P < .001). The expression of p16INK4a was a significant predictor of survival: women who had p16INK4a overexpression had poorer survival rates (multivariate Cox regression, hazard ratio, 3.2; 95% CI, 1.1-8.8). In addition, multivariate models with HPV status and cervical cancer diagnosis showed that HPV status was a significant predictor of survival: HPV-positive women had better survival rates than HPV-negative women (haza. These findings suggest that implementing cervical cancer and HPV screening programs may decrease cervical cancer rates and improve survival rates of women in Saudi Arabia.