Beyond HPV16/18: genotype distribution of high-risk HPV and cycle threshold values in cervical carcinogenesis spectrum

Background Cervical cancer is a virus-dependent gynaecologic malignancy and according to GLOBOCAN 2022 cervical cancer is the fourth frequent women cancer in all over the world. Despite this frequency it is rarely seen in developed countries because of the enforcement of cervical screening programmes with human papillomavirus (HPV) test and Pap test called cotest. The burden of this women cancer is high despite the implementation of HPV-based vaccines and screening strategies, could nearly eliminate cervical cancer as a public health problem.Materials and Methods A retrospective analysis was conducted using non-16/18 high risk human papilloma virus (HR-HPV) genotyping data and cycle threshold (ct) values from women aged ≥18 years that underwent cervical sampling during gynaecological outpatient clinic at a tertiary centre in Turkey, between January 2022 and December 2023.Results The most frequently detected genotypes were HPV52 (n = 24), HPV31 (n = 23), HPV51 (n = 22) and HPV56 (n = 22). On the other hand in cervical intraepithelial neoplasia 3 (CIN3) cases, with combinations involving HPV51, HPV52, HPV59, HPV66 and HPV31 commonly detected. Median minimum patient-level Ct values were 22.0 (Interquartile range-IQR 8) in chronic cervicitis, 19.0 (IQR 10) in CIN1, 17.0 (IQR 8) in CIN2 and 19.0 (IQR 7) in CIN3.Conclusion To the best of our knowledge, there are limited data about cycle threshold values in prediction of viral load. These region-specific, genotype-resolved data may inform extended-genotyping–based risk stratification and support ongoing surveillance of non-16/18 HR-HPV patterns within HPV-based screening programs. Hence this study opens a new perspective in this era.