The presence of high-risk human papillomavirus (hrHPV) in the diagnosis of invasive cervical cancer is linked to a greatly improved prognosis compared with if high-risk HPV cannot be identified in the tumor, researchers at Karolinska Institutet report in the scientific journal PLOS Medicine.

The researchers believe that high-risk HPV can be another important prognostic marker that can inform the choice of therapeutic strategy. hrHPV is the leading cause of cervical cancer. However, whether the presence of hrHPV in the tumor tissue is of significance to the prognosis has been unclear. In this present study, researchers at Karolinska Institutet have, therefore, looked into a possible correlation between the presence of hrHPV in the tumor and survival rates for invasive cervical cancer (ie, cervical cancer that has spread to surrounding tissues).

The researchers gathered information on all cases of invasive cervical cancer in Sweden between the years 2002 and 2011 (4,254 confirmed cases in total). They then collected HPV data from the regional biobanks for 2,845 of these women and compared survival data from national registers.

Lower risk of dying

Their results show that the 5-year relative survival rate for women with hrHPV-positive tumors was 74% compared with the female population of the same age and during the same calendar year, while it was only 54% for women with hrHPV-negative tumors.

HrHPV could be identified in just over 80% of the tumors. Women with hrHPV-positive tumors were more likely to be discovered through screening, were younger, and had a high socioeconomic status. They were also discovered at an earlier clinical stage than women with hrHPV-negative tumors. After having controlled for age, tumor type, tumor stage at diagnosis, and educational background, the researchers found, however, that women with hrHPV-positive tumors still had a much lower risk of dying than the women with hrHPV-negative tumors.

Could be a useful complement

“The presence of hrHPV in invasive tumor tissue is thus a strong and yet routinely accessible prognostic biomarker for the prognosis of invasive cervical cancer and could be a useful complement to the established prognostic tools currently in use,” says coauthor Pär Sparén, professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

The underlying biological mechanisms for why the lack of detectable hrHPV in the tumor gives a much worse prognosis are unknown and need to be interrogated further.