Cervical cancer risk and high-risk HPV types distribution in Saudi Arabia: Trends from a national laboratory-based study.

Objectives: To examine the distribution of human papillomavirus (HPV) genotypes, regional trends, and cytological abnormalities in Saudi Arabia. The findings aim to inform effective cervical cancer prevention strategies. High-risk HPV infections is the leading cause of cervical cancer.

Methods: A retrospective, national laboratory-based study was conducted between 2016 and 2024, analyzing 9,096 medical records. Of these patients, 6,005 underwent co-testing of HPV DNA and cytology-based screening, and 3,091 underwent only cytology-based screening. The HPV genotype distribution, temporal trends, and geographic variations were evaluated.

Results: The HPV positivity rate was 13.84%, with HPV-16 accounting for 25.11% and HPV-18 for 7.55% of cases, while 67.34% of the infections were due to other high-risk strains. The HPV positivity peaked in the 30-39 age group (44.9%) and increased from 5.62% in 2016 to 13.33% in 2024. Jeddah (33.7%) and Riyadh (32.25%) had the highest HPV positivity rates. Among the evaluated cytology samples, 13.41% had precancerous lesions, and 0.64% had cancerous lesions. Notably, 19.37% of HPV-positive cases had normal cytological profiles, reinforcing the importance of co-testing HPV DNA and cytology tests.

Conclusion: This study reveals significant age and regional disparities in HPV prevalence in Saudi Arabia, with a predominance of non-16/18 genotypes. Broad vaccine coverage, genotype surveillance, and regionally adapted screening strategies are essential to reduce cervical cancer burden.