Clinical significance of extended high-risk human papillomavirus genotyping and viral load in cervical cancer and precancerous lesions

Persistent infections with specific high-risk human papillomavirus (HR-HPV) strains are the leading cause of cervical cancer and precancerous lesions. HPV-16 and HPV-18 are associated with more than 70% of cervical cancer. However, with recent widespread vaccination efforts against cervical cancer, the infection rates of HPV-16 and HPV-18 have decreased across all age groups, while the infection rates of other HR-HPV strains have increased. The non-16/18 HR-HPV strains play an important role in cervical lesions. These strains can be identified with extended genotyping, and the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines recommended an HPV-based testing to assess the risk of cervical disease in patients. We reviewed and analyzed the clinical benefits of applying extended HR-HPV genotyping, which was published by the International Agency for Research on Cancer (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), to cervical cancer screening. This review concluded that cervical cancer screening needs to include extended HR-HPV genotyping. The examination of extended HR-HPV genotyping in cervical intraepithelial lesions and cervical cancers can help guide clinical practices.