The Infection Status and Distribution of hrHPV in Cervical Lesions Among Overweight Women Referred for Colposcopy: A Cross-Sectional Study

IntroductionAmong opportunistically screened population with above normal-weight, screening-related information remains limited. This study aimed to evaluate the infection status and distribution of high-risk (hr) human papillomavirus (HPV) on precancerous grades and cancer among overweight women compared with normal-weight women, and further explored the association between clinical characteristics and both HPV infection and cervical lesions.MethodsThe reporting of this cross-sectional retrospective study conforms to STROBE guidelines. This study was conducted in the Affiliated Cancer Hospital of Xinjiang Medical University. A total of 720 out of 1146 women with complete medical records of demographic and clinical characteristics were enrolled on the colposcopy clinic. HrHPV infection status, cytology abnormality rates, detection rates of cervical intraepithelial neoplasia (CIN) grades and cancer, and clinical performance of triage tests were evaluated by Body Mass Index (BMI) levels, which were classified into two groups as overweight women (BMI ≥24 kg/m²) and normal-weight women (BMI <24 kg/m2).ResultsThe hrHPV infection rate of overweight women (73.0%) was not significantly lower than that of normal-weight women (78.6%) by the GenoArray test (<i>P</i> = 0.09) and by HC2 test (68.5% vs 71.0%, <i>P</i> = 0.53). The positive rates of most frequent hrHPV subtypes of overweight women vs normal-weight women were HPV16 (31.1% vs 39.1%, <i>P</i> = 0.03). The detection rates of CIN lesions were lower among overweight vs normal-weight (28.3% vs 37.4%, <i>P</i> = 0.01), while the detections rate of cancer was slightly higher but not significant (7.2% vs 4.6%, <i>P</i> = 0.14). The clinical performance of different screening strategies were similar between overweight and normal weight women.ConclusionsThe HPV16 prevalence and the detection rate of cervical precancerous lesions was lower in overweight women than normal-weight women, indicating that targeted management strategies should be given to overweight women to decrease the underdiagnosis.