The global detection rate of human papillomavirus DNA in ovarian cancer: a systematic review and meta-analysis

Ovarian cancer remains the most lethal gynecological malignancy, with high mortality rates despite advancements in treatment. Microbial infections play a significant role in inducing carcinogenesis. This study aimed to investigate the prevalence of human papillomavirus (HPV) in ovarian cancer cases worldwide. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive systematic search was conducted in PubMed, Web of Science, and Embase databases from 2000 to 2024 using relevant keywords. Data were statistically analyzed using Stata software. After screening and data extraction, 25 original articles were included in the final analysis. The pooled estimate of HPV infection among ovarian cancer patients was 22.9% (95% CI, 15.8–32.1). Subgroup analyses showed the highest prevalence in studies from Asia (26.6%; 95% CI, 18.8–36.4) and Europe (20.9%; 95% CI, 7.2–47.3). HPV types 16 and 18 were the most frequent genotypes detected worldwide (40.2% and 25.9%, respectively). When stratified by diagnostic methods, PCR-based methods (including conventional, real-time, and nested PCR) showed a pooled HPV estimate of 18.9% (95% CI, 12.6–27.3), whereas in situ hybridization (ISH)-based studies reported a substantially higher estimate of 48.9% (95% CI, 34.9–63.1). This meta-analysis indicates that HPV DNA may be detected in a proportion of ovarian cancer cases, with higher prevalence reported in some Asian populations. However, substantial heterogeneity and conflicting evidence, including studies reporting no HPV detection, warrant cautious interpretation. The predominance of HPV-16, HPV-18, and HPV-33 in certain populations requires further investigation. Future well-designed studies, especially in under-represented regions, are needed to clarify the epidemiological patterns and detection trends of HPV in ovarian cancer.