IMR Press / EJGO / Volume 41 / Issue 4 / DOI: 10.31083/j.ejgo.2020.04.5180
Open Access Original Research
Multicentric assessment of cervical HPV infection co-factors in a large cohort of Greek women
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1 Biomedical Engineering Laboratory, National Technical University of Athens, Iroon Politechniou 9, 15780, Zografou, Athens, Greece
2 Second Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, Rimini 1, 12464, Haidari, Athens, Greece
3 Department of Obstetrics & Gynaecology, Health Center of Larisa, Roosevelt 4, 41222, Larisa, Greece
4 Department of Obstetrics & Gynaecology, University Hospital of Patras, 26504, Rio, Patras, Greece
5 Private Cytopathology Laboratory, Kifissias avenue 27A, 11523, Ampelokipi, Athens, Greece
6 Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Imperial College, Hammersmith Campus, Du Cane Road, W12 0NN, London, Great Britain
7 West London Gynaecological Cancer Centre, Queen Charlotte's and Chelsea - Hammersmith Hospital, Imperial Healthcare NHS Trust, Du Cane Road, W12 0HS, White City, London, Great Britain
8 2nd Department of Obstetrics & Gynecology and Molecular Clinical Cytology Laboratory, Hippokration Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642, Thessaloniki, Greece
9 Department of Obstetrics & Gynaecology, University Hospital of Larisa, Mezourlo, 41110, Larisa, Greece
10 Department of Obstetrics & Gynaecology, University Hospital of Ioannina, Leof. Stavrou Niarchou 1, 45500, Ioannina, Greece
Eur. J. Gynaecol. Oncol. 2020, 41(4), 545–555;
Submitted: 11 March 2018 | Accepted: 5 June 2019 | Published: 15 August 2020

Purpose of Investigation: Despite the general principle that persistent high risk human papillomavirus (hr-HPV) infection may progressively cause cervical cancer (CxCa), demographic aspects may still identify groups at high risk for HPV infection and consequently for precancerous lesions. The role of demographic parameters on cervical status, the diagnostic accuracy of cytology, HPV genotyping, and their possible combinations, were investigated in this study. Materials and Methods: 11,072 women from diverse locations across Greece participated in the study. Liquid Based Cytologic (LBC) assessment was followed, when necessary, by HPV-genotyping and histologic confirmation. Demographic characteristics were also assessed. Results: Life style parameters such as age, number of sexual partners, condom use, parity and marital status, education level, and combination of smoking/condom use, were significant factors for CIN2+ lesions (p < 0.05). For LSIL+ detection, cytology had maximum sensitivity: 96.90%, HPV-typing: 72.55% and co-testing: 98.97%, for HSIL+ detection: 98.49%, 92.22%, and 99.55% respectively. Conclusions: There are notable relationships between lifestyle, demographic details, and cervical status. Despite the differences in sensitivity and specificity levels, co-testing might offer some marginal improvement in the detection of particular pre-cancerous conditions.

Cervical cancer
Cervical cytology
Cervical intraepithelial neoplasia
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