Decoding Cervical High Risk HPV Genotype Disparities: A Comprehensive Study on Racially, Ethnically, and Gender Diverse Populations

Summary: Introduction: Racial disparities exist in distributions of high-risk HPV (hr-HPV) genotypes and frequency of high-grade cervical cytology diagnoses. However, most studies contrast African American (AA) and non-Hispanic, white (NHW) cohorts, leaving a knowledge gap about hr-HPV genotypes in Asian and Hispanic patients. This study examines demographic and cytopathologic features of an ethnically and gender diverse cervical hr-HPV positive cohort. Materials and Methods: Cervical hr-HPV positive patients from a single, ethnically diverse hospital were identified between 2022-2023. Demographic features and cytologic interpretations were evaluated amongst four ethnic groups (Hispanic, Asian, NHW, and AA) and straight/cis-gender identifying versus sexual and gender minority (SGM) patients. Results: 1,242 patients were positive for HPV 16, HPV 18, non 16/18 hr-HPV strains, or multiple genotypes. Most patients identified as Hispanic (52%), then Asian (15%), with 12% identifying as NHW and AA. This distribution over-represents Hispanic patients compared to the hospital's overall patient population (31%). 6% of the cohort identified as SGM. Non 16/18 hr-HPV genotypes were most common (76%) (Table 1). Most common cytologic diagnoses were negative (55%) followed by ASCUS (26%) (Table 2). AA were more likely to have non 16/18 hr-HPV genotypes (84%) as compared to NHW (74%, p-value: 0.036, Table 3), whereas no differences in hr-HPV genotypes were seen in Hispanic or Asian patients when compared to NHW patients. No differences in hr-HPV genotypes were seen between cis-gender, straight and SGM patients. High-grade cytologic diagnoses were more associated with HPV-16 as compared to non 16/18 hr-HPV genotypes. Conclusions: This supports prior studies that AA patients more commonly have non 16/18 hr-HPV genotypes, but further highlights that compared to NHW, Hispanic, and Asian patients have similar hr-HPV genotype distributions. No differences in hr-HPV genotypes were identified between cis-gender, straight patients and SGM patients. This study presents one of the most ethnically and gender diverse descriptive analysis of hr-HPV genotypes in cervical cancer screening.