Distribution of HPV Genotypes in Cervical Cancer in Multiethnic Malaysia


Background: Cervical cancer is the third commonest type of cancer among women in Malaysia. Our aim wasto determine the distribution of human papilloma virus (HPV) genotypes in cervical cancer in our multi-ethnicpopulation. Materials and
Methods: This was a multicentre study with a total of 280 cases of cervical cancer from4 referral centres in Malaysia, studied using real-time polymerase chain reaction (qPCR) detection of 12 highrisk-HPV genotypes.
Results: Overall HPV was detected in 92.5% of cases, in 95.9% of squamous cell carcinomasand 84.3%of adenocarcinomas. The five most prevalent high-risk HPV genotypes were HPV 16 (68.2%), 18 (40%),58 (10.7%), 33 (10.4%) and 52 (10.4%). Multiple HPV infections were more prevalent (55.7%) than single HPVinfections (36.8%). The percentage of HPV positive cases in Chinese, Malays and Indians were 95.5%, 91.9%and 80.0%, respectively. HPV 16 and 18 genotypes were the commonest in all ethnic groups. We found that thepercentage of HPV 16 infection was significantly higher in Chinese (75.9%) compared to Malays (63.7%) andIndians (52.0%) (p<0.05), while HPV 18 was significantly higher in Malays (52.6%) compared to Chinese (25.0%)and Indians (28%) (p<0.05). Meanwhile, HPV 33 (17.9%) and 52 (15.2%) were also more commonly detectedin the Chinese (p<0.05).
Conclusions: This study showed that the distribution of HPV genotype in Malaysia issimilar to other Asian countries. Importantly, we found that different ethnic groups in Malaysia have differentHPV genotype infection rates, which is a point to consider during the implementation of HPV vaccination.