A retrospective study conducted in Guangzhou, China, has identified distinct risk profiles, human papillomavirus genotype distributions, and biomarker expressions between the two primary pathological subtypes of cervical cancer: squamous cell carcinoma and cervical adenocarcinoma. The research, published in BMC Women’s Health, analyzed 601 histologically confirmed cases diagnosed at Guangzhou Overseas Chinese Hospital between 2013 and 2023. By systematically examining these cases, the study provides a scientific foundation for enhancing regional control programs and optimizing prevention and therapeutic approaches for cervical cancer, which remains a major global health burden primarily caused by persistent high-risk HPV infection.

The study focused on evaluating epidemiological features, pathological subtypes, HPV genotype distribution, treatment modalities, and the sensitivity of screening methods. Throughout the study period, the proportions of squamous cell carcinoma and cervical adenocarcinoma remained stable, indicating that while the overall burden persists, the relative distribution between these two main types did not shift significantly over the decade.

Regarding risk factors, the analysis revealed that unemployment, gravidity exceeding four pregnancies, and abnormal vaginal bleeding were significant risk factors for squamous cell carcinoma. In contrast, agricultural and occupational workers exhibited a reduced risk of squamous cell carcinoma compared to unemployed individuals. Additionally, patients who presented through asymptomatic screening-based methods had a lower risk of squamous cell carcinoma relative to those who attended due to symptoms.

The investigation into HPV infection status showed that infections predominantly involved single high-risk genotypes, with HPV16 being the most common, followed by HPV18, HPV58, and HPV52. In cases of multiple infections, HPV16 dominated, primarily co-occurring with HPV18, HPV58, or HPV52. The study found strong associations between specific genotypes and cancer subtypes. Squamous cell carcinoma was strongly associated with HPV16, HPV58, and HPV52, with HPV58 and HPV33 showing subtype specificity. Conversely, cervical adenocarcinoma was primarily linked to HPV16 and HPV18, with HPV18 demonstrating significant tropism for this subtype.

Biomarker expression and screening efficacy also showed significant differences between the two subtypes. The study observed significant differences in HPV positivity, TCT efficacy, and p16 expression between squamous cell carcinoma and cervical adenocarcinoma. Specifically, the p-values for these differences were 0.004 for HPV positivity, less than 0.001 for TCT efficacy, and less than 0.001 for p16 expression. These statistical differences indicate that the biological markers and the effectiveness of standard screening tools vary depending on the pathological type of the cancer.

The study further evaluated the performance of different screening approaches. Integrated screening that combined HPV genotyping, cytology (TCT), and p16 expression outperformed single-modality approaches in detecting cervical cancer. The difference in efficacy was statistically significant, with a p-value of less than 0.05. This finding supports the use of multimodal screening strategies to enhance early detection rates.

The authors concluded that squamous cell carcinoma and cervical adenocarcinoma exhibit distinct risk profiles, HPV genotype tropism, and biomarker expression. These differences underscore the need for precision in cervical cancer prevention and management. The study suggests that multimodal screening integrating HPV genotyping, cytology, and p16 significantly enhances early detection, supporting a more tailored approach to cervical cancer control.

It is important to note that this study was a retrospective analysis of cases from a single hospital in Guangzhou, China. While the sample size of 601 cases provides a robust dataset for identifying trends and associations, the findings may not be generalizable to other populations or geographic regions with different demographic or epidemiological characteristics. Nevertheless, the detailed analysis of HPV genotypes and biomarker expressions offers a comprehensive view of the current landscape of cervical cancer in this region, highlighting areas for further research and potential improvements in clinical practice.

Subject of Research: Distinct HPV genotype patterns and risk factors in cervical cancer subtypes in Guangzhou

Article Title: Clinical research on the trends of cervical cancer pathological types and characteristics

Article References: Lin, W., Chen, X., Li, Y., Yin, J., Luo, B., Song, K., Qiao, Y., & Li, L. (2026). Clinical research on the trends of cervical cancer pathological types and characteristics. BMC Women's Health. https://doi.org/10.1186/s12905-026-04942-w

Image Credits: AI Generated

DOI: 10.1186/s12905-026-04942-w

Keywords: cervical cancer, HPV, squamous cell carcinoma, adenocarcinoma, screening, biomarkers, epidemiology, Guangzhou, Clinical, research, trends, cervical