Human papillomavirus and the risk of urothelial carcinoma of the bladder

Takeaway

• There is a significant association between human papillomavirus (HPV) infection, particularly high-risk HPV genotypes, and urothelial carcinoma of the bladder (UCB).
• No significant association was observed between tumour grade and HPV infection.

Why this matters

• The association between HPV and squamous cell carcinomas of the anogenital region has been clearly defined.
• Despite the close anatomical connection between the bladder and the anogenital region, the association between UCB and HPV has been debated for the past 30 years.

Study design

• A case-control study of 69 patients diagnosed with UCB and an equal number of patients who visited the urology outpatient clinic for non-oncological reasons (control group).
• Urethral swab and first-void morning urine samples were collected from all patients.
• All samples were evaluated for the presence of HPV-DNA using a polymerase chain reaction and tested for high- and low-risk HPV genotypes.
• Funding: None disclosed.

Key results

• HPV-DNA positivity was significantly higher in the UCB group compared with the control group (28.9% vs 8.7%; OR, 4.24 [95% CI, 1.63-12.34]).
• In the UCB group, 53.6% (37/69) and 46.4% (32/69) of patients had high- and low-grade UCB, respectively.
• No statistically significant relationship was observed between HPV-DNA positivity and tumour grade (P=.36).
• In the UCB group, high- and low-risk HPV genotypes were identified in 90% (18/20) and 10% (2/20) of the patients, respectively.

Limitations

• Small sample size.