Human papillomavirus and the risk of urothelial carcinoma of the bladder

  • Sarier M & al.
  • Urol Int
  • 8 May 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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.

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