Human Papillomaviruses and Malignant Neoplasms of the Female Upper Reproductive Tract: A Comprehensive Review of the Literature

Malignancies of the female upper reproductive tract, especially endometrial and ovarian cancers, consist a significant burden for women worldwide. The possible etiopathogenetic role of chronic human papillomavirus (HPV) infection in the female upper genital tract carcinogenesis is neither clearly established not completely understood. Therefore, we performed a literature review through PubMed and SCOPUS electronic databases about the prevalence of HPV DNA in endometrial, primary fallopian tube, ovarian and primary peritoneal cancers, as well as uterine sarcomas. The present investigation covered 35 studies from different countries of various continents. Overall, HPV prevalence was approximately 15% in all the above cancers. HPV DNA was isolated from 11%, 0%, 0% and 14% of endometrial carcinomas, uterine sarcomas, primary fallopian tube cancers and ovarian malignant neoplasms, respectively. No relevant studies on primary peritoneal cancers were retrieved. The predominant HPV strain from all tumors of the upper female reproductive tract, regardless of the tumor site, was mostly HPV-16, followed by HPV-18. HPV DNA was identified exclusively from subtypes HPV-6, HPV-11, HPV-16, HPV-18, and HPV-33, which are responsible for the development of not only cervical cancer, but also of condylomata acuminata. The findings of the present review indicate that HPV vaccination might prove to be a useful strategy in the prevention HPV-related carcinomas of the upper genital tract in women.