A Snapshot of the Landscape of Endocervical Adenocarcinoma in Kenya: What Has HPV Got to Do with It?

Objective. To determine the frequency of the HPV associated endocervical adenocarcinomas diagnosed at a tertiary referral laboratory in Kenya over a one-year period and classify them by histologic subtypes according to the proposed criteria by IECC. Materials and Methods. This was a collaborative cross-sectional descriptive study. Formalin-fixed parrafin embedded tissue blocks of 29 confirmed cases of endocervical adenocarcinoma diagnosed at AKUHN between July 2017 and July 2018 were analyzed for presence of 14 hrHPV subtypes including types 16 and 18 using GenomeMETM’s GeneNavTm HPV One qPCR kit. Variables analyzed included age, histologic subtype and presence or absence of hrHPV. Results. Twenty-nine cases were analyzed (median age=48years, range 23-70 years), of which 27(93.1%) were positive for hrHPV, with type 16 alone positive in 11(40.7%) cases and present alone or in combination with others including type 18 in 21(72.4%) cases. All hrHPV positive cases had either type 16 or 18. Twenty cases (69.0%) were classified as usual type adenocarcinoma, all positive for hrHPV. Other HPV associated adenocarcinomas identified were mucinous, signet ring cell type (4), villoglandular (2) and mucinous, NOS (1). There were only two cases of non-HPV associated adenocarcinoma. Conclusion. In this series, we show that the proportion of HPV associated endocervical adenocarcinoma in Kenya is high and is particularly driven by types 16 and 18. Policy makers, hospitals and laboratories in East Africa should make an effort to avail the various techniques of detecting hrHPV critical in screening and diagnosis of endocervical adenocarcinoma.