Cervical cancer is the fourth commonest cancer affecting female population in the world, and the seventh most common cancer in the general population worldwide (Bray et al, 2018). The disease is also the fourth leading cause of cancer death among women with 311,000 associated deaths in 2018. The highest regional incidence and mortality rates are seen in Africa, especially in Eastern (Malawi, with the highest mortality rate ; and Zimbabwe) and Western Africa (Guinea, Burkina Faso, and Mali). Globally, it was previously admitted that low- and middle-income countries account for almost 90% of the burden of cervical cancer (WHO, 2014) due to insufficient awareness, lack of effective screening programs, and late clinical presentation. In addition, reports of trends in cervical cancer mortality in these countries have been limited by poor data quality and inaccurate estimates of population (Bailey et al, 2016). Additionally, in most of these countries, especially in sub-Saharan Africa, there is no cancer registry. Human papillomavirus (HPV) is a causative agent of cervical cancer that has been detected in 99.7% of cervical squamous cell carcinoma and in 94–100% of cervical adenocarcinoma (Steenbergen et al, 2005). HPV is transmitted through sexual intercourse or skin-to-skin genital contact (Hernandez et al, 2008), and persistent infection with high-risk HPV (HR-HPV) is the major cause of cervical intraepithelial neoplasia and invasive cervical cancer (Munoz et al, 1992 ; Schiffman et al, 1993 ; Walboomers et al, 1999). In general, most infections resolve on their own, as the immune response controls infection and prevents progression to precancerous lesions (Rodriguez et al, 2008). Papillomaviruses are circular, nonenveloped double-stranded DNA viruses with a genome length of 8 kb. More than 200 HPV genotypes have been reported and grouped into cutaneous and mucosal types according to their site of infection, and then subdivided into high risk (HR) and low risk (LR) types, depending on their association with a particular infection. Malignant disease (IARC, 2011). Based on epidemiological studies conducted mainly in developed countries, HPV16 and HPV18 are the two most common types of HR in cervical cancer, accounting for about 70% of all cases worldwide (Ramakrishnan et al, 2015). Sensitivity to risk factors for cervical cancer may facilitate public participation in screening campaigns, including young age at first intercourse, (Jimenez et al., 1999, Louie et al., 2009), multiple sexual partners, (Brinton et al., 1989) multiparity, (Castellsague et al., 2003, Brinton et al., 1989) human papillomavirus infections, (Walboomers et al., 1999, Bosch et al. Al, 2007) the first term pregnancy (Appleby et al 2006). Similarly, early research for help may be encouraged if women in middle-income countries are more aware of the symptoms of cervical cancer—menopausal vaginal bleeding, postcoital vaginal bleeding, superficial vaginal discharge, and lower abdominal pain. (Petignat et al., 2007, Lea et al., 2012)
In Senegal, a West African country, a high-incidence and cervical cancer mortality area (Bray et al, 2018 ; IARC, 2018), data on cervical cancer and related genotypes are scarce. While genotype HPV–16 is the most common cervical cancer genotype in the world, the prevalence of other genotypes varies geographically (Crow et al, 2012). These data are highly variable and incomplete in Africa. Thus, the prevalence and distribution of HPV genotypes in Africa among women with invasive cervical cancer is necessary. Until now, two vaccines were available : the « old » Gardasil®, which contains two oncogenic HPV genotypes (HPV 16 and 18) and two other genotypes of HPV responsible for condyloma acuminata, and Cervarix®, which contains HPV 16 and 18. Both vaccines provide 70% protection against cervical cancer. To cover a broader spectrum of oncogenic HPV, a new Gardasil–9® vaccine was developed in 2016 with additional genotypes included ( HPV 31, 33, 45, 52 and 58) and an expected protection against 90% of HPV-induced cervical cancers.