Using Wastewater Surveillance to Detect Cancer-Linked HPV Strains

Scientists in Uruguay are pioneering the use of wastewater analysis to monitor human papillomavirus (HPV), a virus closely linked to cervical cancer. Their study focused on detecting HPV genotypes present in urban sewage, which reflects the infection status of the local population. This approach could serve as a valuable epidemiological tool, especially in low- and middle-income countries where traditional health data may be limited.

The research, published in the journal Food and Environmental Virology, involved collecting monthly wastewater samples from Salto, a city of approximately 114,000 residents, over the course of nearly a year. Genetic analysis revealed HPV in 75% of samples, identifying 28 genotypes, including eight classified as high-risk for cervical cancer such as genotypes 16 and 18. The study also examined clinical Pap smear samples from local patients, finding a significant overlap in prevalent genotypes—88% of the genotypes detected in clinical cases were also present in wastewater.

This correlation supports the potential of wastewater-based epidemiology (WBE) as a surveillance method for HPV and related cancers. Researchers suggest that this technique could enable early detection and ongoing monitoring of infection trends before clinical cases appear, allowing for more timely public health responses.

Uruguay offers the HPV vaccine for free to individuals aged 11 to 26, yet vaccination coverage remains moderate—about 65% for girls under 15 and 55% for boys. The presence of high-risk HPV genotypes in wastewater indicates ongoing transmission, which could be mitigated through increased vaccination efforts. Experts believe that expanding environmental monitoring could improve understanding of HPV prevalence, inform vaccination strategies, and ultimately reduce the incidence of cervical cancer.

The concept of environmental monitoring has gained momentum during the pandemic, with many groups now tracking diverse viruses in wastewater. Virologist Fernando Spilki highlights the importance of this approach for disease prevention and vaccine management, noting its potential to detect pathogen circulation even before clinical symptoms emerge.