Comparative Clinicopathological Features, HPV Status, and Prognostic Determinants of Squamous Cell Carcinoma and Adenocarcinoma of the Cervix: A Retrospective Cohort Analysis (2020–2024)

Background Cervical cancer remains a significant global health burden, with squamous cell carcinoma (SCC) and adenocarcinoma representing the two predominant histological subtypes. While human papillomavirus (HPV) infection underlies most cervical cancers, comparative clinicopathological features and prognostic determinants between SCC and ADC remain incompletely characterized. Methods We conducted a retrospective cohort analysis of cervical cancer patients treated between 2020–2024. Patient demographics, clinical characteristics, p16 immunohistochemistry status, histological subtype, differentiation grade, clinical staging, and survival outcomes were analyzed. Comparative statistics, multivariate logistic regression, LASSO regression, temporal trend analysis, and Kaplan-Meier survival analysis were performed to identify prognostic determinants and histotype-specific differences. Results The analysis included 85 patients: 69 with squamous cell carcinoma and 16 with adenocarcinoma. Both subtypes demonstrated similarly high p16 positivity rates (89.8% vs 88.2%, p = 0.45), confirming HPV's predominant role regardless of histological type. Menopausal status emerged as a significant distinguishing factor (p = 0.0495), with SCC patients more likely to be postmenopausal. SCC patients were older on average (52.16 vs 48.2 years, p = 0.0565). Multivariate analysis identified p16 positivity as the strongest predictor of advanced disease (OR = 2.45, p = 0.047), while marital status demonstrated protective effects (OR = 0.87, p = 0.021). Kaplan-Meier analysis revealed significant survival differences by clinical stage (log-rank p = 0.03), with high-stage patients showing progressive decline from 95% to 73% survival over five years, while low-stage patients maintained 100% survival. Conclusion While SCC and ADC share similar molecular characteristics and clinical presentations, SCC preferentially affects older, postmenopausal women. p16 positivity serves as a key molecular predictor of disease severity, and clinical staging remains the most critical prognostic determinant. These findings underscore the importance of early detection strategies and reinforce the prognostic value of molecular markers in cervical cancer management.