*Systematic Review* **Prevalence of Human Papilloma Virus Infection in Bladder Cancer: A Systematic Review**

**Narcisa Muresu 1,† , Biagio Di Lorenzo 2,† , Laura Saderi 2,† , Illari Sechi <sup>1</sup> , Arcadia Del Rio <sup>3</sup> , Andrea Piana 1,\* and Giovanni Sotgiu <sup>2</sup>**


**Abstract:** The etiology of bladder cancer is known to be associated with behavioral and environmental factors. Moreover, several studies suggested a potential role of HPV infection in the pathogenesis with controversial results. A systematic review was conducted to assess the role of HPV. A total of 46 articles that reported the prevalence of HPV infection in squamous (SCC), urothelial (UC), and transitional cell carcinomas (TCC) were selected. A pooled prevalence of 19% was found, with a significant difference in SCC that was mainly driven by HPV-16. Moreover, infection prevalence in case-control studies showed a higher risk of bladder cancer in HPV-positive cases (OR: 7.84; *p*-value < 0.00001). The results may suggest an etiologic role of HPV in bladder cancer. HPV vaccine administration in both sexes could be key to prevent the infection caused by high-risk genotypes.

**Keywords:** human papillomavirus; HPV; bladder cancer; HPV detection; urothelial carcinoma; transitional cell carcinoma
