Introduction/Background Cervical cancer is the fourth most common female cancer worldwide. Squamous cell carcinoma (SCC) is the most prevalent histotype, while adenocarcinoma (AC) represents less than 25% of cervical malignancies, mostly caused by HR-HPV infection. The incidence of SCC is constantly decreasing, after cervical cancer screening implementation, whereas AC in young women still represents a critical problem. Women reaching the mean age of AC incidence may not have been vaccinated as HPV vaccination started off in 2007 and, in Italy, the cohorts 1997–1998 reports an adhesion of 63–65%.

The aim of the present study is to analyze adenocarcinoma in situ (AIS) and adenocarcinoma invasive (ACI) characteristics in a large sample of Italian women aged 25–45 and their HPV vaccination status.

Methodology A multicenter retrospective study of women 25–45 years affected by AIS and/or ACI was performed between January 2018 and December 2022. The study was proposed by the Italian Society for Cervical Cancer Screening (GISCI) and involved eight gynecological centers.

Patients’ HR-HPV status and vaccination was investigated along with previous cytology and eventual association of squamous cell lesions.

Pathological details included lesion dimensions, margin status and Silva Pattern documentation.

Results 115 patients affected by AIS (76) and ACI (39) were identified. Median age was 41,6 years with 18% in the age group 25–30. A positive HPV test was registered in 85% of patients at the time of diagnosis and an associated squamous lesion was observed in 49% of cases.

Women underwent conization in 79% of cases and 21% had hysterectomy. In 41% of cases the lesions were small (<5 mm) and 59% of positive margins were endocervical.

Among the 115 patients, no one had HPV-vaccination.

Conclusion There is urgent need to implement and enhance primary prevention strategy in terms of HPV vaccination in challenging AC incidence in young women.

Disclosures No disclosures.