Human Papillomavirus 16/18/45 Are Not the Most Frequent Genotypes in African American Women: Analysis in Cervical Papanicolaou Smears of Women in an Inner-City Hospital.

•The distribution of human papillomavirus (HPV) genotypes in each Bethesda category of cervical Pap tests in our institution (Grady Memorial Hospital, Atlanta, GA) between late 2018 and early 2020 was analyzed.•A total of 13,160 Pap smears were evaluated and 75.5% were from African American women.•Overall, HPV 16/18/45 positivity accounted for 18% of all high-risk HPV–positive cases while non-16/18/45 high-risk HPV genotypes accounted for 82%.•Across each of the diagnostic categories of the Bethesda classification system, non-16/18/45 high-risk HPV genotypes were more prevalent, ranging from 60.8% even in high-grade squamous intraepithelial lesion to 90.4% in negative for intraepithelial lesion or malignancy, and this difference was significantly different in almost all the Bethesda categories.•Ethnic variability should be considered when deciding which HPV genotypes to integrate into the HPV vaccine.