Cervical cancer, which is principally caused by high-risk (HR) HPV types, is the second-most frequent cancer among women in Europe, associated with more than 24,000 deaths annually. This study aims to collate published information on HPV genotype distribution among invasive cervical cancer (ICC) cases in Europe.
Systematic literature searches were conducted in PubMed/Medline and EMBASE databases to identify complete publications reporting type-specific prevalence of HPV infections in histologically confirmed ICCs among European women. Original studies, published from January 2000 and available in October 2016 on PubMed/MEDLINE or EMBASE, that reported on type-specific prevalence of types 16 and 18 and at least one other of types 31, 33, 45, 52, 58 were included. Key exclusion criteria were special populations (e.g., immunocompromised, HPV-positive only), not English, population < 50. Study design, country, population characteristics, sample type, HPV assay and HPV data were extracted.
Fifty eligible publications were identified reporting on type-specific HPV prevalence in 11,876 histologically confirmed ICC cases. The United Kingdom and Italy contributed the largest number of studies (7 each), reporting on 2,175 and 1,021 cases, respectively. HPV DNA was detected in 10,685 (90.0%) of ICC cases. HPV 16 was the most common type, with a prevalence of 59.2% (7,026/11,876) across Europe, ranging from 56.6% in Northern to 67.1% in Eastern Europe. HPV 18 was the second most prevalent type (12.6%, 1,477/11,744), ranging from 8.4% in Eastern Europe to 16.4% in Northern Europe. The next most frequently detected HPV types were HPV 33 (5.2%, 566/10,823), HPV 45 (4.4%, 507/11,568), HPV 31 (4.0%, 443/11,000) and HPV 52 (2.1%, 212/10,271), followed by HPV 39 (1.5%, 94/6,137), HPV 35 (1.5%, 94/6,380), HPV 58 (1.4%, 132/9,651), HPV 51 (1.3%, 118/8,969) and HPV 56 (1.2%, 101/8,214).
HPV genotypes 16 and 18 dominated in ICCs from European women, followed by HPV 33, HPV 45 and HPV 31. In subsequent analyses, potential sources of heterogeneity between studies, including geographical region, histological classification, sample collection method, and year of publication, will be evaluated