PRESS RELEASE No.
353
1 August 2024
Global attribution of HPV genotypes to invasive cervical cancer:
a systematic analysis
Lyon, France, 1 August 2024 – A new systematic analysis by scientists from the International Agency for
Research on Cancer (IARC) sheds light on the global impact of different human papillomavirus (HPV) genotypes
in causing cervical cancer. The study, published today in The Lancet, 1 is based on a novel methodology
comparing HPV genotypes in more than 110 000 women with cervical cancer with those in more than 2.5 million
cancer-free women (controls). It aimed to evaluate which HPV genotypes caused cancer as well as their
carcinogenic strength and their contribution to the cervical cancer burden.
“This study marks the most comprehensive attempt to date to estimate the proportion of invasive cervical cancer
caused by different HPV genotypes globally, regionally, and nationally,” says Dr Gary Clifford, Deputy Head of
the Early Detection, Prevention, and Infections Branch at IARC and senior author of the article. “These findings
directly inform strategies for prevention of invasive cervical cancer, emphasizing targeted approaches through
HPV vaccination and screening.”
Results
In the analysis, 17 HPV genotypes were judged to be causal to invasive cervical cancer, but with huge
differences in their carcinogenic strength. HPV types 16 and 18 caused approximately three quarters of cervical
cancer cases across all global regions. HPV types 31, 33, 45, 52, and 58 contributed an additional 15–20% of
cases. The remaining 10 causal genotypes caused only about 5% of cases worldwide, with some notable
regional variations, including a higher proportion (~4%) for HPV 35 in Africa than in other regions.
The eight HPV genotypes that had the highest attributable fractions (HPV types 16, 18, 31, 33, 35, 45, 52, and
58) were also the most carcinogenic and are therefore also clear priority targets for inclusion in HPV-based
screening tests. Other HPV genotypes, which each cause only a small fraction of cases of invasive cervical
cancer, have a lower positive predictive value. Including these genotypes in cervical cancer screening tests
makes the screening less efficient and less cost-effective.
1 Wei F, Georges D, Man I, Baussano I, Clifford GM (2024). Causal attribution of human papillomavirus genotypes to
invasive cervical cancer worldwide: a systematic analysis of the global literature. Lancet. Published online 1 August 2024;
https://doi.org/10.1016/S0140-6736(24)01097-3
“These insights suggest that future HPV vaccines might target HPV 35 to reduce regional disparities,” says Dr
Clifford. “Efficient and equitable cervical cancer prevention could be attained by focusing on at least the major
eight HPV types in vaccines and diagnostics, especially in the resource-limited regions where the burden is
highest.”
Note to the Editors
Invasive cervical cancer is widely acknowledged to be caused by a set of carcinogenic HPV genotypes. In the
most recent evaluation by the IARC Monographs programme (in 2009), 12 HPV genotypes were classified as
carcinogenic to humans (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59).
Cervical cancer represents a significant global health burden, with an estimated 662 301 incident cases and
348 874 deaths in 2022. In response to this high preventable burden, in 2020 the World Health Organization
(WHO) launched the Global Strategy to Accelerate the Elimination of Cervical Cancer, emphasizing the vital
role of vaccination against HPV, screening, and treatment.
For more information, please contact
The International Agency for Research on Cancer (IARC) is part of the World Health Organization. Its mission
is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and
to develop scientific strategies for cancer control. The Agency is involved in both epidemiological and laboratory
research and disseminates scientific information through publications, meetings, courses, and fellowships. If
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