Cervical cancer is the second most common cancer affecting women worldwide [1], with persistent infection by high-risk human papillomavirus (HPV) having an important role in cervical carcinogenesis [2]. Knowledge of HPV genotypes associated with invasive cervical carcinoma is necessary for determining the impact of new HPV vaccines on the incidence of these lesions.An updated meta-analysis of the worldwide distribution of HPV types associated with both invasive cervical cancer and high-grade squamous intraepithelial lesions was recently published [3]. A total of 14 595 cases of invasive cervical cancer revealed HPV 16 to be the most common type on all continents, with HPV 18 the second most common. Types 31, 33, 35, 45, 52, and 58 were the next most common types, although there was regional variation in the relative importance of each of these 6 types. Data from the Middle East were scarce; thus, the objective of the present study was to determine the HPV genotypes involved in invasive cervical cancer in Jordan.The archives of the Pathology Department at King Hussein Cancer Center, Amman, Jordan, were searched for cases of invasive cervical cancer; all cases accessioned at the time of diagnosis between 2003 and 2007, and with available paraffin blocks, were analyzed.Using the Extra DNA Tissue kit (Sacace Biotechnologies, Como, Italy) according to the manufacturer's instructions, DNA was extracted from the paraffin blocks. The adequacy and the integrity of extracted DNA were assessed via spectrophotometry and polymerase chain reaction (PCR) for the gene encoding GAPDH.An HPV typing kit (Sacace Biotechnologies, Como, Italy) containing 4 mixes of multiple primers-types 16, 31, 33, and 35; types 18, 39, 45, and 59; types 52, 56, 58, and 66; and types 6 and 11-was used. Amplification was followed by electrophoresis and band identification using an ultraviolet transilluminator. Negative results were invalidated if the internal control (the gene encoding β-globin) was absent. Positive and negative controls were included in each run.Forty-eight cases of invasive cervical cancer with 54 paraffin blocks available were identified; 7 cases failed to produce adequate DNA. Patient age in the remaining 41 cases ranged from 37 to 80 years, with Cervical cancer Genotypes Human papillomavirus Jordan a median group of 45-49 years. There were 40 cases of squamous cell carcinoma and 1 of adenocarcinoma.The HPV types obtained are shown in Table 1. Multiple infections in a single patient were common in the present study, with 14 patients (34.1%) harboring 2 or 3 types simultaneously. The single case of adenocarcinoma involved types 16 and 18. This combined type was found in 7 cases, with types 16 and/or 18 found in 31 (75.6%) overall. Thus, singly or in combination, the other HPV types were responsible for approximately 25% of cervical cancer cases. The next most common types were 39, 56, 45, 52, and 33. In the present study, type-specific primers were used, which had a higher sensitivity when applied to tissue biopsy than did the g...