Distribution of HPV Types in Tumor Tissue from Women with Cervical Cancer in Norway

Abstract

Background: Understanding the distribution of HPV types in cervical cancer cases is crucial for evaluating the effectiveness of HPV screening and vaccination in reducing cervical cancer burden. This study aimed to assess genotype prevalence among 178 cervical cancer cases detected during a 20-year screening period in Northern Norway and compare the potential efficacy of HPV vaccines in preventing cervical cancer. Methods: A total of 181 formalin-fixed paraffin-embedded (FFPE) tissue samples from women diagnosed with cervical cancer between 1995 and 2015 in Troms and Finnmark, Norway, were analyzed using a 45-type HPV DNA test. The results were compared to a 7-type HPV mRNA test targeting oncogenic types included in the nonavalent HPV vaccine. Results: Invalid HPV test results were observed in 1.7% (3/181) of the samples and were subsequently excluded from further analysis. Among the remaining cases, 92.7% (165/178) tested positive for HPV using any test combination. HPV DNA was detected in 159 cases (89.3%), while HPV mRNA was detected in 149 cases (83.7%). The most prevalent HPV types were 16 and 18, responsible for 70.8% of the cases, with the nonavalent vaccine types accounting for 86.6% of cases. HPV 35 was identified in eight cases (4.5%). Conclusion: The bivalent/quadrivalent HPV vaccines have the potential to prevent 76.4% (126/165) of HPV-positive cervical cancer cases, while the nonavalent vaccine could prevent 93.3% (154/165) of cases. Tailoring screening strategies to target HPV types with the highest oncogenic potential may improve cervical cancer detection and enable targeted interventions for high-risk individuals. The use of a 7-type HPV mRNA test holds promises as an advantageous approach.

Prevalence of High-Risk HPV Subtypes and Efficacy of the HPV Vaccine in Preventing Cervical Epithelial Lesions: Survey and Insights from a German Study

“…A Norwegian study aligns with these findings, as HPV 16, 18, and 45 emerged as the predominant HPV types detected in cervical cancer cases, predominantly among women aged 35–40. Conversely, other oncogenic HPV types, including 31, 33, 35, 39, 52, 58, and 73, displayed a higher prevalence among older age groups [ 19 ]. Notably, two cross-sectional studies investigating HPV distribution in European ICC cases also reported a significant association between young age and HPV 16-, 18-, and 45-positive cervical cancer cases [ 20 ], bolstering our own findings where the mean age for these three types ranged approximately from 44 to 45 years.…”

“…The inclusion of the remaining eight HPV types covered by most screening tests only marginally increased the prevalence by 1.5% [ 21 ]. Similarly, a Norwegian study reported that the eight additional types were detected in only 1.4% of screen-detected cancers, while the majority (93.0% or 66 out of 71 cases) were caused by HPV types 16, 18, 31, 33, and 45 [ 19 ]. In Europe, it has been reported that the majority of cervical cancer cases are caused by five high-risk HPV types, namely HPV 16, 18, 31, 33, and 45 [ 22 ].…”