HPV Genotype Distribution in Cervical Cancer and High‐Grade Lesions in Norway, and Early Vaccine Impact
6 affiliations
- 1Division of Infection Control Norwegian Institute of Public Health Oslo Norway
- 2The Norwegian HPV Reference Laboratory, Department of Microbiology and Infection Control Akershus University Hospital Lorenskog Norway
- 3Department of Pathology Akershus University Hospital Lorenskog Norway
- 4Faculty of Medicine, University of Oslo Oslo Norway
- 5Department of Health Management and Health Economics University of Oslo Oslo Norway
- 6Harvard T.H Chan School of Public Health Boston Massachusetts USA
Abstract
All cases of invasive cervical cancer (ICC) and subsets of high‐grade cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) and adenocarcinoma in situ (AIS) in Norway are tested for 37 human papillomavirus (HPV) genotypes, within a mandatory national surveillance system. We assessed the proportional attribution of HPV types in cervical lesions from predominantly unvaccinated women reported during 2017–2021 (baseline population) and the HPV type distribution by vaccination status in vaccine‐eligible cases reported during 2017–2024. Among baseline CIN2/3 cases (n = 3087), 48% were attributable to HPV16/18, 28% to HPV31/33/45, 12% to HPV52/58 and 8% to other high‐risk types (HPV35/39/51/56/59). For AIS (n = 550), almost all cases were attributed to HPV16/18 (91%) and HPV45 (6%). For ICC (n = 1265), 75% were attributable to HPV16/18, 15% to HPV31/33/45, 3% to HPV52/58 and 4% to other high‐risk types. Among CIN2/3 cases born 1997 or later (eligible for vaccination at age 11–12 years, n = 154), HPV16‐attribution was higher in unvaccinated cases (49.9%, 95% CI: 33.7–66.1) than in cases vaccinated before age 15 (1.1%, 95% CI: 0–3.4). In CIN2/3 cases born 1991–1996 (eligible for catch‐up vaccination, n = 1541), HPV16‐attribution was 45.7% (95% CI: 41.9–49.7) in unvaccinated versus 35.5% (95% CI: 32.5–38.6) in vaccinated cases. Minor differences by vaccination status were observed for catch‐up‐eligible AIS (n = 445) and ICC (n = 135) cases. In conclusion, the baseline genotype distribution in high‐grade cervical lesions and ICC in Norway aligns with global data. Strong protection against HPV16‐induced CIN2/3 was seen in women vaccinated before age 15 years.
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BibTeX
@article{bekkevold2026genotype,
title = {{HPV Genotype Distribution in Cervical Cancer and High‐Grade Lesions in Norway, and Early Vaccine Impact}},
author = {Terese Bekkevold and Ida Laake and Berit Feiring and Kristiane Søreng and Gro Kummeneje Presthus and Glenny Cecilie Alfsen and Irene Kraus Christiansen and Mona Hansen and Hanne Kristiansen and Eirik Olsen and Torstein Gjølgali Frengen and Emily A. Burger and Christine Genieve Monceyron Jonassen and Lill Trogstad},
journal = {International Journal of Cancer},
year = {2026},
month = aug,
doi = {10.1002/ijc.70712},
url = {https://doi.org/10.1002/ijc.70712},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - HPV Genotype Distribution in Cervical Cancer and High‐Grade Lesions in Norway, and Early Vaccine Impact
AU - Terese Bekkevold
AU - Ida Laake
AU - Berit Feiring
AU - Kristiane Søreng
AU - Gro Kummeneje Presthus
AU - Glenny Cecilie Alfsen
AU - Irene Kraus Christiansen
AU - Mona Hansen
AU - Hanne Kristiansen
AU - Eirik Olsen
AU - Torstein Gjølgali Frengen
AU - Emily A. Burger
AU - Christine Genieve Monceyron Jonassen
AU - Lill Trogstad
PY - 2026
DA - 2026/08/28
JO - International Journal of Cancer
DO - 10.1002/ijc.70712
UR - https://doi.org/10.1002/ijc.70712
AB - All cases of invasive cervical cancer (ICC) and subsets of high‐grade cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) and adenocarcinoma in situ (AIS) in Norway are tested for 37 human papillomavirus (HPV) genotypes, within a mandatory national surveillance system. We assessed the proportional attribution of HPV types in cervical lesions from predominantly unvaccinated women reported during 2017–2021 (baseline population) and the HPV type distribution by vaccination status in vaccine‐eligible cases reported during 2017–2024. Among baseline CIN2/3 cases (n = 3087), 48% were attributable to HPV16/18, 28% to HPV31/33/45, 12% to HPV52/58 and 8% to other high‐risk types (HPV35/39/51/56/59). For AIS (n = 550), almost all cases were attributed to HPV16/18 (91%) and HPV45 (6%). For ICC (n = 1265), 75% were attributable to HPV16/18, 15% to HPV31/33/45, 3% to HPV52/58 and 4% to other high‐risk types. Among CIN2/3 cases born 1997 or later (eligible for vaccination at age 11–12 years, n = 154), HPV16‐attribution was higher in unvaccinated cases (49.9%, 95% CI: 33.7–66.1) than in cases vaccinated before age 15 (1.1%, 95% CI: 0–3.4). In CIN2/3 cases born 1991–1996 (eligible for catch‐up vaccination, n = 1541), HPV16‐attribution was 45.7% (95% CI: 41.9–49.7) in unvaccinated versus 35.5% (95% CI: 32.5–38.6) in vaccinated cases. Minor differences by vaccination status were observed for catch‐up‐eligible AIS (n = 445) and ICC (n = 135) cases. In conclusion, the baseline genotype distribution in high‐grade cervical lesions and ICC in Norway aligns with global data. Strong protection against HPV16‐induced CIN2/3 was seen in women vaccinated before age 15 years.
SN - 0020-7136
SN - 1097-0215
ER -