Understanding the proportion of cervical cancers attributable to HPV

Julia ML Brotherton, Alison C Budd and Marion Saville
Med J Aust 2020; 212 (2): . || doi: 10.5694/mja2.50477
Published online: 3 February 2020

Most cervical cancers can be prevented with HPV vaccination and screening

Since Walboomers and colleagues1 published their findings in 1999, citing that 99.7% of cervical cancers are related to the human papillomavirus (HPV), this has become the standard understanding of the proportion of cervical cancers attributable to HPV.

  • 1 VCS Foundation, Melbourne, VIC
  • 2 Australian Institute of Health and Welfare, Canberra, ACT


Competing interests:

Julia Brotherton and Marion Saville are investigators on the Compass Trial, conducted and funded by VCS Foundation. VCS Foundation have received equipment and a funding contribution for the Compass Trial from Roche Molecular Systems and Roche Tissue Diagnostics.

  • 1. Walboomers JM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189: 12–19.
  • 2. Brotherton JML, Tabrizi SN, Phillips S, et al. Looking beyond human papillomavirus (HPV) genotype 16 and 18: defining HPV genotype distribution in cervical cancers in Australia before vaccination. Int J Cancer 2017; 141: 1576–1584.
  • 3. Australian Institute of Health and Welfare. Cervical screening in Australia 2018 [Cat. No. CAN 111]. Canberra: AIHW, 2018. (viewed Dec 2019).
  • 4. Li N, Franceschi S, Howell‐Jones R, et al. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: Variation by geographical region, histological type and year of publication. Int J Cancer 2011; 128: 927–35.
  • 5. Saraiya M, Unger ER, Thompson TD, et al. HPV Typing of Cancers Workgroup. US assessment of HPV types in cancers: implications for current and 9‐valent HPV vaccines. J Natl Cancer Inst 2015; 107: djv086.
  • 6. Lagheden C, Eklund C, Lamin H, et al. Nationwide comprehensive human papillomavirus (HPV) genotyping of invasive cervical cancer. Br J Cancer 2018; 118: 1377–1381.
  • 7. Petry KU, Liebrich C, Luyten A, et al. Surgical staging identified false HPV‐negative cases in a large series of invasive cervical cancers. Papillomavirus Res 2017; 4: 85–89.
  • 8. McCluggage WG. Recent developments in non‐HPV‐related adenocarcinomas of the lower female genital tract and their precursors. Adv Anat Pathol 2016; 23: 58–69.
  • 9. Hodgson A, Park KJ. Cervical adenocarcinomas: a heterogeneous group of tumors with variable etiologies and clinical outcomes. Arch Pathol Lab Med 2019; 143: 34–46.
  • 10. Stolnicu S, Barsan I, Hoang L, et al. International Endocervical Adenocarcinoma Criteria and Classification (IECC): a new pathogenetic classification for invasive adenocarcinomas of the endocervix. Am J Surg Pathol 2018; 42: 214–226.
  • 11. Castle PE, Pierz A, Stoler MH. A systematic review and meta‐analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix. Gynecol Oncol 2018; 148: 422–429.
  • 12. Casey S, Harley I, Jamison J, et al. A rare case of HPV‐negative cervical squamous cell carcinoma. Int J Gynecol Pathol 2015; 34: 208–212.
  • 13. Higgins GD, Uzelin DM, Phillips GE, et al. Increased age and mortality associated with cervical carcinomas negative for human papillomavirus RNA. Lancet 1991; 338: 910–913.
  • 14. Lei J, Ploner A, Lagheden C, et al. High‐risk human papillomavirus status and prognosis in invasive cervical cancer: a nationwide cohort study. PLoS Med 2018; 15: e1002666.
  • 15. Hallowell BD, Saraiya M, Thompson TD, et al. Population‐based assessment of HPV genotype‐specific cervical cancer survival: CDC Cancer Registry Sentinel Surveillance System. JNCI Cancer Spectr 2018; 2: pky036.
  • 16. World Health Organization. Cervical cancer elimination strategy. WHO, 2019. (viewed Dec 2019).


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.