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Human Papillomavirus
and
Related Diseases Report
WORLD
Version posted at www.hpvcentre.net on 15 December 2016
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ICO Information Centre on HPV and Cancer (HPV Information Centre), 2016.
All rights reserved. HPV Information Centre publications can be obtained from the HPV Informa-
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The development of this report has been supported by grants from the European Comission (7th Frame-
work Programme grant HEALTH-F3-2010-242061, HEALTH-F2-2011-282562, HPV AHEAD).
Recommended citation:
Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gmez D, Muoz J, Bosch FX, de Sanjos
S. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and
Related Diseases in the World. Summary Report 15 December 2016. [Date Accessed]
ICO HPV Information Centre

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Abbreviations
Table 1: Abbreviations
Abbreviation Full term
HPV Human papillomavirus
PREHDICT Project Health economic modelling of prevention strategies for HPV-related diseases in
European countries
HPV Information Centre ICO Information Centre on HPV and Cervical Cancer
GW Genital warts
RRP Recurrent respiratory papillomatosis
SIL Squamous intraepithelial lesions
LSIL Low-grade cervical lesions
HSIL High-grade cervical lesions
ICC Invasive cervical cancer
CIS Carcinoma in situ
CIN Cervical intraepithelial neoplasia
AIN2/3 Anal intraepithelial neoplasia of grade 2 and/or 3
VIN 2/3 Vulvar intraepithelial neoplasia of grade 2 and/or 3
VaIN 2/3 Vaginal intraepithelial neoplasia of grade 2 and/or 3
PeIN 2/3 Penile intraepithelial neoplasia of grade 2 and/or 3
95% CI 95% confidence interval
N Number of cases tested
HPV Prev HPV prevalence
ASR Age-standardised rate
MSM Men who have sex with men
Non MSM Heterosexual men
SCC Squamous cell carcinomas
STI Sexually transmitted infections
HIV/AIDS Human immunodeficiency virus/acquired immunodeficiency syndrome
TS Type specific
EIA Enzyme immunoassay
RLBM Reverse line blotting method
RFLP Restriction fragment length polymorphism
RHA Reverse hybridisation assay
RLH Reverse line hybridisation
LiPA Line probe assay
SBH Southern blot hybridisation
ISH In situ hybridisation
MABA Micro array-based assay
LBA Line blot assay
HC2 Hybrid Capture 2
SAT Suspension array technology
PCR Polymerase chain reaction
SPF Short primer fragment
q-PCR Quantitative polymerase chain reaction
RLBH Reverse line blot hybridisation
RT-PCR Real-time polymerase chain reaction
DBH Dot blot hybridisation
HR High risk
DSA Direct sequence analysis
MAA Microchip array assay

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Executive summary
Human papillomavirus (HPV) infection is now a well-established cause of cervical cancer and there is
growing evidence of HPV being a relevant factor in other anogenital cancers (anus, vulva, vagina and
penis) as well as head and neck cancers. HPV types 16 and 18 are responsible for about 70% of all cer-
vical cancer cases worldwide. HPV vaccines that prevent HPV 16 and 18 infections are now available
and have the potential to reduce the incidence of cervical and other anogenital cancers.
This report provides key information for Less developed regions on: cervical cancer; other anogeni-
tal cancers and head and neck cancers; HPV-related statistics; factors contributing to cervical cancer;
cervical cancer screening practises; HPV vaccine introduction; and other relevant immunization indi-
cators. The report is intended to strengthen the guidance for health policy implementation of primary
and secondary cervical cancer prevention strategies in the region.
The World has a population of 2,716 million women aged 15 years and older who are at risk of de-
veloping cervical cancer. Current estimates indicate that every year 527,624 women are diagnosed with
cervical cancer and 265,672 die from the disease. Cervical cancer ranks* as the fourth most frequent
cancer among women in the World.
* Ranking of cervical cancer incidence to other cancers among all women according to highest incidence rates (ranking 1st). Ranking is based on crude incidence rates (actual number of
cervical cancer cases). Ranking using age-standardized rate (ASR) may differ.
Table 2: Key statistics
More developed regions

Less developed regions
World
Population
Women at risk for cervical cancer (Female population aged >=15 yrs) in millions 2,716.8 2,174.6 542.2
Burden of cervical cancer
Annual number of new cervical cancer cases 527,624 444,546 83,078
Standardized incidence rates per 100,000 population 14.0 15.7 9.9
Annual number of cervical cancer deaths 265,672 230,158 35,514
Standardized mortality rates per 100,000 population 6.8 8.3 3.3
Burden of cervical HPV infection
Prevalence (%) of HPV 16 and/or HPV 18 among women with:
Normal cytology 4.1 4.4 3.9
Low-grade cervical lesions (LSIL/CIN-1) 25.7 25.0 25.9
High-grade cervical lesions (HSIL/ CIN-2 / CIN-3 / CIS) 51.8 46.6 54.1
Cervical cancer 69.4 69.5 71.8
Please see the specific sections for more information.

LIST OF CONTENTS -v-
Contents
Abbreviations iii
Executive summary iv
1 Introduction 1
2 Demographic and socioeconomic factors 3
3 Burden of HPV related cancers 7

3.1 Cervical cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.1.1 Incidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.1.2 Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.1.3 Comparison of incidence and mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
3.2 Anogenital cancers other than the cervix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
3.2.1 Anal cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
3.2.2 Vulvar cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
3.2.3 Vaginal cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
3.2.4 Penile cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
3.3 Head and neck cancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
3.3.1 Pharyngeal cancer (excluding nasopharynx) . . . . . . . . . . . . . . . . . . . . . . . . 74
4 HPV related statistics 79

4.1 HPV burden in women with normal cervical cytology, cervical precancerous lesions or
invasive cervical cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
4.1.1 HPV prevalence in women with normal cervical cytology . . . . . . . . . . . . . . . . 80
4.1.2 HPV type distribution among women with normal cervical cytology, precancerous
cervical lesions and cervical cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
4.1.3 Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
4.2 HPV burden in anogenital cancers other than the cervix . . . . . . . . . . . . . . . . . . . . . 151
4.2.1 Anal cancer and precancerous anal lesions . . . . . . . . . . . . . . . . . . . . . . . . . 151
4.2.2 Vulvar cancer and precancerous vulvar lesions . . . . . . . . . . . . . . . . . . . . . . . 161
4.2.3 Vaginal cancer and precancerous vaginal lesions . . . . . . . . . . . . . . . . . . . . . 173
4.2.4 Penile cancer and precancerous penile lesions . . . . . . . . . . . . . . . . . . . . . . . 181
4.3 HPV burden in men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
4.4 HPV burden in the head and neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
4.4.1 Burden of oral HPV infection in healthy population . . . . . . . . . . . . . . . . . . . . 202
4.4.2 HPV burden in head and neck cancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
5 Factors contributing to cervical cancer 239
6 Sexual behaviour and reproductive health indicators 244
7 HPV preventive strategies 245

7.1 Cervical cancer screening practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
7.2 HPV vaccination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
7.2.1 HPV vaccine licensure and introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
8 Protective factors for cervical cancer 260
9 References 264
10 Glossary 298

LIST OF FIGURES - vi -
List of Figures
1 World geographical regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Population pyramids by World, developing and developed regions, estimates for 2015 . . . . . . . . . . . . . . . . 3
3 Population trends in four selected age groups by World, developing and developed regions for 2015 . . . . . . . . 4
4 Age-standardised incidence rates of cervical cancer in the World (estimates for 2012) . . . . . . . . . . . . . . . . 7
5 Ranking of cervical cancer versus other cancers among all women and women aged 15-44 years, according to
incidence rates in the World (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
6 World age-standardised incidence rates by World and sub regions (estimates for 2012) . . . . . . . . . . . . . . . . 10
7 Comparison of the ten most frequent cancers in all women by World, developing and developed regions (estimates
for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
8 Comparison of the ten most frequent cancers in all women by World and continents (estimates for 2012) . . . . 12
9 Comparison of the ten most frequent cancers in women aged 15-44 years by World developing and developed
regions (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
10 Comparison of the ten most frequent cancers in women aged 15-44 years by World and continents (estimates for
2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
11 Age-specific incidence of cervical cancer by World, developing and developed regions and five continents . . . . . 15
12 Annual number of new cases of cervical cancer by age group in developing and developed regions and five
continents World (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
13 Annual number of cases and age-specific incidence rates of cervical cancer in the World and its regions (estimates
for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
14 Annual number of cases and age-specific incidence rates of cervical cancer in the World and its regions (estimates
for 2012) (Continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
15 Age-standardised mortality rates of cervical cancer in the World (estimates for 2012) . . . . . . . . . . . . . . . . 21
16 Ranking of cervical cancer versus other cancers among all women and women aged 15-44 years, according to
mortality rates in the World (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
17 World age-standardised mortality rates of cervical cancer by World and sub regions World (estimates for 2012) . 24
18 Comparison of the ten most frequent cancer deaths in all women in the World compared to developing and
developed regions (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
19 Comparison of the ten most frequent cancer deaths in all women in the World compared to the continents
(estimations for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
20 Comparison of the ten most frequent cancer deaths in women aged 15-44 years by World, developing and devel-
oped regions (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
21 Comparison of the ten most frequent cancer deaths in women aged 15-44 years by World and continents (esti-
mates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
22 Age-specific mortality of cervical cancer by World and continents . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
23 Annual number of deaths of cervical cancer by age group by developing and developed regions and continents
(estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
24 Annual number of deaths and age-specific mortality rates of cervical cancer in the World and its regions (esti-
mates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
25 Annual number of deaths and age-specific mortality rates of cervical cancer in the World and its regions (esti-
mates for 2012) (Continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
26 Age-specific incidence and mortality rates of cervical cancer in the World and its regions (estimates for 2012) . 34
27 Comparison of cancer incidence and mortality of pharynx (excluding nasopharynx) by sex and age group in the
World. Includes ICD-10 codes: C09-10,C12-14 (estimates for 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
28 Comparison of cancer incidence and mortality of pharynx (excluding nasopharynx) in males by age group in the
World and its regions. . Includes ICD-10 codes: C09-10,C12-14 (estimates for 2012) . . . . . . . . . . . . . . . . . 77
29 Comparison of cancer incidence and mortality of pharynx (excluding nasopharynx) in females by age group in
the World and its regions. . Includes ICD-10 codes: C09-10,C12-14 (estimates for 2012) . . . . . . . . . . . . . . . 78
30 Prevalence of HPV among women with normal cervical cytology in the World . . . . . . . . . . . . . . . . . . . . . 80
31 Crude age-specific HPV prevalence (%) and 95% confidence interval in women with normal cervical cytology in
the World and its regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
32 Prevalence of HPV among women with normal cervical cytology in Africa by country and study . . . . . . . . . . 82
33 Prevalence of HPV among women with normal cervical cytology in Africa by country and study (continued) . . . 84
34 Prevalence of HPV among women with normal cervical cytology in the Americas by country and study . . . . . . 85
35 Prevalence of HPV among women with normal cervical cytology in the Americas by country and study (continued) 87
38 Prevalence of HPV among women with normal cervical cytology in Asia by country and study . . . . . . . . . . . 92
39 Prevalence of HPV among women with normal cervical cytology in Asia by country and study (continued) . . . . 94
44 Prevalence of HPV among women with normal cervical cytology in Europe by country and study . . . . . . . . . 103

LIST OF FIGURES - vii -
45 Prevalence of HPV among women with normal cervical cytology in Europe by country and study (continued) . . 105
48 Prevalence of HPV among women with normal cervical cytology in Oceania by country and study . . . . . . . . . 110
49 Prevalence of HPV 16 among women with normal cervical cytology in Africa by country and study . . . . . . . . 112
50 Prevalence of HPV 16 among women with normal cervical cytology in the Americas by country and study . . . . 113
51 Prevalence of HPV 16 among women with normal cervical cytology in the Americas by country and study (con-
tinued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
52 Prevalence of HPV 16 among women with normal cervical cytology in Asia by country and study . . . . . . . . . 115
53 Prevalence of HPV 16 among women with normal cervical cytology in Asia by country and study (continued) . . 116
54 Prevalence of HPV 16 among women with normal cervical cytology in Europe by country and study . . . . . . . . 117
55 Prevalence of HPV 16 among women with normal cervical cytology in Europe by country and study (continued) 118
56 Prevalence of HPV 16 among women with normal cervical cytology in Oceania by country and study . . . . . . . 119
57 Prevalence of HPV 16 among women with low-grade cervical lesions in Africa by country and study . . . . . . . 120
58 Prevalence of HPV 16 among women with low-grade cervical lesions in the Americas by country and study . . . 121
59 Prevalence of HPV 16 among women with low-grade cervical lesions in the Americas by country and study
(continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
60 Prevalence of HPV 16 among women with low-grade cervical lesions in Asia by country and study . . . . . . . . 123
61 Prevalence of HPV 16 among women with low-grade cervical lesions in Asia by country and study (continued) . 124
62 Prevalence of HPV 16 among women with low-grade cervical lesions in Europe by country and study . . . . . . . 125
63 Prevalence of HPV 16 among women with low-grade cervical lesions in Europe by country and study (continued) 126
64 Prevalence of HPV 16 among women with low-grade cervical lesions in Oceania by country and study . . . . . . 127
65 Prevalence of HPV 16 among women with high-grade cervical lesions in Africa by country and study . . . . . . . 128
66 Prevalence of HPV 16 among women with high-grade cervical lesions in the Americas by country and study . . 129
67 Prevalence of HPV 16 among women with high-grade cervical lesions in the Americas by country and study
(continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
68 Prevalence of HPV 16 among women with high-grade cervical lesions in Asia by country and study . . . . . . . . 131
69 Prevalence of HPV 16 among women with high-grade cervical lesions in Asia by country and study (continued) 132
70 Prevalence of HPV 16 among women with high-grade cervical lesions in Europe by country and study . . . . . . 133
71 Prevalence of HPV 16 among women with high-grade cervical lesions in Europe by country and study (continued) 134
72 Prevalence of HPV 16 among women with high-grade cervical lesions in Oceania by country and study . . . . . . 135
73 Prevalence of HPV 16 among women with invasive cervical cancer in Africa by country and study . . . . . . . . . 136
74 Prevalence of HPV 16 among women with invasive cervical cancer in the Americas by country and study . . . . 137
75 Prevalence of HPV 16 among women with invasive cervical cancer in the Americas by country and study (con-
tinued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
76 Prevalence of HPV 16 among women with invasive cervical cancer in Asia by country and study . . . . . . . . . . 139
77 Prevalence of HPV 16 among women with invasive cervical cancer in Asia by country and study (continued) . . 140
78 Prevalence of HPV 16 among women with invasive cervical cancer in Asia by country and study (continued) . . 141
79 Prevalence of HPV 16 among women with invasive cervical cancer in Europe by country and study . . . . . . . . 142
80 Prevalence of HPV 16 among women with invasive cervical cancer in Europe by country and study (continued) . 143
81 Prevalence of HPV 16 among women with invasive cervical cancer in Europe by country and study (continued) . 144
82 Prevalence of HPV 16 among women with invasive cervical cancer in Oceania by country and study . . . . . . . 145
83 Comparison of the ten most frequent HPV oncogenic types among women with and without cervical lesions by
World compared to developing and developed regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
84 Comparison of the ten most frequent HPV types among women with invasive cervical cancer by histology by
World, developing and developed regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
85 Comparison of the ten most frequent HPV types in anal cancer cases in Africa and the rest of the World . . . . . 156
86 Comparison of the ten most frequent HPV types in anal cancer cases in the Americas and the rest of the World 156
87 Comparison of the ten most frequent HPV types in anal cancer cases in Asia and the rest of the World . . . . . . 157
88 Comparison of the ten most frequent HPV types in anal cancer cases in Europe and the rest of the World . . . . 157
89 Comparison of the ten most frequent HPV types in anal cancer cases in Oceania and the rest of the World . . . . 158
90 Comparison of the ten most frequent HPV types in AIN 2/3 cases in Africa and the rest of the World . . . . . . . 158
91 Comparison of the ten most frequent HPV types in AIN 2/3 cases in the Americas and the rest of the World . . . 159
92 Comparison of the ten most frequent HPV types in AIN 2/3 cases in Asia and the rest of the World . . . . . . . . 159
93 Comparison of the ten most frequent HPV types in AIN 2/3 cases in Europe and the rest of the World . . . . . . 160
94 Comparison of the ten most frequent HPV types in AIN 2/3 cases in Oceania and the rest of the World . . . . . . 160
95 Comparison of the ten most frequent HPV types in vulvar cancer cases in Africa and the rest of the World . . . . 168
96 Comparison of the ten most frequent HPV types in vulvar cancer cases in the Americas and the rest of the World 168
97 Comparison of the ten most frequent HPV types in vulvar cancer cases in Asia and the rest of the World . . . . . 169
98 Comparison of the ten most frequent HPV types in vulvar cancer cases in Europe and the rest of the World . . . 169
99 Comparison of the ten most frequent HPV types in vulvar cancer cases in Oceania and the rest of the World . . 170
100 Comparison of the ten most frequent HPV types in VIN 2/3 cases in Africa and the rest of the World . . . . . . . 170
101 Comparison of the ten most frequent HPV types in VIN 2/3 cases in the Americas and the rest of the World . . . 171
102 Comparison of the ten most frequent HPV types in VIN 2/3 cases in Asia and the rest of the World . . . . . . . . 171
103 Comparison of the ten most frequent HPV types in VIN 2/3 cases in Europe and the rest of the World . . . . . . 172

LIST OF FIGURES - viii -
104 Comparison of the ten most frequent HPV types in VIN 2/3 cases in Oceania and the rest of the World . . . . . . 172
105 Comparison of the ten most frequent HPV types in vaginal cancer cases in Africa and the rest of the World . . . 175
106 Comparison of the ten most frequent HPV types in vaginal cancer cases in the Americas and the rest of the World176
107 Comparison of the ten most frequent HPV types in vaginal cancer cases in Asia and the rest of the World . . . . 176
108 Comparison of the ten most frequent HPV types in vaginal cancer cases in Europe and the rest of the World . . 177
109 Comparison of the ten most frequent HPV types in vaginal cancer cases in Oceania and the rest of the World . . 177
110 Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Africa and the rest of the World . . . . . . 178
111 Comparison of the ten most frequent HPV types in VaIN 2/3 cases in the Americas and the rest of the World . . 178
112 Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Asia and the rest of the World . . . . . . . 179
113 Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Europe and the rest of the World . . . . . . 179
114 Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Oceania and the rest of the World . . . . . 180
115 Comparison of the ten most frequent HPV types in penile cancer cases in Africa and the rest of the World . . . . 186
116 Comparison of the ten most frequent HPV types in penile cancer cases in the Americas and the rest of the World 186
117 Comparison of the ten most frequent HPV types in penile cancer cases in Asia and the rest of the World . . . . . 187
118 Comparison of the ten most frequent HPV types in penile cancer cases in Europe and the rest of the World . . . 187
119 Comparison of the ten most frequent HPV types in penile cancer cases in Oceania and the rest of the World . . 188
120 Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Africa and the rest of the World . . . . . . . 188
121 Comparison of the ten most frequent HPV types in PeIN 2/3 cases in the Americas and the rest of the World . . 189
122 Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Asia and the rest of the World . . . . . . . . 189
123 Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Europe and the rest of the World . . . . . . 190
124 Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Oceania and the rest of the World . . . . . 190
125 Female smoking prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
126 Total fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
127 World prevalence of hormonal contraceptive use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
128 World HIV prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
129 Percentage of 15-year-old girls who report sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
130 Worldwide status of cervical cancer screening programmes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
131 Worldwide status of HPV vaccination programmes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
132 Worldwide prevalence of male circumcision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
133 Worldwide prevalence of condom use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262

LIST OF TABLES - ix -
List of Tables
1 Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
2 Key statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
3 World population estimates (in millions), 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
4 World sociodemographic indicators, 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
5 Incidence of cervical cancer by World region and sub regions (estimates for 2012) . . . . . . . . . . . . . . . . . . . 8
6 Cervical cancer mortality by World region and sub regions (estimates for 2012) . . . . . . . . . . . . . . . . . . . . 22
7 Incidence of anal cancer by cancer registry and sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
8 Incidence of vulvar cancer by cancer registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
9 Incidence of vaginal cancer by cancer registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
10 Incidence of penile cancer by cancer registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
11 Cancer incidence of pharynx (excluding nasopharynx) by sex, in the World and its regions. Includes ICD-10
codes: C09-10, C12-14 (estimates for 2012). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
12 Cancer mortality of pharynx (excluding nasopharynx) by sex, in the World and its regions. Includes ICD-10
codes: C09-10, C12-14 (estimates for 2012). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
13 Prevalence of HPV 16/18 in women with normal cervical cytology, precancerous cervical lesions and invasive
cervical cancer by World region and sub-regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
14 Type-specific HPV prevalence in women with normal cervical cytology, precancerous cervical lesions and invasive
cervical cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
15 Type-specific HPV prevalence among invasive cervical cancer cases by histology . . . . . . . . . . . . . . . . . . . 149
16 Studies on HPV prevalence among anal cancer cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
17 Studies on HPV prevalence among AIN 2/3 cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
18 Studies on HPV prevalence among vulvar cancer cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
19 Studies on HPV prevalence among VIN 2/3 cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
20 Studies on HPV prevalence among vaginal cancer cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
21 Studies on HPV prevalence among VaIN 2/3 cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
22 Studies on HPV prevalence among penile cancer cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
23 Studies on HPV prevalence among PeIN 2/3 cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
24 Studies on anogenital HPV prevalence among men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
25 Studies on anogenital HPV prevalence among men from special subgroups . . . . . . . . . . . . . . . . . . . . . . 194
26 Studies on oral HPV prevalence among healthy populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
27 Studies on HPV prevalence among cases of oral cavity cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
28 Studies on HPV prevalence among cases of oropharyngeal cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
29 Studies on HPV prevalence among cases of hypopharyngeal or laryngeal cancer . . . . . . . . . . . . . . . . . . . 227
30 Cervical cancer screening policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
31 HPV vaccination policies for the female population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
32 References of studies included . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
33 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298

1 INTRODUCTION -1-
1 Introduction
Figure 1: World geographical regions
Northern Europe
Eastern Europe
Northern America Central Asia

Western Europe
Southern Europe Eastern Asia
Northern Africa
Western Asia Southern Asia

Caribbean
Central America
Western Africa SouthEastern Asia Micronesia
Eastern Africa
Middle Africa
Melanesia
Polynesia
South America Australia and New Zealand
Southern Africa
Data sources: United Nations Statistics Division- Standard Country and Area Codes Classifications.
The HPV Information Centre aims to compile and centralize updated data and statistics on HPV and
HPV-related cancers. This report aims to summarize the data available to fully evaluate the burden of
disease in the World and to facilitate stakeholders and relevant bodies of decision makers to formulate
recommendations on the prevention of cervical cancer and other HPV-related cancers. Data include rel-
evant cancer statistic estimates, epidemiological determinants of cervical cancer such as demographics,
socioeconomic factors, risk factors, burden of HPV infection in women and men, and cervical screening
and immunization practices. The report is structured into the following sections:
Section 2, Demographic and socioeconomic factors. This section summarizes the sociodemo-
graphic profile of the World. For analytical purposes, the World is divided into five regions: Africa,
the Americas, Asia, Europe and Oceania (Figure 1).
Section 3, Burden of HPV related cancers. This section describes the current burden of invasive
cervical cancer and other HPV-related cancers in the World with estimates of prevalence, incidence and
mortality rates.
Section 4, HPV related statistics. This section summarizes reports on prevalence of HPV and HPV
type-specific distribution in women with normal cytology, women with precancerous lesions and inva-
sive cervical cancer. In addition, the burden of HPV in other anogenital cancers (anus, vulva, vagina,
and penis) are presented.
Section 5, Factors contributing to cervical cancer. This section describes factors that can modify
the natural history of HPV and cervical carcinogenesis such as smoking, parity, oral contraceptive use
and co-infection with HIV.
Section 6, Sexual behaviour and reproductive health indicators. This section presents sex-
ual behaviour and reproductive health indicators that may be used as proxy measures of risk for HPV
infection and anogenital cancers.
Section 7, HPV preventive strategies. This section presents preventive strategies that include ba-
sic characteristics and performance of cervical cancer screening status, status of HPV vaccine licensure

1 INTRODUCTION -2-
introduction, and recommendations for national immunization programmes.
Section 8, Protective factors for cervical cancer. This section presents the prevalence of male
circumcision and condom use.

2 DEMOGRAPHIC AND SOCIOECONOMIC FACTORS -3-
2 Demographic and socioeconomic factors
Figure 2: Population pyramids by World, developing and developed regions, estimates for 2015
World
Males Females
80+ 48,276,426 76,996,744

7579 50,595,216 64,057,096
7074 71,182,650 82,024,376
6569 102,619,243 112,427,908
6064 142,749,095 149,977,697
5559 167,871,466 171,820,001
5054 200,783,388 200,969,735
4549 228,545,898 225,496,674
4044 245,532,194 239,525,754
3539 251,914,808 245,840,826
3034 279,682,235 271,403,191
2529 311,657,089 298,136,118
2024 310,593,270 292,915,285
1519 304,828,740 285,240,597
1014 314,040,269 293,391,030
59 329,582,263 307,866,632
Under 5 346,751,503 324,176,682

Males Females
80+ 27,402,564 38,764,751

7579 32,357,802 38,636,328
7074 48,452,013 53,816,759
6569 71,316,159 76,616,697
6064 105,967,905 108,792,228
5559 126,644,077 127,727,005
5054 156,520,362 155,191,159
4549 185,922,140 182,447,074
4044 202,213,725 195,995,383
3539 209,921,312 204,047,584
3034 236,174,095 228,730,576
2529 268,698,839 256,648,260
2024 270,889,199 255,094,564
1519 269,899,286 252,073,759
1014 279,886,799 260,835,550
59 294,143,102 274,091,583
Under 5 311,499,226 290,703,148

Males Females
80+ 20,873,862 38,231,993

7579 18,237,414 25,420,768
7074 22,730,637 28,207,617
6569 31,303,084 35,811,211
6064 36,781,190 41,185,469
5559 41,227,389 44,092,996
5054 44,263,026 45,778,576
4549 42,623,758 43,049,600
4044 43,318,469 43,530,371
3539 41,993,496 41,793,242
3034 43,508,140 42,672,615
2529 42,958,250 41,487,858
2024 39,704,071 37,820,721
1519 34,929,454 33,166,838
1014 34,153,470 32,555,480
59 35,439,161 33,775,049
Under 5 35,252,277 33,473,534
Population by sex and age group
Data accessed on 26 Aug 2015.

Estimated population in a country, area or region as of 1 July of the year indicated.
Data sources:
United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision. Available at: http://esa.un.org/unpd/wpp/
[Accessed: August 2015]

Figure 3: Population trends in four selected age groups by World, developing and developed regions for
2015
World
Projections Projections
Women 1524 yrs

Number of women (in millions)

700 All Women
5,200
600
500 4,200
400 3,200
Girls 1014 yrs
Women 2564 yrs
300
2,200
200
1,200
100
200
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
700
Women 1524 yrs
600 5,200 All Women
500 4,200
400
3,200
Girls 1014 yrs
300
Women 2564 yrs
2,200
200
1,200
100
0 200
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
700
600 5,200
500 4,200
400
3,200
300
2,200
200
1,200
100 Women 1524 yrs
Girls 1014 yrs All Women
Women 2564 yrs
0 200
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
Female population trends

Number of women by year and age group
Data sources:

Table 3: World population estimates (in millions), 2015

Region / Country Male Female
10-14 years 15+ years Total 10-14 years 15+ years Total
World 314.04 2716.83 3707.21 293.39 2716.83 3642.27
Less developed regionsa 279.89 2212.38 3097.91 260.84 2174.58 3000.21
More developed regionsb 34.15 504.45 609.30 32.56 542.25 642.05
Africa 70.81 347.14 593.45 69.15 353.06 592.72
Eastern Africa 25.16 109.81 196.13 24.97 113.33 198.34
Middle Africa 9.75 41.03 75.78 9.65 41.90 76.18
Northern Africa 10.62 75.57 112.40 10.14 76.36 111.49
Southern Africa 2.98 21.32 30.82 2.95 22.50 31.82
Western Africa c,d 22.31 99.42 178.32 21.44 98.97 174.90
Americas e 40.00 373.57 490.89 38.44 388.75 501.33
Caribbean f 1.85 15.87 21.41 1.77 16.49 21.79
Central America 8.45 60.45 85.64 8.14 62.93 87.10
Northern America g 11.49 143.29 177.38 11.01 147.81 180.46
South Americah 18.21 153.95 206.46 17.52 161.51 211.98
Asia 182.81 1684.64 2246.99 166.41 1634.21 2146.31
Central Asia 2.78 23.07 33.09 2.67 24.68 34.23
Eastern Asia 46.37 680.06 824.70 40.60 661.51 787.59
South-Eastern Asia 28.33 229.92 316.15 26.93 235.42 317.34
Southern Asia 93.13 657.02 938.88 84.58 627.26 884.09
Western Asia 12.20 94.56 134.17 11.63 85.35 123.06
Europe 18.91 296.53 356.17 17.98 325.67 382.28
Eastern Europe 7.06 113.99 137.87 6.70 132.42 155.07
Northern Europe i 2.84 41.19 50.43 2.71 43.12 51.93
Southern Europe j 3.87 62.92 74.28 3.66 67.33 78.07
Western Europek 5.15 78.44 93.58 4.91 82.80 97.21
Oceania 1.50 14.95 19.71 1.41 15.15 19.62
Australia & New Zealand 0.88 11.42 14.19 0.83 11.68 14.31
Melanesia 0.56 3.10 4.90 0.52 3.05 4.72
Micronesial 0.03 0.19 0.27 0.03 0.18 0.26
Polynesiam 0.04 0.24 0.35 0.03 0.24 0.34
a Less developed regions comprise all regions of Africa, Asia (except Japan), Latin America and the Caribbean plus Melanesia, Micronesia and Polynesia.
b More developed regions comprise Europe, Northern America, Australia/New Zealand and Japan.
c Including Saint Helena, Ascension and Tristan da Cunha.
d Including Saint Helena, Ascension, and Tristan da Cunha.
e Aggregated by the HPV Information Centre pooling its individual areas/countries.
f Including Anguilla, British Virgin Islands, Caribbean Netherlands, Cayman Islands, Dominica, Montserrat, Saint Kitts and Nevis, Sint Maarten (Dutch part) and Turks and Caicos
Islands.
g Including Bermuda, Greenland, and Saint-Pierre-et-Miquelon.
h Including Falkland Islands (Malvinas).
i Including Faeroe Islands, and Isle of Man.
j Including Andorra, Gibraltar, Holy See, and San Marino.
k Including Liechtenstein, and Monaco.
l Including Marshall Islands, Nauru, Northern Mariana Islands, and Palau.
m Including American Samoa, Cook Islands, Niue, Pitcairn, Tokelau, Tuvalu, and Wallis and Futuna Islands.
Data sources:
Table 4: World sociodemographic indicators, 2015

Indicator Male Female Total
Population in thousands1,a 3,707,205.4 3,642,266.4 7,349,471.7
Population growth rate (%), - - 1.2
,
Median age of the population (in years) - - 28.5
2,,
Population living in urban areas (%) - - 51.6
,
Crude birth rate (births per 1,000) - - 20.1
Crude death rate (deaths per 1,000), - - 8.1
3
Life expectancy at birth (in years) - - -
Adult mortality rate (probability of dying between 15 and 60 years - - -
old per 1,000)3
Under age five mortality rate (per 1,000 live births)3 - - -
(Continued on next page)

( Table 4 continued from previous page)

Indicator Male Female Total
4,b,c
Density of physicians (per 10,000 population) - - -
5,
Gross national income per capita (PPP int $) - - 15032
6,?
Adult literacy rate (%) (aged 15 and older) 89.9 82.2 86.1
Youth literacy rate (%) (aged 15-24 years)6,? 92.8 89.7 91.3
6,
Net primary school enrollment ratio 89.8 88.3 89.0
6,
Net secondary school enrollment ratio 67.3 64.6 66.0
a Estimated population in a country, area or region as of 1 July of the year indicated.
b Density (per 10,000 population) and number of physicians.
c Includes generalist medical practitioners and specialist medical practitioners.
Year of estimate: 2005-2010; 2010; 2014; ? 2015; 2013;
For methods of estimation, please refer to original source.
Data sources:
1 United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision. Available at: http://esa.un.org/unpd/wpp/
2 United Nations, Department of Economic and Social Affairs, Population Division (2012). World Urbanization Prospects : The 2011 Revision. CD-ROM Edition - Data in digital form (POP/
DB/WUP/Rev.2011).
3 World Health Statistics 2015. Geneva, World Health Organization, 2013. Available at: http://www.who.int/gho/publications/world_health_statistics/2015/en/ [Accessed on
July 2015].
4 WHO Global Health Workforce Statistics [online database]. Geneva, World Health Organization, 2014. Available at: http://www.who.int/hrh/statistics/hwfstats/[Accessed on
July 2015]
5 World Development Indicators Database, 2015. Washington, DC, World Bank. Available at: http://databank.worldbank.org/data/reports.aspx?source=
world-development-indicators [Accessed on July 2015]
6 UNESCO Institute for Statistics Data Centre [online database]. Montreal, UNESCO Institute for Statistics, 2015. Available at: http://stats.uis.unesco.org [Accessed on July 2015]

3 BURDEN OF HPV RELATED CANCERS -7-
3 Burden of HPV related cancers

3.1 Cervical cancer
Cancer of the cervix uteri is the 4th most common cancer among women worldwide, with an estimated
527,624 new cases and 265,672 deaths in 2012 (GLOBOCAN). The majority of cases are squamous cell
carcinoma followed by adenocarcinomas. (Vaccine 2006, Vol. 24, Suppl 3; Vaccine 2008, Vol. 26, Suppl
10; Vaccine 2012, Vol. 30, Suppl 5; IARC Monographs 2007, Vol. 90)
This section describes the current burden of invasive cervical cancer in the World and its regions with
estimates of the annual number of new cases, deaths, incidence and mortality.
3.1.1 Incidence
KEY STATS.
About 527,624 new cervical cancer cases are diagnosed annually in

World (estimates for 2012).
Cervical cancer ranks* as the 4 th leading cause of female cancer in the

World.
Cervical cancer is the 2nd most common female cancer in the women
aged 15 to 44 years in World.
Figure 4: Age-standardised incidence rates of cervical cancer in the World (estimates for 2012)
Data accessed on 15 Nov 2015.

ASR: Age-standardized rate, Standardized rates have been estimated using the direct method and the World population as the reference;
Rates per 100,000 women per year.
For Sudan, South Sudan: Estimate for Sudan and South Sudan
Data sources: Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.2, Cancer Incidence and Mortality
Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr.

Table 5: Incidence of cervical cancer by World region and sub regions (estimates for 2012)
Cumulative risk (%) Ranking of CC
Area N cases Crude ratea ASRa ages 0-74 yearsb All women Women 15-44 years
World 527,624 15.1 14.0 1.4 4 2
Less developed re- 444,546 15.6 15.7 1.6 2 2
gions
More developed re- 83,078 13.0 9.9 0.9 11 2
gions
Africa 99,038 18.5 27.6 3.0 2 2
Eastern Africa 45,707 25.8 42.7 4.6 1 1
Middle Africa 11,540 17.2 30.6 3.4 1 2
Northern Africa 5,813 5.6 6.6 0.7 4 4
Southern Africa 8,652 29.3 31.5 3.1 2 1
Western Africa 27,326 17.2 29.3 3.2 2 2
Americas 83,195 17.2 14.9 1.4 4 2
Caribbean 5,018 23.6 21.0 2.0 2 2
Central America 18,792 23.1 23.5 2.3 2 1
Northern America 14,377 8.1 6.6 0.6 13 4
South America 45,008 22.2 20.3 2.0 2 2
Asia 284,823 13.7 12.7 1.3 3 2
Central Asia 5,850 18.5 18.6 1.8 2 1
Eastern Asia 78,006 10.1 7.9 0.7 7 2
Southern Asia 145,946 17.1 19.3 2.1 2 2
South-Eastern 50,566 16.6 16.3 1.7 2 2
Asia
Western Asia 4,455 3.8 4.4 0.5 11 4
Europe 58,373 15.2 11.4 1.1 6 2
Eastern Europe 33,882 21.7 16.3 1.5 4 2
Northern Europe 5,382 10.6 8.7 0.8 10 3
Southern Europe 9,285 11.6 8.5 0.8 11 2
Western Europe 9,824 10.2 7.3 0.7 14 4
Oceania 2,195 11.7 10.2 0.9 8 3
Australia & New 938 6.8 5.5 0.5 12 4
Zealand
Melanesia 1,198 26.8 33.3 3.2 2 1
Micronesia 23 8.5 8.7 0.9 6 4
Polynesia 36 10.8 11.0 1.1 5 3
Standardised rates have ben estimated using the direct method and the World population as the reference.
Ranking of cervical cancer incidence to other cancers among all women ages 15-44 years according to highest incidence rates (ranking 1st). Ranking is based on crude incidence rates (actual
number of cervical cancer cases). Ranking using ASR may differ.
a Rates per 100,000 women per year.
b Cumulative risk (incidence) is the probability or risk of individuals getting from the disease during ages 0-74 years. For cancer, it is expressed as the % of new born children who would be
expected to develop from a particular cancer before the age of 75 if they had the rates of cancer observed in the period in the absence of competing causes.
Data sources:
1 Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.2, Cancer Incidence and Mortality Worldwide: IARC
CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr.

Figure 5: Ranking of cervical cancer versus other cancers among all women and women aged 15-44
years, according to incidence rates in the World (estimates for 2012)


3 BURDEN OF HPV RELATED CANCERS - 10 -
Figure 6: World age-standardised incidence rates by World and sub regions (estimates for 2012)
World, developed and developing regions Continental subregions
Less developed 15.7
Eastern Africa 42.7
Melanesia 33.3
Southern Africa 31.5
Middle Africa 30.6
World 14.0 Western Africa 29.3

Central America 23.5
Caribbean 21.0
South America 20.3
Southern Asia 19.3
More developed 9.9
Central Asia 18.6
0 10 20 SouthEastern Asia 16.3
Eastern Europe 16.3
Five continents
Polynesia 11.0
Africa 27.6
Northern Europe 8.7
Micronesia 8.7
Americas 14.9
Southern Europe 8.5
Eastern Asia 7.9
Asia 12.7 Western Europe 7.3
Northern America 6.6
Europe 11.4 Northern Africa 6.6

Australia & New Zealand 5.5
Western Asia 4.4
Oceania 10.2
0 10 20 30 0 10 20 30 40 50
Cervical cancer: Agestandardised mortality rate per 100,000 women

World Standard. Female (All ages)

Data sources:
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.2, Cancer Incidence and Mortality Worldwide: IARC

Figure 7: Comparison of the ten most frequent cancers in all women by World, developing and developed
regions (estimates for 2012)
World More developed regions

Breast 43.1 Breast 73.4
Colorectum(a) 14.3 Colorectum(a) 23.6
Cervix uteri 14.0 Lung 19.6
Lung 13.6 Corpus uteri 14.7
Corpus uteri 8.2 Thyroid 11.1
Stomach 7.5 Cervix uteri 9.9
Ovary 6.1 Melanoma of skin 9.3
Thyroid 6.1 Ovary 9.1
Liver 5.4 NonHodgkin lymphoma(b) 7.1
NonHodgkin lymphoma(b) 4.1 Stomach 6.7
0 15 30 45 60 75 0 15 30 45 60 75
Less developed regions Agestandardised incidence rate per 100,000

women
Breast 31.3
Cervix uteri 15.7
Lung 11.1
Colorectum(a) 9.8
Stomach 7.8
Liver 6.6
Corpus uteri 5.5
Ovary 5.0
Thyroid 4.7
Oesophagus 4.1
0 15 30 45 60 75
a Includes anal cancer (C21).
b Includes HIV disease resulting in malignant neoplasms (B21).
Data sources:

Figure 8: Comparison of the ten most frequent cancers in all women by World and continents (estimates
for 2012)
World Asia
Colorectum(a) 14.3 Cervix uteri 12.7
Lung 13.6 Colorectum(a) 11.1
Corpus uteri 8.2 Stomach 9.3
Stomach 7.5 Liver 6.9
Ovary 6.1 Corpus uteri 5.9
Thyroid 6.1 Ovary 5.0
Liver 5.4 Thyroid 5.0
NonHodgkin lymphoma(b) 4.1 Oesophagus 4.3
0 15 30 45 60 75 0 15 30 45 60 75
Africa Europe
Cervix uteri 27.6 Colorectum(a) 23.6
Colorectum(a) 5.8 Lung 15.1
Liver 5.8 Corpus uteri 13.9
Ovary 4.8 Cervix uteri 11.4
NonHodgkin lymphoma(b) 3.8 Ovary 9.9
Corpus uteri 3.5 Melanoma of skin 8.9
Oesophagus 3.5 Thyroid 7.8
Stomach 3.2 Stomach 6.4
Kaposi sarcoma(c) 2.9 NonHodgkin lymphoma(b) 5.9
0 15 30 45 60 75 0 15 30 45 60 75
Americas Oceania
Lung 21.6 Colorectum(a) 29.2
Colorectum(a) 17.6 Melanoma of skin 25.5
Corpus uteri 12.3 Corpus uteri 12.3
Thyroid 12.1 Thyroid 11.3
NonHodgkin lymphoma(b) 7.0 Cervix uteri 10.2
Ovary 6.8 NonHodgkin lymphoma(b) 9.4
Melanoma of skin 6.2 Ovary 8.0
Leukaemia 5.6 Leukaemia 6.4
0 15 30 45 60 75 0 15 30 45 60 75
Agestandardised incidence rate per 100,000

women

c Includes B21.0 (HIV disease resulting in Kaposi sarcoma).

( Figure 8 continued from previous page)

Data sources:
Figure 9: Comparison of the ten most frequent cancers in women aged 15-44 years by World developing
and developed regions (estimates for 2012)

Cervix uteri 11.1 Cervix uteri 11.8
Colorectum(a) 2.5 Ovary 4.8
Corpus uteri 2.2 Colorectum(a) 4.4
Leukaemia 2.1 Corpus uteri 3.4
Brain, nervous system 1.7 Hodgkin lymphoma 2.9
NonHodgkin lymphoma(b) 1.6 Brain, nervous system 2.7
Lung 1.5 NonHodgkin lymphoma(b) 2.7
0 10 20 30 40 0 10 20 30 40
Less developed regions Agestandardised incidence rate per 100,000

women
Breast 19.0
Cervix uteri 11.0
Thyroid 4.7
Ovary 2.8
Colorectum(a) 2.1
Leukaemia 2.1
Corpus uteri 2.0
Brain, nervous system 1.6
Stomach 1.5
NonHodgkin lymphoma(b) 1.4
0 10 20 30 40
Data sources:

Figure 10: Comparison of the ten most frequent cancers in women aged 15-44 years by World and
continents (estimates for 2012)
World Asia
Ovary 3.1 Ovary 3.0
Colorectum(a) 2.5 Corpus uteri 2.5
Corpus uteri 2.2 Colorectum(a) 2.2
Brain, nervous system 1.7 Brain, nervous system 1.7
NonHodgkin lymphoma(b) 1.6 Stomach 1.7
Lung 1.5 Lung 1.5
0 10 20 30 40 0 10 20 30 40
Africa Europe
Kaposi sarcoma(c) 3.9 Melanoma of skin 8.0
Ovary 2.4 Thyroid 7.3
Liver 1.6 Hodgkin lymphoma 3.2
Thyroid 1.5 Brain, nervous system 2.8
Lip, oral cavity 0.7 NonHodgkin lymphoma(b) 2.5
0 10 20 30 40 0 10 20 30 40
Americas Oceania
Cervix uteri 15.3 Melanoma of skin 15.8
Thyroid 12.2 Cervix uteri 12.7
Melanoma of skin 3.9 Thyroid 11.6
Ovary 3.2 Ovary 4.0
Brain, nervous system 2.4 NonHodgkin lymphoma(b) 2.6
Corpus uteri 2.3 Hodgkin lymphoma 2.4
NonHodgkin lymphoma(b) 2.3 Lip, oral cavity 2.4
0 10 20 30 40 0 10 20 30 40
Agestandardised incidence rate per 100,000

women



Data sources:
Figure 11: Age-specific incidence of cervical cancer by World, developed and developing regions
and five continents
World Asia
Africa Europe
Americas Oceania
Agespecific rates of cervical cancer per 100,000
100
75
50
25
0
19 024 529 034 539 044 549 054 559 064 569 074 >=75
15 2 2 3 3 4 4 5 5 6 6 7
Age group (years)

Figure 12: Annual number of new cases of cervical cancer by age group in developing and developed
regions and five continents World (estimates for 2012)
DEVELOPED AND DEVELOPING REGIONS

Less developed regions More developed regions
Annual number of new cases of cervical cancer
350000
323619*
315000
280000
245000
210000
175000
140000
111503*
105000 92337*
70000
35000
0
1539 4064 65+
FIVE CONTINENTS
Asia Americas Oceania
Africa Europe
Annual number of new cases of cervical cancer
350000
323619*
315000
280000
245000
210000
175000
140000
111503*
105000 92337*
70000
35000
0
1539 4064 65+
* Less developed regions 15-39 years: 91746 cases. 40-64 years: 278880 cases. 65+ years: 73762 cases.
* More developed regions 15-39 years: 19757 cases. 40-64 years: 44739 cases. 65+ years: 18575 cases.
* Asia 15-39 years: 55178 cases. 40-64 years: 188892 cases. 65+ years: 40668 cases.
* Africa 15-39 years: 19650 cases. 40-64 years: 58316 cases. 65+ years: 21014 cases.
* Americas 15-39 years: 22725 cases. 40-64 years: 42915 cases. 65+ years: 17537 cases.
* Europe 15-39 years: 13249 cases. 40-64 years: 32345 cases. 65+ years: 12775 cases.
* Oceania 15-39 years: 701 cases. 40-64 years: 1151 cases. 65+ years: 343 cases.



Data sources:

Figure 13: Annual number of cases and age-specific incidence rates of cervical cancer in the World and
its regions (estimates for 2012)
World Africa
Agespecific rates of
cervical cancer(a)
90 90
60 60

30

30

0
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
324000 323619* 190000
270000
Annual number of cases
152000
of cervical cancer
216000
114000
162000
111503* 76000
108000 92337 58316*
54000 38000
19637* 21014
0 0
1539 4064 65+ 1539 4064 65+
* World 15-19 yrs: 754 cases. 20-24 yrs: 6445 cases. 25-29 yrs: 19167 cases. 30-34 yrs: 34149 cases. 35-39 yrs: 50988 cases. 40-44 yrs: 66308 cases. 45-49 yrs: 73307 cases. 50-54 yrs: 71492
cases. 55-59 yrs: 63571 cases. 60-64 yrs: 48941 cases.
* Africa 15-19 yrs: 352 cases. 20-24 yrs: 1091 cases. 25-29 yrs: 3310 cases. 30-34 yrs: 6198 cases. 35-39 yrs: 8686 cases. 40-44 yrs: 10474 cases. 45-49 yrs: 11987 cases. 50-54 yrs: 12753

Data sources:

Figure 14: Annual number of cases and age-specific incidence rates of cervical cancer in the World and
its regions (estimates for 2012) (Continued)
Americas Europe
cervical cancer(a)
90 90
60 60

30

30

0
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
190000 190000
152000 152000
of cervical cancer
114000 114000
76000 76000
42915*
38000 38000 32345*
22679* 17537 13242* 12775
0 0
1539 4064 65+ 1539 4064 65+
Asia Oceania
cervical cancer(a)
90 90
60 60

30

30

0
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
190000 188892* 190000

152000 152000
of cervical cancer
114000 114000
76000 76000
55178*
40668
38000 38000
0 0 696* 1151* 343

1539 4064 65+ 1539 4064 65+
* Americas 15-19 yrs: 180 cases. 20-24 yrs: 2047 cases. 25-29 yrs: 4668 cases. 30-34 yrs: 6901 cases. 35-39 yrs: 8883 cases. 40-44 yrs: 9817 cases. 45-49 yrs: 9862 cases. 50-54 yrs: 8951
* Asia 15-19 yrs: 195 cases. 20-24 yrs: 2443 cases. 25-29 yrs: 8394 cases. 30-34 yrs: 16585 cases. 35-39 yrs: 27561 cases. 40-44 yrs: 39251 cases. 45-49 yrs: 44160 cases. 50-54 yrs: 42416
* Europe 15-19 yrs: 22 cases. 20-24 yrs: 798 cases. 25-29 yrs: 2639 cases. 30-34 yrs: 4235 cases. 35-39 yrs: 5548 cases. 40-44 yrs: 6449 cases. 45-49 yrs: 7020 cases. 50-54 yrs: 7137 cases.
55-59 yrs: 6518 cases. 60-64 yrs: 5221 cases.
* Oceania 15-19 yrs: 4 cases. 20-24 yrs: 60 cases. 25-29 yrs: 144 cases. 30-34 yrs: 208 cases. 35-39 yrs: 280 cases. 40-44 yrs: 317 cases. 45-49 yrs: 278 cases. 50-54 yrs: 235 cases. 55-59 yrs:
181 cases. 60-64 yrs: 140 cases.



Data sources:
NOTE.
For time trends in cervical cancer incidence, please refer to individual country data.

3.1.2 Mortality
KEY STATS.
About 265,672 new cervical cancer deaths occur annually in the

World (estimations for 2012).
Cervical cancer ranks* as the 4 th leading cause of female cancer deaths

in the World.
Cervical cancer is the 2nd most common female cancer deaths in women
aged 15 to 44 years in the World.
Figure 15: Age-standardised mortality rates of cervical cancer in the World (estimates for 2012)

ASR: Age-standardized rate, Standardized rates have been estimated using the direct method and the World population as the reference;
For Sudan, South Sudan: Estimate for Sudan and South Sudan

Table 6: Cervical cancer mortality by World region and sub regions (estimates for 2012)
Cumulative risk (%) Ranking of CC
Area N cases Crude ratea ASRa ages 0-74 yearsb All women Women 15-44 years
World 265,672 7.6 6.8 0.8 4 2
Less developed re- 230,158 8.1 8.3 0.9 3 2
gions
More developed re- 35,514 5.6 3.3 0.3 9 2
gions
Africa 60,098 11.2 17.5 2.0 2 2
Eastern Africa 28,197 15.9 27.6 3.1 1 1
Middle Africa 7,917 11.8 22.2 2.6 1 2
Northern Africa 2,717 2.6 3.2 0.4 8 8
Southern Africa 4,721 16.0 17.9 1.9 1 1
Western Africa 16,546 10.4 18.5 2.1 2 2
Americas 35,673 7.4 5.9 0.6 5 2
Caribbean 2,254 10.6 8.6 0.9 4 2
Central America 6,937 8.5 8.9 1.0 2 1
Northern America 7,108 4.0 2.6 0.3 11 2
South America 19,374 9.5 8.6 0.9 3 2
Asia 144,434 7.0 6.4 0.7 6 2
Central Asia 2,286 7.2 7.7 0.8 3 2
Eastern Asia 36,320 4.7 3.3 0.3 8 2
Southern Asia 79,958 9.4 11.0 1.2 2 2
South-Eastern 23,989 7.9 7.9 0.9 3 2
Asia
Western Asia 1,881 1.6 1.9 0.2 11 9
Europe 24,404 6.4 3.8 0.4 7 2
Eastern Europe 15,436 9.9 6.2 0.6 7 1
Northern Europe 1,963 3.9 2.2 0.2 16 2
Southern Europe 3,526 4.4 2.4 0.2 13 3
Western Europe 3,479 3.6 1.8 0.2 15 4
Oceania 1,063 5.6 4.5 0.5 6 2
Australia & New 357 2.6 1.5 0.2 17 5
Zealand
Melanesia 684 15.3 20.7 2.2 1 1
Micronesia 6 2.2 2.7 0.4 5 12
Polynesia 16 4.8 5.1 0.6 4 2
Standardised rates have ben estimated using the direct method and the World population as the reference.
Ranking of cervical cancer mortality to other cancers among all women ages 15-44 years according to highest mortality rates (ranking 1st). Ranking is based on crude mortality rates(actual
number of cervical cancer deaths). Ranking using AST may differ.
b Cumulative risk (mortality) is the probability or risk of individuals dying from the disease during ages 0-74 years. For cancer, it is expressed as the % of new born children who would be
expected to die from a particular cancer before the age of 75 if they had the rates of cancer observed in the period in the absence of competing causes.
Data sources:
1 Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.2, Cancer Incidence and Mortality Worldwide: IARC

Figure 16: Ranking of cervical cancer versus other cancers among all women and women aged 15-44
years, according to mortality rates in the World (estimates for 2012)


Figure 17: World age-standardised mortality rates of cervical cancer by World and sub regions World
(estimates for 2012)
World, developed and developing regions Continental subregions
Less developed 8.3
Eastern Africa 27.6
Middle Africa 22.2
Melanesia 20.7
Western Africa 18.5
World 6.8 Southern Africa 17.9

Southern Asia 11.0
Central America 8.9
South America 8.6
Caribbean 8.6
More developed 3.3
SouthEastern Asia 7.9
0 10 Central Asia 7.7
Eastern Europe 6.2
Five continents
Polynesia 5.1
Africa 17.5
Eastern Asia 3.3
Northern Africa 3.2
Asia 6.4
Micronesia 2.7
Northern America 2.6
Americas 5.9 Southern Europe 2.4
Northern Europe 2.2
Oceania 4.5 Western Asia 1.9

Western Europe 1.8
Australia & New Zealand 1.5
Europe 3.8
0 10 20 0 10 20 30
Cervical cancer: Agestandardised mortality rate per 100,000 women

World Standard. Female (All ages)

Data sources:

Figure 18: Comparison of the ten most frequent cancer deaths in all women in the World compared to
developing and developed regions (estimates for 2012)

Lung 11.1 Lung 14.3
Cervix uteri 6.8 Pancreas 5.5
Stomach 5.7 Ovary 5.0
Liver 5.1 Stomach 4.2
Pancreas 3.4 Leukaemia 2.8
Leukaemia 2.8 Brain, nervous system 2.7
Oesophagus 2.7 Liver 2.5
0 5 10 15 20 25 0 5 10 15 20 25
Less developed regions Agestandardised mortality rate per 100,000

women
Breast 11.5
Lung 9.8
Cervix uteri 8.3
Stomach 6.5
Liver 6.4
Colorectum(a) 5.6
Oesophagus 3.6
Ovary 3.1
Leukaemia 2.6
Pancreas 2.3
0 5 10 15 20 25
Data sources:

Figure 19: Comparison of the ten most frequent cancer deaths in all women in the World compared to
the continents (estimations for 2012)
World Asia
Breast 12.9 Lung 11.0
Lung 11.1 Breast 10.2
Colorectum(a) 6.9 Stomach 7.1
Cervix uteri 6.8 Liver 6.6
Liver 5.1 Colorectum(a) 6.0
Ovary 3.7 Oesophagus 3.8
Pancreas 3.4 Ovary 3.0
Oesophagus 2.7 Pancreas 2.5
0 5 10 15 20 25 0 5 10 15 20 25
Africa Europe
Cervix uteri 17.5 Breast 16.1
Colorectum(a) 4.2 Ovary 5.4
Ovary 3.8 Pancreas 5.3
Oesophagus 3.3 Stomach 4.6
NonHodgkin lymphoma(b) 2.9 Brain, nervous system 3.0
Lung 2.4 Corpus uteri 2.6
0 5 10 15 20 25 0 5 10 15 20 25
Americas Oceania
Lung 15.9 Breast 15.6
Cervix uteri 5.9 Ovary 4.9
Pancreas 5.0 Pancreas 4.6
Stomach 3.7 Leukaemia 2.9
Leukaemia 3.4 Liver 2.9
Liver 3.3 Brain, nervous system 2.6
0 5 10 15 20 25 0 5 10 15 20 25
Agestandardised mortality rate per 100,000

women

Data sources:


Figure 20: Comparison of the ten most frequent cancer deaths in women aged 15-44 years by World,
developing and developed regions (estimates for 2012)

Leukaemia 1.5 Lung 1.2
Colorectum(a) 1.1 Brain, nervous system 1.1
Ovary 1.1 Ovary 1.1
Lung 1.0 Leukaemia 0.9
Stomach 1.0 Stomach 0.8
Brain, nervous system 0.9 Melanoma of skin 0.6
NonHodgkin lymphoma(b) 0.7 NonHodgkin lymphoma(b) 0.4
0 5 10 15 0 5 10 15
Less developed regions Agestandardised mortality rate per 100,000

women
Breast 5.6
Cervix uteri 3.4
Leukaemia 1.6
Colorectum(a) 1.1
Liver 1.1
Ovary 1.1
Stomach 1.1
Lung 0.9
Brain, nervous system 0.8
NonHodgkin lymphoma(b) 0.7
0 5 10 15
Data sources:

Figure 21: Comparison of the ten most frequent cancer deaths in women aged 15-44 years by World
and continents (estimates for 2012)
World Asia
Ovary 1.1 Colorectum(a) 1.1
Liver 1.0 Lung 1.1
Lung 1.0 Ovary 1.1
Stomach 1.0 Liver 1.0
Brain, nervous system 0.9 Brain, nervous system 0.9
NonHodgkin lymphoma(b) 0.7 Oesophagus 0.5
0 5 10 15 0 5 10 15
Africa Europe
Kaposi sarcoma(c) 1.8 Lung 1.4
Liver 1.6 Brain, nervous system 1.3
Leukaemia 1.2 Colorectum(a) 0.9
Ovary 1.2 Leukaemia 0.9
Stomach 0.6 Melanoma of skin 0.7
0 5 10 15 0 5 10 15
Americas Oceania
Leukaemia 1.5 Ovary 1.4
Brain, nervous system 1.1 Leukaemia 1.1
Colorectum(a) 1.1 Liver 1.1
Stomach 1.0 Colorectum(a) 1.0
Lung 0.9 Brain, nervous system 0.8
NonHodgkin lymphoma(b) 0.6 Lip, oral cavity 0.7
Liver 0.5 Stomach 0.7
0 5 10 15 0 5 10 15
Agestandardised mortality rate per 100,000

women



Data sources:
Figure 22: Age-specific mortality of cervical cancer by World and continents
World Asia
Africa Europe
Americas Oceania
Agespecific mortality rates of cervical cancer per 100,000
100
80
60
40
20
0
19 024 529 034 539 044 549 054 559 064 569 074 >=75
15 2 2 3 3 4 4 5 5 6 6 7
Age group (years)

Figure 23: Annual number of deaths of cervical cancer by age group by developing and developed regions
and continents (estimates for 2012)
DEVELOPED AND DEVELOPING REGIONS

Less developed regions More developed regions
Annual number of cervical cancer deaths
200000
180000
160000 151872*
140000
120000
100000
85534*
80000
60000
40000 28201*
20000
0
1539 4064 65+
FIVE CONTINENTS
Asia Americas Oceania
Africa Europe
Annual number of cervical cancer deaths
200000
180000
160000 151872*
140000
120000
100000
85534*
80000
60000
40000 28201*
20000
0
1539 4064 65+
* Less developed regions 15-39 years: 25130 cases. 40-64 years: 134922 cases. 65+ years: 70041 cases.
* More developed regions 15-39 years: 3071 cases. 40-64 years: 16950 cases. 65+ years: 15493 cases.
* Asia 15-39 years: 13567 cases. 40-64 years: 88208 cases. 65+ years: 42647 cases.
* Africa 15-39 years: 8065 cases. 40-64 years: 33320 cases. 65+ years: 18669 cases.
* Americas 15-39 years: 4168 cases. 40-64 years: 18020 cases. 65+ years: 13476 cases.
* Europe 15-39 years: 2212 cases. 40-64 years: 11779 cases. 65+ years: 10413 cases.
* Oceania 15-39 years: 189 cases. 40-64 years: 545 cases. 65+ years: 329 cases.



Data sources:

Figure 24: Annual number of deaths and age-specific mortality rates of cervical cancer in the World and
its regions (estimates for 2012)
World Africa
cervical cancer(a)
90 90
75 75
60 60
45 45
30
30

15

15

0
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
156000 151872*
144000 84000
Annual number of deaths
132000
120000 72000
of cervical cancer
108000
60000
96000
85534
84000 48000
72000
60000 36000 33320*
48000
36000 24000 18669
28201*
24000 12000 8060*
12000
0 0
1539 4064 65+ 1539 4064 65+
World 15-19 yrs: 314 cases. 20-24 yrs: 1101 cases. 25-29 yrs: 3654 cases. 30-34 yrs: 8158 cases. 35-39 yrs: 14974 cases. 40-44 yrs: 22872 cases. 45-49 yrs: 30105 cases. 50-54 yrs: 33939
cases. 55-59 yrs: 34263 cases. 60-64 yrs: 30693 cases. Africa 15-19 yrs: 265 cases. 20-24 yrs: 553 cases. 25-29 yrs: 1331 cases. 30-34 yrs: 2360 cases. 35-39 yrs: 3551 cases. 40-44 yrs: 4707
cases. 45-49 yrs: 6021 cases. 50-54 yrs: 7190 cases. 55-59 yrs: 7801 cases. 60-64 yrs: 7601 cases.
Data sources:

Figure 25: Annual number of deaths and age-specific mortality rates of cervical cancer in the World and
its regions (estimates for 2012) (Continued)
Americas Europe
cervical cancer(a)
90 90
75 75
60 60
45 45
30 30
15

15

0
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
84000 84000
72000 72000
of cervical cancer
60000 60000
48000 48000
36000 36000
24000 24000
18020*
13476 11779* 10413
12000 12000
4161* 2212*
0 0
1539 4064 65+ 1539 4064 65+
Asia Oceania
cervical cancer(a)
90 90
75 75
60 60
45 45
30 30
15

15

0
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
75+
88208*
84000 84000
72000 72000
of cervical cancer
60000 60000
48000 42647 48000
36000 36000
24000 24000
13567*
12000 12000
0 0 189* 545* 329
1539 4064 65+ 1539 4064 65+
Americas 15-19 yrs: 12 cases. 20-24 yrs: 137 cases. 25-29 yrs: 620 cases. 30-34 yrs: 1325 cases. 35-39 yrs: 2067 cases. 40-44 yrs: 2852 cases. 45-49 yrs: 3629 cases. 50-54 yrs: 3997 cases.
55-59 yrs: 3944 cases. 60-64 yrs: 3598 cases. Asia 15-19 yrs: 34 cases. 20-24 yrs: 363 cases. 25-29 yrs: 1333 cases. 30-34 yrs: 3699 cases. 35-39 yrs: 8138 cases. 40-44 yrs: 13641 cases. 45-49
yrs: 18256 cases. 50-54 yrs: 19983 cases. 55-59 yrs: 19563 cases. 60-64 yrs: 16765 cases. Europe 15-19 yrs: 2 cases. 20-24 yrs: 32 cases. 25-29 yrs: 332 cases. 30-34 yrs: 715 cases. 35-39
yrs: 1131 cases. 40-44 yrs: 1565 cases. 45-49 yrs: 2088 cases. 50-54 yrs: 2647 cases. 55-59 yrs: 2850 cases. 60-64 yrs: 2629 cases. Oceania 15-19 yrs: 1 cases. 20-24 yrs: 16 cases. 25-29 yrs:
36 cases. 30-34 yrs: 56 cases. 35-39 yrs: 80 cases. 40-44 yrs: 107 cases. 45-49 yrs: 111 cases. 50-54 yrs: 122 cases. 55-59 yrs: 105 cases. 60-64 yrs: 100 cases.
Data sources:

3.1.3 Comparison of incidence and mortality
Figure 26: Age-specific incidence and mortality rates of cervical cancer in the World and its regions
(estimates for 2012)
Africa Europe
110 110
100 100
90 90
80 80
70 70
60 60
50 50
40 40
30 30
20 20
10 10
0 0
of cervical cancer per 100,000
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
>=75
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
>=75
Agespecific rates
110
Americas 110
Oceania
100 100
90 90
80 80
70 70
60 60
50 50
40 40
30 30
20 20
10 10
0 0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
>=75
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
>=75
110
Asia
100
90
80
70
60
50
40
30
20
10
0
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
>=75
Incidence Mortality
Data sources:

3.2 Anogenital cancers other than the cervix

Data on HPV role in anogenital cancers other than the cervix are limited, but there is an increasing body
of evidence strongly linking HPV DNA with cancers of the anus, vulva, vagina, and penis. Although
these cancers are much less frequent compared to cervical cancer, their association with HPV make
them potentially preventable and subject to similar preventative strategies as those for cervical cancer.
(Vaccine 2006, Vol. 24, Suppl 3; Vaccine 2008, Vol. 26, Suppl 10; Vaccine 2012, Vol. 30, Suppl 5; IARC
Monographs 2007, Vol. 90)
3.2.1 Anal cancer
Anal cancer is rare in the general population with an average worldwide incidence of 1 per 100,000,
but is reported to be increasing in more developed regions. Globally, there are an estimated 27,000 new
cases every year (de Martel C et al. Lancet Oncol 2012;13(6):607-15). Women have higher incidences of
anal cancer than men. Incidence is particularly high among populations of men who have sex with men
(MSM), women with history of cervical or vulvar cancer, and immunosuppressed populations, including
those who are HIV-infected and patients with a history of organ transplantation. These cancers are
predominantly squamous cell carcinoma, adenocarcinomas, or basaloid and cloacogenic carcinomas.
Table 7: Incidence of anal cancer by cancer registry and sex

Male Female
Country / Registry Period N casesa Crude rateb ASRb N casesa Crude rate c ASR c
Algeria1
Setif 2003-2007 8 0.2 0.3 1 0.0 0.1
Argentina1
Bahia Blanca 2003-2007 3 0.4 0.4 10 1.3 0.8
Cordoba 2004-2007 20 0.8 0.7 16 0.6 0.4
Mendoza 2003-2007 21 0.5 0.4 33 0.8 0.6
Tierra del Fuego 2003-2007 1 0.3 0.2 0 0.0 0.0
Australia1
Australian Capital 2003-2007 6 0.7 0.6 7 0.8 0.6
Territory
New South Wales 2003-2007 229 1.4 0.9 248 1.5 0.9
Northern Territory 2003-2007 7 1.3 1.1 10 2.0 2.2
(Indigenous)
(Non-Indigenous)
Queensland 2003-2007 137 1.4 0.9 193 1.9 1.3
South 2003-2007 41 1.1 0.7 46 1.2 0.7
Tasmania 2003-2007 19 1.6 1.0 27 2.2 1.2
Victoria 2003-2007 155 1.2 0.9 205 1.6 1.0
Western 2003-2007 45 0.9 0.6 72 1.4 1.0
Austria1
National 2003-2007 196 1.0 0.6 378 1.8 0.9
Tyrol 2003-2007 16 0.9 0.6 38 2.1 1.3
Vorarlberg 2003-2007 4 0.4 0.3 13 1.4 0.8
Bahrain1
National (Bahraini) 2003-2007 6 0.5 0.8 2 0.2 0.3
Belarus1
National 2003-2007 55 0.2 0.2 109 0.4 0.2
Belgium1
National 2004-2007 204 1.0 0.6 310 1.4 0.7
Brazil1
Aracaju 2003-2006 9 1.0 1.4 11 1.0 1.2


Male Female
Belo Horizonte 2003-2005 25 0.8 0.9 53 1.4 1.4
Cuiaba 2003-2006 10 0.7 0.8 13 0.8 1.2
Fortaleza 2003-2006 13 0.3 0.4 49 1.0 1.2
Goiania 2003-2007 12 0.4 0.6 33 1.1 1.2
Sao Paulo 2003-2007 235 0.9 1.0 387 1.4 1.3
Bulgaria1
National 2003-2007 167 0.9 0.5 127 0.6 0.4
Canada1
Alberta 2003-2007 60 0.7 0.5 135 1.6 1.2
British Columbia 2003-2007 150 1.4 1.0 215 2.0 1.2
Manitoba 2003-2007 28 1.0 0.7 51 1.7 1.1
National 2003-2007 1114 1.4 0.9 1492 1.8 1.1
New Brunswick 2003-2007 23 1.3 0.8 30 1.6 0.9
Newfoundland and 2003-2007 8 0.6 0.4 17 1.3 0.8
Labrador
Northwest Territories 2003-2007 0 0.0 0.0 2 1.9 1.7
Nova Scotia 2003-2007 34 1.5 0.9 47 2.0 1.1
Ontario 2003-2007 585 1.9 1.3 693 2.2 1.4
Prince Edward Island 2003-2007 2 0.6 0.4 8 2.3 1.5
Quebec 2003-2007 196 1.0 0.7 257 1.3 0.8
Saskatchewan 2003-2007 27 1.1 0.7 37 1.5 0.8
Yukon 2003-2007 1 1.2 0.8 0 0.0 0.0
Chile1
Bo Bo Province 2003-2007 3 0.3 0.3 2 0.2 0.1
Region of Antofagasta 2003-2007 4 0.3 0.4 14 1.1 1.0
Valdivia 2003-2007 5 0.5 0.5 7 0.8 0.7
China1
Beijing City 2003-2007 35 0.2 0.1 25 0.1 0.1
Cixian County 2003-2007 4 0.3 0.3 2 0.1 0.2
Haining County 2003-2007 6 0.4 0.3 2 0.1 0.1
Harbin City, Nangang 2003-2007 7 0.3 0.2 2 0.1 0.1
District
Hong Kong 2003-2007 108 0.7 0.4 88 0.5 0.3
Jiashan County 2003-2007 3 0.3 0.2 1 0.1 0.0
Jiaxing City 2005-2007 1 0.1 0.1 2 0.3 0.1
Macao 2003-2007 5 0.4 0.3 7 0.6 0.4
Qidong County 2003-2007 5 0.2 0.1 7 0.2 0.1
Shanghai City 2003-2007 70 0.4 0.2 67 0.4 0.2
Wuhan City 2003-2007 40 0.3 0.3 39 0.3 0.3
Yangcheng County 2003-2007 2 0.2 0.2 0 0.0 0.0
Yanting County 2003-2007 0 0.0 0.0 0 0.0 0.0
Zhongshan City 2004-2007 4 0.1 0.2 4 0.1 0.1
Colombia1
Bucaramanga 2003-2007 6 0.2 0.3 35 1.3 1.4
Cali 2003-2007 29 0.6 0.7 101 1.9 1.9
Manizales 2003-2007 12 1.3 1.3 10 1.0 0.8
Pasto 2003-2007 2 0.2 0.3 8 0.8 0.8
Costa Rica1
National 2003-2007 44 0.4 0.5 56 0.5 0.6
Croatia1


Male Female
National 2003-2007 41 0.4 0.3 73 0.6 0.3
Cuba1
Villa Clara 2004-2007 13 0.8 0.6 20 1.2 0.8
Cyprus1
National 2003-2007 8 0.4 0.3 14 0.7 0.5
Czech Rep.1
National 2003-2007 192 0.8 0.5 348 1.3 0.7
Denmark1
National 2003-2007 157 1.2 0.7 332 2.4 1.4
Ecuador1
Cuenca 2003-2007 2 0.2 0.2 2 0.2 0.2
Quito 2003-2007 5 0.1 0.2 25 0.6 0.7
Egypt1
Gharbiah 2003-2007 36 0.4 0.5 40 0.4 0.5
Estonia1
National 2003-2007 17 0.5 0.4 48 1.3 0.6
Finland1
National 2003-2007 65 0.5 0.3 115 0.9 0.4
France1
Bas-Rhin 2003-2007 12 0.5 0.3 35 1.3 0.7
Calvados 2003-2007 19 1.2 0.8 40 2.3 1.2
Doubs 2003-2007 14 1.1 0.8 21 1.6 1.0
Haut-Rhin 2003-2007 16 0.9 0.6 36 1.9 0.9
Herault 2003-2007 27 1.1 0.8 90 3.5 1.9
Isere 2003-2007 20 0.7 0.5 68 2.3 1.3
Loire Atlantique 2003-2007 32 1.1 0.7 78 2.5 1.5
Manche 2003-2007 11 0.9 0.5 25 2.0 0.7
Martinique 2003-2007 3 0.3 0.2 8 0.8 0.3
Somme 2003-2007 16 1.2 0.6 29 2.0 1.2
Tarn 2003-2007 9 1.0 0.4 19 2.0 0.8
Vendee 2003-2007 11 0.8 0.4 36 2.4 1.3
Gambia2
National 1997-1998 1 0.1 0.2 2 0.2 0.3
Germany1
Brandenburg 2003-2007 66 1.0 0.6 144 2.2 1.0
Bremen 2003-2007 29 1.8 1.1 35 2.0 1.0
Free State Of Saxony 2003-2007 103 1.0 0.5 214 1.9 0.8
Hamburg 2003-2007 109 2.6 1.5 153 3.4 1.8
Mecklenburg-Western 2003-2007 41 1.0 0.6 77 1.8 0.8
Pomerania
Munich 2003-2007 107 1.1 0.7 259 2.6 1.3
North Rhine-Westphalia 2003-2007 69 1.1 0.6 126 1.9 1.0
Saarland 2003-2007 33 1.3 0.7 50 1.8 0.9
Schleswig-Holstein 2003-2007 123 1.8 1.0 215 3.0 1.5
Iceland1
National 2003-2007 6 0.8 0.6 10 1.4 0.8
India1
Bangalore 2005-2007 33 0.3 0.5 23 0.2 0.3
Barshi, Paranda and 2003-2007 3 0.2 0.2 3 0.2 0.3
Bhum
Bhopal 2004-2007 10 0.3 0.4 11 0.3 0.5
Chennai 2003-2007 69 0.6 0.7 49 0.4 0.5


Male Female
Dindigul, Ambilikkai 2003-2007 14 0.3 0.3 9 0.2 0.2
Karunagappally 2003-2007 3 0.3 0.3 4 0.4 0.3
Mizoram 2003-2007 1 0.0 0.1 3 0.1 0.2
Mumbai 2003-2007 102 0.3 0.4 70 0.2 0.3
New Delhi 2003-2007 170 0.4 0.7 87 0.2 0.4
Poona 2003-2007 31 0.3 0.4 27 0.3 0.4
Sikkim State 2003-2007 3 0.2 0.4 3 0.2 0.4
Trivandrum 2005-2007 2 0.1 0.1 6 0.3 0.3
Iran1
Golestan Province 2005-2007 10 0.4 0.6 5 0.2 0.4
Ireland1
National 2003-2007 64 0.6 0.5 94 0.9 0.6
Israel1
National 2003-2007 57 0.3 0.3 101 0.6 0.4
National (Jews) 2003-2007 56 0.4 0.3 99 0.7 0.5
National (Non-Jews) 2003-2007 1 0.0 0.0 2 0.1 0.1
Italy1
Biella 2003-2007 9 2.0 0.8 15 3.1 1.1
Brescia 2003-2006 16 0.8 0.4 43 2.0 0.9
Catania and Messina 2003-2005 20 0.8 0.5 24 0.9 0.5
Catanzaro 2003-2007 7 1.2 0.5 9 1.5 0.7
Como 2003-2007 19 1.4 0.8 29 2.0 0.9
Ferrara 2003-2007 21 2.5 0.9 23 2.5 0.7
Florence and Prato 2003-2005 42 2.4 0.9 46 2.5 1.0
Friuli-Venezia Giulia 2003-2007 41 1.4 0.6 78 2.5 0.8
Genoa 2003-2006 44 2.7 1.3 72 3.9 1.4
Latina 2003-2007 20 1.6 0.7 37 2.8 1.3
Lecco 2003-2007 6 0.8 0.4 9 1.1 0.4
Lombardy, South 2003-2005 5 0.5 0.3 19 1.7 0.7
Mantua 2003-2005 7 1.2 0.5 5 0.8 0.3
Milan 2003-2006 22 0.9 0.5 58 2.1 1.0
Modena 2003-2007 18 1.1 0.4 30 1.8 0.8
Naples 2003-2007 6 0.4 0.3 9 0.6 0.4
Nuoro 2003-2007 4 0.7 0.4 7 1.1 0.4
Palermo 2003-2006 27 1.1 0.7 24 0.9 0.5
Parma 2003-2007 12 1.2 0.6 17 1.6 0.6
Ragusa 2003-2007 9 1.2 0.6 18 2.3 1.2
Reggio Emilia 2003-2007 9 0.7 0.4 22 1.8 0.7
Romagna 2003-2007 59 2.1 1.1 78 2.6 1.2
Salerno 2003-2007 33 1.2 0.7 24 0.9 0.5
Sassari 2003-2007 6 0.5 0.3 13 1.1 0.5
Sondrio 2003-2007 8 1.8 1.0 17 3.7 1.8
South Tyrol 2003-2006 11 1.2 0.7 31 3.2 1.5
Syracuse 2003-2007 10 1.0 0.6 4 0.4 0.1
Trapani 2003-2006 13 1.6 0.9 11 1.2 0.6
Trento 2003-2006 8 0.8 0.4 14 1.4 0.5
Turin 2003-2007 45 2.1 1.0 65 2.8 1.3
Umbria 2003-2007 26 1.2 0.7 40 1.8 0.8
Varese 2003-2007 31 1.5 0.8 41 1.9 0.8


Male Female
Veneto 2003-2006 58 1.3 0.6 72 1.5 0.7
Jamaica1
Kingston and St Andrew 2003-2007 6 0.4 0.4 16 0.9 1.0
Japan1
Aichi Prefecture 2003-2007 18 0.5 0.3 13 0.4 0.2
Fukui Prefecture 2003-2007 12 0.6 0.2 12 0.6 0.2
Hiroshima 2003-2007 15 0.5 0.3 21 0.7 0.3
Miyagi Prefecture 2003-2007 39 0.7 0.3 38 0.6 0.2
Nagasaki Prefecture 2003-2007 18 0.5 0.2 23 0.6 0.2
Niigata Prefecture 2003-2007 41 0.7 0.3 45 0.7 0.2
Osaka Prefecture 2003-2007 186 0.9 0.4 141 0.6 0.2
Saga Prefecture 2003-2007 11 0.5 0.2 9 0.4 0.1
Kuwait1
National 2003-2007 11 0.1 0.1 9 0.2 0.3
National (Kuwaitis) 2003-2007 4 0.2 0.3 6 0.2 0.4
National (Non-Kuwaitis) 2003-2007 7 0.1 0.1 3 0.1 0.1
Latvia1
National 2004-2007 23 0.5 0.4 38 0.8 0.4
Libya1
Benghazi 2003-2005 5 0.2 0.3 3 0.1 0.2
Lithuania1
National 2003-2007 35 0.4 0.3 51 0.6 0.3
Malawi1
Blantyre 2003-2007 3 0.1 0.2 4 0.2 0.5
Malaysia1
Penang 2004-2007 6 0.2 0.3 6 0.2 0.2
Penang (Chinese) 2004-2007 2 0.2 0.2 2 0.2 0.1
Penang (Indian) 2004-2007 0 0.0 0.0 1 0.3 0.3
Penang (Malay) 2004-2007 4 0.3 0.6 3 0.2 0.4
Mali2
Bamako 1994-1996 4 0.3 0.6 6 0.5 1.1
Malta1
National 2003-2007 3 0.3 0.1 8 0.8 0.5
Netherlands1
Eindhoven 2003-2007 13 0.5 0.3 23 0.9 0.5
National 2003-2007 293 0.7 0.5 374 0.9 0.5
New Zealand1
National 2003-2007 77 0.8 0.5 180 1.7 1.1
National (Maori) 2003-2007 8 0.5 0.9 15 0.9 1.1
National (Other) 2003-2007 69 0.9 0.5 164 2.0 1.2
National (Pacific 2003-2007 0 0.0 0.0 1 0.2 0.1
Islander)
Norway1
National 2003-2007 97 0.8 0.5 229 2.0 1.0
Oman3
Omani 1998-2001 11 0.3 0.7 1 0.0 0.1
Pakistan3
South Karachi 1998-2002 19 0.4 0.7 8 0.2 0.4
Peru3
Trujillo 1998-2002 4 0.3 0.5 13 0.8 1.2
Philippines1
Manila 2003-2007 28 0.2 0.3 28 0.2 0.3


Male Female
Rizal 2003-2007 17 0.1 0.2 19 0.1 0.2
Poland1
Cracow 2003-2006 4 0.3 0.2 24 1.5 0.8
Kielce 2003-2007 9 0.3 0.2 15 0.5 0.2
Lower Silesia 2003-2007 55 0.8 0.5 101 1.3 0.7
Podkarpackie 2003-2007 22 0.4 0.3 35 0.7 0.3
Portugal1
Azores 2003-2007 4 0.7 0.6 6 1.0 0.6
Qatar1
National (Qatari) 2003-2007 1 0.2 0.5 0 0.0 0.0
Rep. Korea1
Busan 2003-2007 29 0.3 0.3 31 0.3 0.2
Daegu 2003-2007 24 0.4 0.4 21 0.3 0.3
Daejeon 2003-2007 13 0.4 0.4 25 0.7 0.6
Gwangju 2003-2007 10 0.3 0.3 18 0.5 0.4
Incheon 2003-2007 15 0.2 0.3 23 0.4 0.3
Jejudo 2004-2007 5 0.5 0.5 4 0.4 0.3
National 2003-2007 450 0.4 0.4 482 0.4 0.3
Seoul 2003-2007 106 0.4 0.4 91 0.4 0.3
Ulsan 2003-2007 9 0.3 0.4 5 0.2 0.2
Russia1
Saint Petersburg 2003-2007 22 0.2 0.1 117 0.9 0.5
Saudi Arabia1
Riyadh (Saudi) 2003-2007 9 0.1 0.2 14 0.1 0.3
Serbia1
Central 2003-2007 90 0.7 0.4 86 0.6 0.3
Singapore1
National 2003-2007 59 0.7 0.6 43 0.5 0.3
National (Chinese) 2003-2007 51 0.8 0.6 38 0.6 0.4
National (Indian) 2003-2007 1 0.1 0.1 2 0.3 0.2
National (Malay) 2003-2007 7 0.6 0.7 2 0.2 0.2
Slovakia1
National 2003-2007 63 0.5 0.4 104 0.8 0.4
Slovenia1
National 2003-2007 45 0.9 0.6 56 1.1 0.5
South Africa1
PROMEC 2003-2007 9 0.4 0.7 3 0.1 0.1
Spain1
Albacete 2003-2007 5 0.5 0.4 1 0.1 0.0
Asturias 2003-2007 29 1.1 0.7 19 0.7 0.3
Basque Country 2003-2007 43 0.8 0.5 40 0.7 0.3
Canary Islands 2003-2006 28 0.9 0.6 27 0.8 0.5
Ciudad Real 2004-2007 7 0.7 0.4 3 0.3 0.1
Cuenca 2003-2007 5 1.0 0.5 5 1.0 0.6
Girona 2003-2007 15 0.9 0.7 14 0.9 0.4
Granada 2003-2007 10 0.5 0.3 13 0.6 0.3
La Rioja 2003-2007 2 0.3 0.1 6 0.8 0.4
Mallorca 2003-2007 29 1.5 1.0 18 0.9 0.5
Murcia 2003-2007 29 0.8 0.6 15 0.5 0.2
Navarra 2003-2007 9 0.6 0.4 9 0.6 0.2
Tarragona 2003-2007 18 1.0 0.5 9 0.5 0.2


Male Female
Sweden1
National 2003-2007 198 0.9 0.5 459 2.0 1.0
Switzerland1
Basel 2003-2007 11 1.0 0.6 21 1.9 0.9
Geneva 2003-2007 19 1.9 1.2 63 5.6 3.0
Graubunden and Glarus 2003-2007 4 0.7 0.5 10 1.7 1.0
Neuchatel 2003-2007 12 2.9 1.6 22 5.1 2.2
St Gall-Appenzell 2003-2007 11 0.8 0.6 22 1.6 0.9
Ticino 2003-2007 8 1.0 0.6 36 4.3 2.1
Valais 2003-2007 8 1.1 0.7 19 2.6 1.6
Vaud 2003-2007 24 1.5 0.9 76 4.5 2.3
Zurich 2003-2007 40 1.3 0.8 103 3.2 1.7
Thailand1
Bangkok 2003-2007 28 0.2 0.2 40 0.2 0.2
Chiang Mai 2003-2007 6 0.2 0.1 16 0.4 0.3
Chonburi 2003-2007 2 0.1 0.1 3 0.1 0.1
Khon Kaen 2003-2007 7 0.2 0.2 6 0.1 0.1
Lampang 2003-2007 1 0.1 0.0 6 0.3 0.2
Songkhla 2004-2007 7 0.3 0.3 2 0.1 0.1
Tunisia1
North 2003-2005 23 0.3 0.3 11 0.2 0.2
Turkey1
Antalya 2003-2007 8 0.2 0.2 15 0.4 0.4
Edirne 2004-2007 3 0.4 0.4 1 0.1 0.1
Izmir 2003-2007 33 0.4 0.3 22 0.2 0.2
Trabzon 2005-2007 0 0.0 0.0 0 0.0 0.0
Uganda1
Kyadondo county 2003-2007 5 0.1 0.3 7 0.1 0.5
UK1
England 2003-2007 1491 1.2 0.7 2274 1.8 1.0
England, East of 2003-2007 134 1.0 0.6 270 1.9 1.0
England Region
England, North Western 2003-2007 188 1.2 0.7 288 1.7 0.9
England, Northern and 2003-2007 229 1.4 0.8 335 2.0 1.1
Yorkshire
England, Oxford Region 2003-2007 67 1.0 0.6 134 1.9 1.1
England, South and 2003-2007 197 1.2 0.7 336 1.9 0.9
Western Regions
England, Thames 2003-2007 384 1.3 0.9 513 1.7 1.0
England, Trent 2005-2007 71 1.0 0.6 115 1.5 0.7
England, West Midlands 2003-2007 162 1.2 0.7 211 1.6 0.9
Northern Ireland 2003-2007 50 1.2 0.8 51 1.2 0.8
Scotland 2003-2007 136 1.1 0.7 254 1.9 1.0
Wales 2003-2007 98 1.4 0.7 151 2.0 1.1
Ukraine1
National 2003-2007 438 0.4 0.3 640 0.5 0.3
Uruguay1
National 2005-2007 62 1.3 0.9 73 1.4 0.8
USA1
Alabama 2003-2007 137 1.2 0.9 238 2.0 1.3
Alabama (Black) 2003-2007 30 1.1 1.0 42 1.3 1.0


Male Female
Alabama (White) 2003-2007 106 1.3 0.9 195 2.3 1.4
Alaska 2003-2007 25 1.4 1.3 40 2.5 2.0
Alaska (American 2003-2007 8 2.8 3.0 6 2.2 2.3
Indian)
Arizona 2003-2007 155 1.0 0.8 241 1.6 1.1
Arizona (American 2003-2007 2 0.3 0.3 1 0.1 0.1
Indian)
Arizona (Asian and 2003-2007 0 0.0 0.0 3 0.7 0.6
Pacific Islander)
Arizona (Black) 2003-2007 12 1.9 2.0 6 1.0 1.0
Arizona (White) 2003-2007 139 1.1 0.7 227 1.7 1.1
Arkansas 2003-2007 92 1.4 0.9 160 2.3 1.4
Arkansas (Black) 2003-2007 12 1.1 1.2 10 0.9 0.7
Arkansas (White) 2003-2007 80 1.4 0.9 148 2.6 1.6
California 2003-2007 1184 1.3 1.1 1673 1.9 1.3
California (American 2003-2007 6 0.5 0.4 5 0.4 0.3
Indian)
California (Asian and 2003-2007 48 0.4 0.3 66 0.5 0.4
Pacific Islander)
California (Black) 2003-2007 87 1.4 1.2 105 1.6 1.3
California (White) 2003-2007 1028 1.5 1.1 1481 2.1 1.5
California, Los Angeles 2003-2007 318 1.3 1.1 408 1.7 1.2
County
County (Asian and
Pacific Islander)
County (Black)
County (Chinese)
County (Filipino)
County (Hispanic White)
County (Japanese)
County (Korean)
County (Non-Hispanic
White)
County (White)
California: San 2003-2007 218 2.1 1.5 183 1.7 1.1
Francisco
California: San 2003-2007 12 0.5 0.4 12 0.5 0.3
Francisco (Asian and
Pacific Islander)
California: San 2003-2007 23 2.4 1.8 25 2.3 1.6
Francisco (Black)
California: San 2003-2007 14 0.7 0.9 18 1.0 1.0
Francisco (Hispanic
White)
California: San 2003-2007 168 3.4 2.0 126 2.5 1.3
Francisco (Non-Hispanic
White)


Male Female
California: San 2003-2007 182 2.6 1.8 144 2.1 1.2
Francisco (White)
Colorado 2003-2007 119 1.0 0.8 221 1.9 1.3
Colorado (Asian and 2003-2007 0 0.0 0.0 0 0.0 0.0
Pacific Islander)
Colorado (Black) 2003-2007 5 0.9 0.9 4 0.8 0.7
Colorado (White) 2003-2007 111 1.0 0.8 214 2.0 1.4
Connecticut 2003-2007 114 1.3 0.9 174 1.9 1.2
Connecticut (Black) 2003-2007 12 1.4 1.4 16 1.7 1.2
Connecticut (White) 2003-2007 102 1.4 0.9 157 2.1 1.2
Delaware 2003-2007 28 1.4 0.9 54 2.5 1.8
Delaware (Black) 2003-2007 6 1.4 1.1 8 1.7 1.3
Delaware (White) 2003-2007 21 1.4 0.9 46 2.8 1.9
Florida 2003-2007 727 1.7 1.1 1227 2.7 1.6
Florida (Asian and 2003-2007 6 0.6 0.4 4 0.4 0.3
Pacific Islander)
Florida (Black) 2003-2007 66 1.0 0.9 83 1.1 1.0
Florida (White) 2003-2007 646 1.8 1.1 1132 3.1 1.7
Georgia 2003-2007 273 1.2 1.0 382 1.6 1.2
Georgia (Asian and 2003-2007 0 0.0 0.0 1 0.2 0.2
Pacific Islander)
Georgia (Black) 2003-2007 73 1.1 1.1 69 1.0 0.9
Georgia (White) 2003-2007 198 1.3 1.0 311 2.0 1.4
Georgia, Atlanta 2003-2007 117 1.4 1.2 128 1.5 1.2
Georgia, Atlanta (Black) 2003-2007 40 1.4 1.3 32 1.0 1.0
Georgia, Atlanta (White) 2003-2007 75 1.6 1.3 96 2.1 1.5
Hawaii 2003-2007 39 1.2 0.8 33 1.1 0.6
Hawaii (Chinese) 2003-2007 1 0.7 0.2 2 1.1 0.8
Hawaii (Filipino) 2003-2007 4 0.9 0.8 2 0.4 0.1
Hawaii (Hawaiian) 2003-2007 7 1.0 0.9 7 1.0 1.1
Hawaii (Japanese) 2003-2007 2 0.3 0.2 3 0.5 0.2
Hawaii (White) 2003-2007 22 2.6 1.6 17 2.4 1.3
Idaho 2003-2007 31 0.9 0.7 65 1.8 1.3
Illinois 2003-2007 421 1.4 1.0 579 1.8 1.2
Illinois (Asian and 2003-2007 4 0.3 0.3 3 0.2 0.2
Pacific Islander)
Illinois (Black) 2003-2007 89 1.9 1.8 68 1.3 1.1
Illinois (White) 2003-2007 319 1.3 0.9 505 2.0 1.2
Indiana 2003-2007 177 1.1 0.8 376 2.4 1.5
Indiana (Black) 2003-2007 15 1.1 1.0 22 1.5 1.3
Indiana (White) 2003-2007 160 1.2 0.8 353 2.5 1.6
Iowa 2003-2007 75 1.0 0.7 165 2.2 1.4
Kentucky 2003-2007 135 1.3 1.0 268 2.5 1.6
Louisiana 2003- 110 1.3 1.0 161 1.8 1.1
2004,2006-
2007
Louisiana (Black) 2003- 31 1.1 1.1 37 1.2 1.0
2004,2006-
2007
Louisiana (White) 2003- 78 1.4 1.0 123 2.1 1.2
2004,2006-
2007


Male Female
Louisiana, New Orleans 2003- 26 1.6 1.3 31 1.8 1.1
2004,2006-
2007
(Black) 2004,2006-
2007
(White) 2004,2006-
2007
Maine 2003-2007 59 1.8 1.3 86 2.6 1.4
Massachusetts 2003-2007 197 1.3 0.9 316 1.9 1.2
Massachusetts (Asian 2003-2007 1 0.1 0.1 4 0.5 0.5
and Pacific Islander)
Massachusetts (Black) 2003-2007 9 0.8 0.9 13 1.1 0.9
Massachusetts (White) 2003-2007 186 1.4 0.9 294 2.0 1.2
Michigan 2003-2007 265 1.1 0.8 507 2.0 1.3
Michigan (Asian and 2003-2007 1 0.2 0.2 0 0.0 0.0
Pacific Islander)
Michigan (Black) 2003-2007 57 1.6 1.5 64 1.6 1.4
Michigan (White) 2003-2007 201 1.0 0.7 437 2.1 1.3
Michigan, Detroit 2003-2007 114 1.2 0.8 202 1.9 1.3
(Black)
(White)
Mississippi 2003-2007 106 1.5 1.2 119 1.6 1.0
Missouri 2003-2007 202 1.4 1.0 367 2.5 1.6
Missouri (Black) 2003-2007 22 1.4 1.4 34 1.9 1.6
Missouri (White) 2003-2007 177 1.4 1.0 332 2.6 1.6
Montana 2003-2007 23 1.0 0.6 48 2.1 1.3
Montana (American 2003-2007 2 1.3 1.3 1 0.6 0.6
Indian)
Nebraska 2003-2007 40 0.9 0.7 68 1.5 1.1
Nebraska (Black) 2003-2007 0 0.0 0.0 3 1.5 1.5
Nebraska (White) 2003-2007 36 0.9 0.7 64 1.6 1.0
New Hampshire 2003-2007 30 0.9 0.6 65 2.0 1.1
New Jersey 2003-2007 249 1.2 0.9 429 1.9 1.2
New Jersey (Black) 2003-2007 41 1.3 1.3 58 1.7 1.3
New Jersey (White) 2003-2007 202 1.2 0.8 366 2.2 1.2
New Mexico 2003-2007 51 1.1 0.8 91 1.9 1.3
New Mexico (Hispanic 2003-2007 7 0.3 0.3 21 1.0 0.9
White)
New Mexico 2003-2007 42 2.1 1.2 64 3.0 1.6
(Non-Hispanic White)
New Mexico (White) 2003-2007 49 1.2 0.8 85 2.1 1.3
New York State 2003-2007 745 1.6 1.1 996 2.0 1.2
New York State (Asian 2003-2007 13 0.4 0.3 13 0.4 0.3
New York State (Black) 2003-2007 144 1.8 1.6 134 1.5 1.1
New York State (White) 2003-2007 569 1.6 1.1 832 2.3 1.3
North Carolina 2003-2007 253 1.2 0.9 463 2.1 1.3
North Carolina 2003-2007 3 1.1 1.0 2 0.7 0.6
(American Indian)


Male Female
North Carolina (Asian 2003-2007 1 0.2 0.2 2 0.5 0.5
North Carolina (Black) 2003-2007 55 1.2 1.1 67 1.3 1.1
North Carolina (White) 2003-2007 192 1.2 0.8 389 2.4 1.4
North Dakota 2003-2007 6 0.4 0.3 18 1.1 0.6
NPCR (42 States) 2003-2007 8243 1.3 0.9 13207 2.0 1.3
NPCR (42 States) 2003-2007 53 0.7 0.7 62 0.9 0.8
(American Indian)
NPCR (42 States) (Asian 2003-2007 93 0.3 0.3 135 0.4 0.3
NPCR (42 States) 2003-2007 1125 1.3 1.3 1171 1.3 1.0
(Black)
NPCR (42 States) 2003-2007 6869 1.3 0.9 11726 2.2 1.4
(White)
Ohio 2003-2007 347 1.2 0.9 588 2.0 1.3
Ohio (Asian and Pacific 2003-2007 0 0.0 0.0 0 0.0 0.0
Islander)
Ohio (Black) 2003-2007 48 1.4 1.3 45 1.2 1.0
Ohio (White) 2003-2007 295 1.2 0.8 533 2.1 1.3
Oklahoma 2003-2007 116 1.3 1.0 210 2.3 1.6
Oklahoma (American 2003-2007 7 0.9 0.9 25 3.1 2.9
Indian)
Oklahoma (Black) 2003-2007 7 1.0 1.0 10 1.3 1.1
Oklahoma (White) 2003-2007 102 1.4 1.0 173 2.4 1.5
Oregon 2003-2007 140 1.6 1.1 237 2.6 1.6
Oregon (Asian and 2003-2007 1 0.3 0.2 0 0.0 0.0
Pacific Islander)
Oregon (Black) 2003-2007 2 0.9 0.9 2 1.0 1.2
Oregon (White) 2003-2007 132 1.6 1.1 233 2.8 1.7
Pennsylvania 2003-2007 415 1.4 0.9 690 2.2 1.3
Pennsylvania (Asian and 2003-2007 4 0.6 0.7 4 0.5 0.5
Pacific Islander)
Pennsylvania (Black) 2003-2007 55 1.7 1.7 66 1.8 1.4
Pennsylvania (White) 2003-2007 351 1.3 0.8 610 2.2 1.3
Puerto Rico 2003-2007 79 0.8 0.6 166 1.6 1.0
Rhode Island 2003-2007 36 1.4 1.0 46 1.7 1.1
Rhode Island (Black) 2003-2007 1 0.6 0.6 3 1.7 1.5
Rhode Island (White) 2003-2007 35 1.5 1.0 43 1.7 1.0
SEER (18 Registries) 2003-2007 2535 1.2 1.0 3912 1.9 1.3
SEER (18 Registries) 2003-2007 72 0.4 0.3 95 0.5 0.3
(Asian and Pacific
Islander)
SEER (18 Registries) 2003-2007 308 1.3 1.2 358 1.4 1.2
(Black)
SEER (18 Registries) 2003-2007 182 0.4 0.6 310 0.8 0.9
(Hispanic White)
SEER (18 Registries) 2003-2007 1941 1.6 1.1 3109 2.5 1.5
SEER (18 Registries) 2003-2007 2123 1.3 1.0 3419 2.1 1.4
(White)
SEER (9 Registries) 2003-2007 911 1.3 1.0 1304 1.8 1.2
SEER (9 Registries) 2003-2007 133 1.6 1.5 131 1.4 1.2
(Black)


Male Female
SEER (9 Registries) 2003-2007 743 1.4 1.0 1125 2.1 1.3
(White)
South Carolina 2003-2007 131 1.3 0.9 213 1.9 1.2
South Carolina (Black) 2003-2007 44 1.5 1.4 36 1.1 0.8
South Carolina (White) 2003-2007 85 1.2 0.8 175 2.3 1.4
South Dakota 2003-2007 13 0.7 0.5 32 1.6 1.0
Tennessee 2003-2007 163 1.1 0.8 329 2.1 1.4
Tennessee (Black) 2003-2007 24 1.0 1.0 32 1.2 1.0
Tennessee (White) 2003-2007 138 1.2 0.8 296 2.4 1.5
Texas 2003-2007 603 1.1 0.9 827 1.4 1.1
Texas (Asian and Pacific 2003-2007 5 0.2 0.3 8 0.4 0.4
Islander)
Texas (Black) 2003-2007 80 1.2 1.2 77 1.1 1.0
Texas (White) 2003-2007 512 1.1 0.9 738 1.5 1.1
Utah 2003-2007 35 0.6 0.5 59 0.9 0.8
Vermont 2003-2007 21 1.4 1.0 27 1.7 1.1
Virginia 2003-2007 204 1.1 0.8 354 1.8 1.2
Virginia (Asian and 2003-2007 2 0.2 0.2 4 0.4 0.4
Pacific Islander)
Virginia (Black) 2003-2007 41 1.1 1.1 46 1.1 0.8
Virginia (White) 2003-2007 159 1.1 0.8 294 2.1 1.3
Washington State 2003-2007 192 1.2 0.9 371 2.4 1.5
Washington, Seattle 2003-2007 148 1.4 1.0 269 2.5 1.6
West Virginia 2003-2007 53 1.2 0.8 117 2.5 1.5
Wisconsin 2003-2007 128 0.9 0.6 248 1.8 1.1
Wisconsin (Black) 2003-2007 11 1.3 1.4 14 1.6 1.5
Wisconsin (White) 2003-2007 113 0.9 0.6 228 1.8 1.1
Wyoming 2003-2007 14 1.1 0.7 22 1.8 1.1
Viet Nam2
Hanoi 1993-1997 7 0.1 0.2 5 0.1 0.1
Ho Chi Minh City 1995-1998 32 0.4 0.6 36 0.4 0.4
Zimbabwe1
Harare (African) 2003-2006 3 0.1 0.4 2 0.1 0.2
Data accessed on 05 May 2015.
a Accumulated number of cases during the period in the population covered by the corresponding registry.
b Rates per 100,000 men per year.
c Rates per 100,000 women per year.
Data sources:
1 Forman D, Bray F, Brewster DH, Gombe Mbalawa C, Kohler B, Pieros M, Steliarova-Foucher E, Swaminathan R and Ferlay J eds (2013). Cancer Incidence in Five Continents, Vol. X
(electronic version) Lyon, IARC. http://ci5.iarc.fr
2 Parkin, D.M., Whelan, S.L., Ferlay, J., Teppo, L., and Thomas, D.B., eds (2002). Cancer Incidence in Five Continents, Vol. VIII. IARC Scientific Publications No. 155, Lyon, IARC.
3 Curado. M. P., Edwards, B., Shin. H.R., Storm. H., Ferlay. J., Heanue. M. and Boyle. P., eds (2007). Cancer Incidence in Five Continents, Vol. IX. IARC Scientific Publications No. 160,
Lyon, IARC.
NOTE.
For time trends in anal cancer incidence please refer to individual country data.

3.2.2 Vulvar cancer
Cancer of the vulva is rare among women worldwide, with an estimated 27,000 new cases in 2008, rep-
resenting 4% of all gynaecologic cancers (de Martel C et al. Lancet Oncol 2012;13(6):607-15). Worldwide,
about 60% of all vulvar cancer cases occur in more developed countries. Vulvar cancer has two distinct
histological patterns with two different risk factor profiles: (1) basaloid/warty types (2) keratinizing
types. Basaloid/warty lesions are more common in young women, are very often associated with HPV
DNA detection (75-100%), and have a similar risk factor profile as cervical cancer. Keratinizing vulvar
carcinomas represent the majority of the vulvar lesions (>60%), they occur more often in older women
and are more rarely associated with HPV (IARC Monograph Vol 100B)
Table 8: Incidence of vulvar cancer by cancer registry

Female
Country name Cancer registry Period N casesa Crude rateb ASRb
Africa
Algeria1 Setif 2003-2007 5 0.1 0.2
Egypt1 Gharbiah 2003-2007 49 0.5 0.8
Gambia2 National 1997-1998 1 0.1 0.2
Libya1 Benghazi 2003-2005 5 0.2 0.4
Malawi1 Blantyre 2003-2007 16 0.7 1.0
Mali2 Bamako 1994-1996 1 0.1 0.2
South Africa1 PROMEC 2003-2007 8 0.3 0.3
Tunisia1 North 2003-2005 41 0.6 0.6
Uganda1 Kyadondo county 2003-2007 12 0.2 0.6
Zimbabwe1 Harare (African) 2003-2006 14 0.5 1.1
Americas
Argentina1 Bahia Blanca 2003-2007 6 0.8 0.3
Cordoba 2004-2007 49 1.8 1.1
Mendoza 2003-2007 69 1.6 1.2
Tierra del Fuego 2003-2007 5 1.8 3.0
Brazil1 Aracaju 2003-2006 10 1.0 1.0
Belo Horizonte 2003-2005 33 0.9 0.8
Cuiaba 2003-2006 12 0.8 1.0
Fortaleza 2003-2006 17 0.3 0.4
Goiania 2003-2007 34 1.1 1.3
Sao Paulo 2003-2007 510 1.8 1.6
Canada1 Alberta 2003-2007 189 2.3 1.5
British Columbia 2003-2007 207 2.0 1.0
Manitoba 2003-2007 84 2.8 1.8
National 2003-2007 2044 2.5 1.4
New Brunswick 2003-2007 55 2.9 1.7
Newfoundland and Labrador 2003-2007 36 2.8 1.3
Northwest Territories 2003-2007 1 1.0 1.2
Nova Scotia 2003-2007 83 3.5 1.8
Ontario 2003-2007 827 2.6 1.4
Prince Edward Island 2003-2007 7 2.0 0.8
Quebec 2003-2007 472 2.5 1.2
Saskatchewan 2003-2007 83 3.3 1.6
Yukon 2003-2007 0 0.0 0.0
Chile1 Bo Bo Province 2003-2007 4 0.4 0.3
Region of Antofagasta 2003-2007 17 1.3 1.3
Valdivia 2003-2007 9 1.0 0.6
Colombia1 Bucaramanga 2003-2007 20 0.7 0.7
Cali 2003-2007 55 1.0 0.9
Manizales 2003-2007 5 0.5 0.3
Pasto 2003-2007 5 0.5 0.6
Costa Rica1 National 2003-2007 92 0.9 0.9
Cuba1 Villa Clara 2004-2007 29 1.8 1.0


Female
Ecuador1 Cuenca 2003-2007 9 0.7 0.6
Quito 2003-2007 28 0.7 0.8
Jamaica1 Kingston and St Andrew 2003-2007 8 0.5 0.4
Peru3 Trujillo 1998-2002 21 1.3 2.0
Uruguay1 National 2005-2007 110 2.1 1.0
USA1 Alabama (Black) 2003-2007 52 1.6 1.3
Alabama (White) 2003-2007 240 2.9 1.5
Alabama 2003-2007 301 2.6 1.5
Alaska 2003-2007 30 1.9 1.6
Alaska (American Indian) 2003-2007 5 1.8 1.7
Arizona (Asian and Pacific Islander) 2003-2007 1 0.2 0.3
Arizona (American Indian) 2003-2007 6 0.8 0.8
Arizona 2003-2007 287 1.9 1.2
Arizona (Black) 2003-2007 3 0.5 0.5
Arizona (White) 2003-2007 273 2.1 1.2
Arkansas 2003-2007 215 3.0 1.9
Arkansas (White) 2003-2007 187 3.2 1.9
Arkansas (Black) 2003-2007 24 2.0 1.6
California (American Indian) 2003-2007 4 0.3 0.2
California (Asian and Pacific Islander) 2003-2007 90 0.7 0.5
California (Black) 2003-2007 95 1.4 1.1
California (White) 2003-2007 1508 2.2 1.3
California 2003-2007 1735 1.9 1.2
California, Los Angeles County 2003-2007 447 1.8 1.2
California, Los Angeles County (Black) 2003-2007 45 1.7 1.2
California, Los Angeles County (Chinese) 2003-2007 10 1.0 0.7
California, Los Angeles County (Filipino) 2003-2007 6 0.7 0.4
California, Los Angeles County (Hispanic 2003-2007 116 1.1 1.1
White)
California, Los Angeles County (Japanese) 2003-2007 2 0.6 0.3
California, Los Angeles County (Korean) 2003-2007 6 1.1 0.6
California, Los Angeles County (White) 2003-2007 367 2.0 1.3
California, Los Angeles County (Asian and 2003-2007 27 0.8 0.4
Pacific Islander)
California: San Francisco (Asian and 2003-2007 26 1.0 0.6
Pacific Islander)
California: San Francisco (Hispanic White) 2003-2007 10 0.6 0.6
California: San Francisco 2003-2007 209 2.0 1.1
California: San Francisco (Black) 2003-2007 20 1.9 1.3
California: San Francisco (Non-Hispanic 2003-2007 149 3.0 1.4
White)
California: San Francisco (White) 2003-2007 159 2.3 1.3
Colorado 2003-2007 251 2.2 1.4
Colorado (Asian and Pacific Islander) 2003-2007 2 0.5 0.5
Colorado (Black) 2003-2007 5 1.0 0.9
Colorado (White) 2003-2007 233 2.2 1.3
Connecticut (Black) 2003-2007 17 1.8 1.4
Connecticut 2003-2007 287 3.2 1.5
Connecticut (White) 2003-2007 267 3.5 1.5
Delaware (Black) 2003-2007 6 1.3 1.1
Delaware (White) 2003-2007 49 3.0 1.6
Delaware 2003-2007 56 2.6 1.5
Florida 2003-2007 1297 2.9 1.5
Florida (Asian and Pacific Islander) 2003-2007 1 0.1 0.1


Female
Florida (Black) 2003-2007 91 1.2 1.0
Florida (White) 2003-2007 1190 3.3 1.6
Georgia 2003-2007 530 2.3 1.6
Georgia (Asian and Pacific Islander) 2003-2007 4 0.6 0.6
Georgia (Black) 2003-2007 93 1.3 1.1
Georgia (White) 2003-2007 425 2.8 1.7
Georgia, Atlanta 2003-2007 150 1.8 1.4
Georgia, Atlanta (Black) 2003-2007 44 1.3 1.3
Georgia, Atlanta (White) 2003-2007 97 2.1 1.5
Hawaii (Filipino) 2003-2007 5 1.0 0.7
Hawaii (Hawaiian) 2003-2007 9 1.3 1.0
Hawaii (Japanese) 2003-2007 22 3.4 0.9
Hawaii (White) 2003-2007 24 3.3 2.1
Hawaii (Chinese) 2003-2007 0 0.0 0.0
Hawaii 2003-2007 65 2.1 1.1
Idaho 2003-2007 87 2.4 1.4
Illinois (Black) 2003-2007 83 1.6 1.3
Illinois (White) 2003-2007 748 2.9 1.6
Illinois (Asian and Pacific Islander) 2003-2007 4 0.3 0.2
Illinois 2003-2007 857 2.7 1.5
Indiana (Black) 2003-2007 24 1.6 1.4
Indiana (White) 2003-2007 446 3.2 1.8
Indiana 2003-2007 479 3.0 1.8
Iowa 2003-2007 280 3.7 1.9
Kentucky 2003-2007 384 3.6 2.2
Louisiana 2003- 262 2.9 1.8
2004,2006-
2007
Louisiana (White) 2003- 207 3.5 2.0
2004,2006-
2007
Louisiana (Black) 2003- 52 1.7 1.4
2004,2006-
2007
Louisiana, New Orleans 2003- 50 2.8 1.7
2004,2006-
2007
Louisiana, New Orleans (Black) 2003- 13 1.7 1.4
2004,2006-
2007
Louisiana, New Orleans (White) 2003- 37 3.9 2.0
2004,2006-
2007
Maine 2003-2007 128 3.8 1.9
Massachusetts 2003-2007 545 3.3 1.8
Massachusetts (Asian and Pacific Islander) 2003-2007 3 0.4 0.5
Massachusetts (Black) 2003-2007 14 1.2 1.0
Massachusetts (White) 2003-2007 520 3.6 1.8
Michigan 2003-2007 772 3.0 1.7
Michigan (Asian and Pacific Islander) 2003-2007 2 0.3 0.4
Michigan (Black) 2003-2007 68 1.7 1.5
Michigan (White) 2003-2007 686 3.3 1.8
Michigan, Detroit 2003-2007 307 3.0 1.7
Michigan, Detroit (Black) 2003-2007 56 2.0 1.6
Michigan, Detroit (White) 2003-2007 247 3.4 1.8
Mississippi 2003-2007 211 2.8 1.8
Missouri 2003-2007 485 3.3 1.9


Female
Missouri (Black) 2003-2007 36 2.0 1.7
Missouri (White) 2003-2007 446 3.5 2.0
Montana (American Indian) 2003-2007 2 1.3 1.1
Montana 2003-2007 75 3.2 1.7
Nebraska 2003-2007 126 2.8 1.5
Nebraska (Black) 2003-2007 3 1.5 1.5
Nebraska (White) 2003-2007 116 2.8 1.4
New Hampshire 2003-2007 112 3.4 1.7
New Jersey 2003-2007 595 2.7 1.4
New Jersey (White) 2003-2007 523 3.1 1.5
New Jersey (Black) 2003-2007 52 1.5 1.2
New Mexico 2003-2007 90 1.9 1.2
New Mexico (Hispanic White) 2003-2007 19 0.9 0.7
New Mexico (Non-Hispanic White) 2003-2007 58 2.7 1.4
New Mexico (White) 2003-2007 77 1.9 1.1
New York State 2003-2007 1346 2.7 1.4
New York State (Asian and Pacific 2003-2007 12 0.4 0.2
Islander)
New York State (Black) 2003-2007 148 1.6 1.2
New York State (White) 2003-2007 1159 3.1 1.5
North Carolina 2003-2007 551 2.5 1.5
North Carolina (White) 2003-2007 461 2.8 1.6
North Carolina (Asian and Pacific Islander) 2003-2007 2 0.5 0.4
North Carolina (American Indian) 2003-2007 1 0.3 0.3
North Carolina (Black) 2003-2007 83 1.6 1.2
North Dakota 2003-2007 50 3.2 1.5
NPCR (42 States) 2003-2007 17514 2.6 1.5
NPCR (42 States) (American Indian) 2003-2007 78 1.1 1.0
NPCR (42 States) (Asian and Pacific 2003-2007 151 0.5 0.4
Islander)
NPCR (42 States) (Black) 2003-2007 1374 1.5 1.2
NPCR (42 States) (White) 2003-2007 15617 2.9 1.6
Ohio 2003-2007 870 3.0 1.7
Ohio (Asian and Pacific Islander) 2003-2007 0 0.0 0.0
Ohio (Black) 2003-2007 47 1.3 1.0
Ohio (White) 2003-2007 810 3.2 1.8
Oklahoma 2003-2007 293 3.3 2.0
Oklahoma (American Indian) 2003-2007 19 2.3 2.2
Oklahoma (Black) 2003-2007 8 1.1 1.0
Oklahoma (White) 2003-2007 265 3.6 2.1
Oregon 2003-2007 255 2.8 1.6
Oregon (Asian and Pacific Islander) 2003-2007 0 0.0 0.0
Oregon (Black) 2003-2007 3 1.5 1.6
Oregon (White) 2003-2007 238 2.8 1.6
Pennsylvania (Black) 2003-2007 78 2.2 1.7
Pennsylvania (Asian and Pacific Islander) 2003-2007 2 0.3 0.2
Pennsylvania 2003-2007 1195 3.7 1.9
Pennsylvania (White) 2003-2007 1097 4.0 1.9
Puerto Rico 2003-2007 200 2.0 1.0
Rhode Island 2003-2007 119 4.3 2.5
Rhode Island (White) 2003-2007 108 4.4 2.3
Rhode Island (Black) 2003-2007 4 2.2 2.0
SEER (18 Registries) (Asian and Pacific 2003-2007 155 0.8 0.5
Islander)
SEER (18 Registries) (Black) 2003-2007 394 1.5 1.3


Female
SEER (18 Registries) (Hispanic White) 2003-2007 370 1.0 1.0
SEER (18 Registries) (White) 2003-2007 4264 2.7 1.5
SEER (18 Registries) 2003-2007 4909 2.4 1.4
SEER (18 Registries) (Non-Hispanic 2003-2007 3894 3.2 1.6
White)
SEER (9 Registries) 2003-2007 1757 2.5 1.5
South Carolina (Black) 2003-2007 42 1.3 0.9
South Carolina 2003-2007 306 2.8 1.7
South Carolina (White) 2003-2007 259 3.5 1.9
South Dakota 2003-2007 66 3.4 1.9
Tennessee (Black) 2003-2007 33 1.2 1.0
Tennessee (White) 2003-2007 378 3.0 1.7
Tennessee 2003-2007 415 2.7 1.6
Texas (White) 2003-2007 987 2.1 1.4
Texas (Asian and Pacific Islander) 2003-2007 6 0.3 0.2
Texas (Black) 2003-2007 111 1.6 1.3
Texas 2003-2007 1130 2.0 1.4
Utah 2003-2007 82 1.3 1.0
Vermont 2003-2007 49 3.1 1.7
Virginia 2003-2007 451 2.3 1.4
Virginia (Black) 2003-2007 56 1.4 1.0
Virginia (White) 2003-2007 380 2.7 1.5
Virginia (Asian and Pacific Islander) 2003-2007 4 0.4 0.4
Washington State 2003-2007 388 2.5 1.5
Washington, Seattle 2003-2007 287 2.7 1.6
West Virginia 2003-2007 167 3.6 1.9
Wisconsin (Black) 2003-2007 12 1.3 1.4
Wisconsin 2003-2007 380 2.7 1.4
Wisconsin (White) 2003-2007 358 2.8 1.3
Wyoming 2003-2007 27 2.1 1.3
Asia
Bahrain1 National (Bahraini) 2003-2007 0 0.0 0.0
China1 Beijing City 2003-2007 121 0.7 0.4
Cixian County 2003-2007 5 0.3 0.4
Haining County 2003-2007 6 0.4 0.3
Harbin City, Nangang District 2003-2007 10 0.4 0.3
Hong Kong 2003-2007 147 0.8 0.5
Jiashan County 2003-2007 4 0.4 0.2
Jiaxing City 2005-2007 6 0.8 0.5
Macao 2003-2007 3 0.2 0.2
Qidong County 2003-2007 3 0.1 0.0
Shanghai City 2003-2007 98 0.6 0.3
Wuhan City 2003-2007 27 0.2 0.2
Yangcheng County 2003-2007 1 0.1 0.1
Yanting County 2003-2007 5 0.3 0.3
Zhongshan City 2004-2007 13 0.5 0.4
India1 Bangalore 2005-2007 43 0.4 0.7
Barshi, Paranda and Bhum 2003-2007 2 0.2 0.1
Bhopal 2004-2007 5 0.2 0.3
Chennai 2003-2007 51 0.5 0.5
Dindigul, Ambilikkai 2003-2007 20 0.4 0.5
Karunagappally 2003-2007 3 0.3 0.2
Mizoram 2003-2007 13 0.5 0.8


Female
Mumbai 2003-2007 65 0.2 0.3
New Delhi 2003-2007 104 0.3 0.5
Poona 2003-2007 25 0.3 0.3
Sikkim State 2003-2007 2 0.2 0.3
Trivandrum 2005-2007 4 0.2 0.2
Iran1 Golestan Province 2005-2007 1 0.0 0.1
Israel1 National 2003-2007 229 1.4 0.9
National (Non-Jews) 2003-2007 16 0.5 0.8
National (Jews) 2003-2007 213 1.6 0.9
Japan1 Aichi Prefecture 2003-2007 18 0.5 0.2
Fukui Prefecture 2003-2007 22 1.0 0.4
Hiroshima 2003-2007 26 0.9 0.3
Miyagi Prefecture 2003-2007 41 0.7 0.2
Nagasaki Prefecture 2003-2007 46 1.2 0.3
Niigata Prefecture 2003-2007 50 0.8 0.3
Osaka Prefecture 2003-2007 164 0.7 0.3
Saga Prefecture 2003-2007 20 0.9 0.3
Kuwait1 National 2003-2007 10 0.2 0.3
National (Non-Kuwaitis) 2003-2007 4 0.1 0.3
National (Kuwaitis) 2003-2007 6 0.2 0.4
Malaysia1 Penang (Malay) 2004-2007 3 0.2 0.3
Penang (Indian) 2004-2007 2 0.7 0.9
Penang 2004-2007 10 0.4 0.4
Penang (Chinese) 2004-2007 5 0.4 0.3
Oman3 Omani 1998-2001 3 0.1 0.2
Pakistan3 South Karachi 1998-2002 3 0.1 0.1
Philippines1 Manila 2003-2007 42 0.3 0.5
Rizal 2003-2007 41 0.2 0.4
Qatar1 National (Qatari) 2003-2007 0 0.0 0.0
Rep. Korea1 Busan 2003-2007 24 0.3 0.2
Daegu 2003-2007 17 0.3 0.2
Daejeon 2003-2007 4 0.1 0.1
Gwangju 2003-2007 14 0.4 0.3
Incheon 2003-2007 18 0.3 0.2
Jejudo 2004-2007 2 0.2 0.1
National 2003-2007 426 0.4 0.3
Seoul 2003-2007 101 0.4 0.3
Ulsan 2003-2007 8 0.3 0.3
Saudi Arabia1 Riyadh (Saudi) 2003-2007 5 0.1 0.1
Singapore1 National (Indian) 2003-2007 2 0.3 0.3
National (Chinese) 2003-2007 62 0.9 0.6
National 2003-2007 69 0.8 0.6
National (Malay) 2003-2007 4 0.3 0.3
Thailand1 Bangkok 2003-2007 34 0.2 0.2
Chiang Mai 2003-2007 39 1.0 0.8
Chonburi 2003-2007 15 0.5 0.4
Khon Kaen 2003-2007 17 0.4 0.3
Lampang 2003-2007 21 1.1 0.8
Songkhla 2004-2007 9 0.3 0.3
Turkey1 Antalya 2003-2007 15 0.4 0.4
Edirne 2004-2007 4 0.5 0.2
Izmir 2003-2007 66 0.7 0.6
Trabzon 2005-2007 4 0.4 0.2
Viet Nam2 Hanoi 1993-1997 53 0.9 1.0


Female
Ho Chi Minh City 1995-1998 35 0.4 0.4
Europe
Austria1 National 2003-2007 660 3.1 1.5
Tyrol 2003-2007 44 2.5 1.5
Vorarlberg 2003-2007 27 3.0 1.5
Belarus1 National 2003-2007 755 2.9 1.3
Belgium1 National 2004-2007 710 3.3 1.5
Bulgaria1 National 2003-2007 619 3.1 1.3
Croatia1 National 2003-2007 346 3.0 1.2
Cyprus1 National 2003-2007 39 2.0 1.1
Czech Rep.1 National 2003-2007 1000 3.8 1.8
Denmark1 National 2003-2007 471 3.4 1.7
Estonia1 National 2003-2007 132 3.6 1.4
Finland1 National 2003-2007 376 2.8 1.2
France1 Bas-Rhin 2003-2007 84 3.1 1.3
Calvados 2003-2007 26 1.5 0.7
Doubs 2003-2007 46 3.5 1.5
Haut-Rhin 2003-2007 51 2.7 1.3
Herault 2003-2007 42 1.6 0.5
Isere 2003-2007 44 1.5 0.7
Loire Atlantique 2003-2007 51 1.6 0.7
Manche 2003-2007 21 1.7 0.8
Martinique 2003-2007 3 0.3 0.2
Somme 2003-2007 29 2.0 0.9
Tarn 2003-2007 20 2.1 0.8
Vendee 2003-2007 22 1.5 0.9
Germany1 Brandenburg 2003-2007 301 4.7 1.9
Bremen 2003-2007 90 5.3 2.0
Free State Of Saxony 2003-2007 603 5.5 1.8
Hamburg 2003-2007 257 5.8 2.5
Mecklenburg-Western Pomerania 2003-2007 199 4.6 1.7
Munich 2003-2007 420 4.2 1.7
North Rhine-Westphalia 2003-2007 326 4.9 2.1
Saarland 2003-2007 255 9.4 4.1
Schleswig-Holstein 2003-2007 585 8.1 3.6
Iceland1 National 2003-2007 11 1.5 0.9
Ireland1 National 2003-2007 217 2.1 1.3
Italy1 Biella 2003-2007 27 5.5 1.7
Brescia 2003-2006 50 2.3 0.9
Catania and Messina 2003-2005 72 2.7 1.1
Catanzaro 2003-2007 22 3.6 1.6
Como 2003-2007 56 3.9 1.2
Ferrara 2003-2007 42 4.6 1.5
Florence and Prato 2003-2005 72 3.9 1.1
Friuli-Venezia Giulia 2003-2007 131 4.2 1.1
Genoa 2003-2006 101 5.4 1.7
Latina 2003-2007 44 3.3 1.4
Lecco 2003-2007 21 2.6 0.9
Lombardy, South 2003-2005 42 3.8 1.3
Mantua 2003-2005 27 4.5 1.3
Milan 2003-2006 73 2.7 0.7
Modena 2003-2007 77 4.5 1.3
Naples 2003-2007 41 2.9 1.8
Nuoro 2003-2007 8 1.3 0.6


Female
Palermo 2003-2006 78 3.0 1.4
Parma 2003-2007 30 2.8 0.8
Ragusa 2003-2007 21 2.7 1.2
Reggio Emilia 2003-2007 49 3.9 1.3
Romagna 2003-2007 117 4.0 1.1
Salerno 2003-2007 77 2.8 1.2
Sassari 2003-2007 19 1.6 0.8
Sondrio 2003-2007 19 4.2 1.3
South Tyrol 2003-2006 35 3.6 1.6
Syracuse 2003-2007 22 2.2 1.0
Trapani 2003-2006 38 4.3 1.5
Trento 2003-2006 41 4.0 1.5
Turin 2003-2007 84 3.6 1.0
Umbria 2003-2007 105 4.7 1.4
Varese 2003-2007 67 3.1 1.0
Veneto 2003-2006 174 3.7 1.3
Latvia1 National 2004-2007 162 3.3 1.4
Lithuania1 National 2003-2007 274 3.0 1.3
Malta1 National 2003-2007 36 3.5 1.6
Netherlands1 Eindhoven 2003-2007 84 3.3 1.7
National 2003-2007 1416 3.4 1.7
Norway1 National 2003-2007 451 3.9 1.9
Poland1 Cracow 2003-2006 33 2.0 0.9
Kielce 2003-2007 70 2.1 0.8
Lower Silesia 2003-2007 196 2.6 1.3
Podkarpackie 2003-2007 106 2.0 1.0
Portugal1 Azores 2003-2007 8 1.3 0.7
Russia1 Saint Petersburg 2003-2007 354 2.8 1.1
Serbia1 Central 2003-2007 459 3.3 1.6
Slovakia1 National 2003-2007 350 2.5 1.3
Slovenia1 National 2003-2007 247 4.8 2.1
Spain1 Albacete 2003-2007 29 3.0 1.0
Asturias 2003-2007 101 3.6 1.2
Basque Country 2003-2007 160 3.0 1.2
Canary Islands 2003-2006 62 1.9 1.0
Ciudad Real 2004-2007 24 2.4 1.0
Cuenca 2003-2007 17 3.3 1.2
Girona 2003-2007 43 2.7 1.1
Granada 2003-2007 50 2.3 1.0
La Rioja 2003-2007 22 3.0 0.8
Mallorca 2003-2007 68 3.5 1.5
Murcia 2003-2007 66 2.0 1.0
Navarra 2003-2007 47 3.2 1.0
Tarragona 2003-2007 56 3.3 1.2
Sweden1 National 2003-2007 803 3.5 1.4
Switzerland1 Basel 2003-2007 40 3.5 1.2
Geneva 2003-2007 31 2.8 1.3
Graubunden and Glarus 2003-2007 20 3.5 1.6
Neuchatel 2003-2007 12 2.8 1.6
St Gall-Appenzell 2003-2007 34 2.5 1.1
Ticino 2003-2007 24 2.9 0.8
Valais 2003-2007 16 2.2 0.7
Vaud 2003-2007 56 3.3 1.4
Zurich 2003-2007 102 3.2 1.4


Female
UK1 England 2003-2007 4408 3.4 1.6
England, East of England Region 2003-2007 440 3.1 1.4
England, North Western 2003-2007 580 3.5 1.7
England, Northern and Yorkshire 2003-2007 649 3.8 1.8
England, Oxford Region 2003-2007 210 3.0 1.6
England, South and Western Regions 2003-2007 731 4.2 1.7
England, Thames 2003-2007 759 2.5 1.3
England, Trent 2005-2007 322 4.3 1.9
England, West Midlands 2003-2007 523 3.8 1.8
Northern Ireland 2003-2007 122 2.8 1.5
Scotland 2003-2007 493 3.7 1.9
Wales 2003-2007 342 4.5 2.0
Ukraine1 National 2003-2007 3345 2.6 1.1
Oceania
Australia1 Australian Capital Territory 2003-2007 16 1.9 1.3
New South Wales 2003-2007 445 2.6 1.4
Northern Territory (Indigenous) 2003-2007 7 4.4 4.6
Northern Territory 2003-2007 15 3.0 3.0
Northern Territory (Non-Indigenous) 2003-2007 8 2.4 2.5
Queensland 2003-2007 208 2.1 1.2
South 2003-2007 107 2.7 1.2
Tasmania 2003-2007 36 2.9 1.4
Victoria 2003-2007 333 2.6 1.4
Western 2003-2007 120 2.4 1.4
New Zealand1 National (Other) 2003-2007 219 2.6 1.3
National (Pacific Islander) 2003-2007 3 0.5 0.6
National (Maori) 2003-2007 23 1.4 1.7
National 2003-2007 245 2.3 1.4
b Rates per 100,000 women per year.
Data sources:
Lyon, IARC.
NOTE.
For time trends in vulvar cancer incidence, please refer to individual country data.

3.2.3 Vaginal cancer
Cancer of the vagina is a rare cancer, with an estimated 13,000 new cases in 2008, representing 2% of
all gynaecologic cancers (de Martel C et al. Lancet Oncol 2012;13(6):607-15). Although unreported and
similar to cervical cancer, the majority of vaginal cancer cases (68%) occur in less developed countries.
Most vaginal cancers are squamous cell carcinoma (90%) generally attributable to HPV, followed by
clear cell adenocarcinomas and melanoma. Metastatic cervical cancer can be misclassified as cancer of
the vagina. Invasive vaginal cancer is diagnosed primarily in old women (>=65 years) and the diagnosis
is rare in women under 45 years whereas the peak incidence of carcinoma in situ is observed between
ages 55 and 70 (Vaccine 2008, Vol. 26, Suppl 10)
Table 9: Incidence of vaginal cancer by cancer registry

Female
Africa
Algeria1 Setif 2003-2007 3 0.1 0.1
Egypt1 Gharbiah 2003-2007 15 0.2 0.2
Gambia2 National 1997-1998 2 0.2 0.2
Libya1 Benghazi 2003-2005 3 0.1 0.2
Malawi1 Blantyre 2003-2007 16 0.7 1.4
Mali2 Bamako 1994-1996 1 0.1 0.1
Tunisia1 North 2003-2005 20 0.3 0.3
Americas
Cordoba 2004-2007 14 0.5 0.4
Mendoza 2003-2007 24 0.6 0.5
Tierra del Fuego 2003-2007 1 0.4 0.4
Brazil1 Aracaju 2003-2006 6 0.6 0.9
Belo Horizonte 2003-2005 24 0.6 0.6
Cuiaba 2003-2006 7 0.4 0.6
Fortaleza 2003-2006 22 0.4 0.5
Goiania 2003-2007 22 0.7 0.8
Sao Paulo 2003-2007 348 1.2 1.1
Canada1 Alberta 2003-2007 53 0.6 0.4
Manitoba 2003-2007 20 0.7 0.4
National 2003-2007 621 0.8 0.4
New Brunswick 2003-2007 21 1.1 0.5
Nova Scotia 2003-2007 33 1.4 0.7
Ontario 2003-2007 251 0.8 0.5
Quebec 2003-2007 135 0.7 0.3
Saskatchewan 2003-2007 13 0.5 0.3
Yukon 2003-2007 0 0.0 0.0
Valdivia 2003-2007 2 0.2 0.2
Cali 2003-2007 31 0.6 0.6
Manizales 2003-2007 5 0.5 0.5
Pasto 2003-2007 0 0.0 0.0
Cuba1 Villa Clara 2004-2007 4 0.2 0.1


Female
Ecuador1 Cuenca 2003-2007 5 0.4 0.4
Quito 2003-2007 15 0.4 0.5
Peru3 Trujillo 1998-2002 2 0.1 0.2
USA1 Alabama (Black) 2003-2007 25 0.8 0.6
Alabama (White) 2003-2007 67 0.8 0.4
Alabama 2003-2007 94 0.8 0.5
Alaska 2003-2007 12 0.7 0.6
Arizona 2003-2007 81 0.5 0.3
Arizona (Black) 2003-2007 0 0.0 0.0
Arizona (White) 2003-2007 77 0.6 0.3
Arkansas 2003-2007 64 0.9 0.5
Arkansas (White) 2003-2007 52 0.9 0.5
Arkansas (Black) 2003-2007 12 1.0 0.8
California 2003-2007 593 0.7 0.4
White)
Pacific Islander)
Pacific Islander)
White)
Colorado 2003-2007 71 0.6 0.4
Colorado (Black) 2003-2007 4 0.8 0.8
Colorado (White) 2003-2007 62 0.6 0.4
Connecticut 2003-2007 80 0.9 0.4
Delaware (Black) 2003-2007 5 1.1 0.8
Delaware (White) 2003-2007 10 0.6 0.4
Delaware 2003-2007 15 0.7 0.4
Florida 2003-2007 363 0.8 0.4


Female
Florida (Black) 2003-2007 62 0.8 0.7
Florida (White) 2003-2007 290 0.8 0.4
Georgia 2003-2007 203 0.9 0.6
Georgia (Black) 2003-2007 69 1.0 0.9
Georgia (White) 2003-2007 132 0.9 0.5
Georgia, Atlanta 2003-2007 63 0.8 0.6
Hawaii (Filipino) 2003-2007 2 0.4 0.3
Hawaii (Hawaiian) 2003-2007 4 0.6 0.6
Hawaii (Japanese) 2003-2007 3 0.5 0.1
Hawaii (White) 2003-2007 8 1.1 0.5
Hawaii (Chinese) 2003-2007 1 0.6 0.1
Hawaii 2003-2007 22 0.7 0.4
Idaho 2003-2007 28 0.8 0.5
Illinois (Black) 2003-2007 59 1.1 0.8
Illinois (White) 2003-2007 182 0.7 0.4
Illinois 2003-2007 252 0.8 0.5
Indiana (Black) 2003-2007 13 0.9 0.7
Indiana (White) 2003-2007 112 0.8 0.4
Indiana 2003-2007 126 0.8 0.5
Iowa 2003-2007 65 0.9 0.4
Kentucky 2003-2007 105 1.0 0.6
Louisiana 2003- 82 0.9 0.6
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
Maine 2003-2007 32 1.0 0.5
Massachusetts 2003-2007 123 0.7 0.4
Michigan 2003-2007 224 0.9 0.5
Michigan (Black) 2003-2007 30 0.8 0.6
Michigan (White) 2003-2007 186 0.9 0.5
Mississippi 2003-2007 68 0.9 0.6
Missouri 2003-2007 112 0.8 0.4


Female
Missouri (Black) 2003-2007 16 0.9 0.7
Missouri (White) 2003-2007 95 0.7 0.4
Montana 2003-2007 17 0.7 0.3
Nebraska 2003-2007 29 0.7 0.4
Nebraska (Black) 2003-2007 2 1.0 1.0
Nebraska (White) 2003-2007 26 0.6 0.3
New Hampshire 2003-2007 17 0.5 0.3
New Jersey 2003-2007 191 0.9 0.5
New Jersey (White) 2003-2007 143 0.8 0.4
New Jersey (Black) 2003-2007 35 1.0 0.9
New Mexico 2003-2007 36 0.7 0.4
New Mexico (White) 2003-2007 34 0.8 0.5
New York State 2003-2007 403 0.8 0.5
Islander)
North Carolina 2003-2007 173 0.8 0.5
North Dakota 2003-2007 8 0.5 0.2
NPCR (42 States) 2003-2007 5057 0.8 0.4
Islander)
Ohio 2003-2007 224 0.8 0.4
Ohio (Black) 2003-2007 29 0.8 0.5
Ohio (White) 2003-2007 189 0.8 0.4
Oklahoma 2003-2007 76 0.8 0.5
Oklahoma (Black) 2003-2007 4 0.5 0.4
Oklahoma (White) 2003-2007 64 0.9 0.5
Oregon 2003-2007 58 0.6 0.4
Oregon (Black) 2003-2007 2 1.0 1.1
Oregon (White) 2003-2007 54 0.6 0.4
Pennsylvania 2003-2007 277 0.9 0.4
Puerto Rico 2003-2007 110 1.1 0.7
Rhode Island 2003-2007 16 0.6 0.3
Islander)


Female
SEER (18 Registries) 2003-2007 1578 0.8 0.5
White)
SEER (9 Registries) 2003-2007 536 0.8 0.5
South Carolina 2003-2007 100 0.9 0.5
South Dakota 2003-2007 13 0.7 0.3
Tennessee (Black) 2003-2007 21 0.8 0.7
Tennessee (White) 2003-2007 110 0.9 0.5
Tennessee 2003-2007 136 0.9 0.5
Texas (White) 2003-2007 315 0.7 0.4
Texas (Black) 2003-2007 65 0.9 0.7
Texas 2003-2007 391 0.7 0.5
Utah 2003-2007 23 0.4 0.3
Vermont 2003-2007 17 1.1 0.7
Virginia 2003-2007 139 0.7 0.4
Virginia (Black) 2003-2007 40 1.0 0.7
Virginia (White) 2003-2007 91 0.6 0.4
West Virginia 2003-2007 47 1.0 0.5
Wisconsin (Black) 2003-2007 7 0.8 0.7
Wisconsin 2003-2007 81 0.6 0.3
Wisconsin (White) 2003-2007 73 0.6 0.3
Wyoming 2003-2007 11 0.9 0.7
Asia
Cixian County 2003-2007 2 0.1 0.1
Haining County 2003-2007 2 0.1 0.1
Hong Kong 2003-2007 97 0.5 0.3
Jiashan County 2003-2007 0 0.0 0.0
Jiaxing City 2005-2007 1 0.1 0.1
Macao 2003-2007 6 0.5 0.4
Qidong County 2003-2007 2 0.1 0.1
Shanghai City 2003-2007 39 0.3 0.1
Wuhan City 2003-2007 29 0.3 0.2
Yanting County 2003-2007 1 0.1 0.1
Zhongshan City 2004-2007 9 0.3 0.3
India1 Bangalore 2005-2007 54 0.6 0.8
Bhopal 2004-2007 7 0.2 0.4
Chennai 2003-2007 79 0.7 0.8
Mizoram 2003-2007 4 0.2 0.3


Female
Mumbai 2003-2007 160 0.6 0.7
New Delhi 2003-2007 97 0.3 0.4
Poona 2003-2007 44 0.4 0.6
Sikkim State 2003-2007 4 0.3 0.6
Trivandrum 2005-2007 8 0.5 0.4
Israel1 National 2003-2007 71 0.4 0.3
National (Jews) 2003-2007 70 0.5 0.3
Hiroshima 2003-2007 11 0.4 0.2
Saga Prefecture 2003-2007 15 0.7 0.2
Kuwait1 National 2003-2007 1 0.0 0.1
National (Non-Kuwaitis) 2003-2007 0 0.0 0.0
Penang (Indian) 2004-2007 2 0.7 0.8
Penang 2004-2007 9 0.3 0.3
Penang (Chinese) 2004-2007 4 0.3 0.2
Oman3 Omani 1998-2001 6 0.2 0.3
Rizal 2003-2007 31 0.2 0.3
Rep. Korea1 Busan 2003-2007 15 0.2 0.1
Daegu 2003-2007 24 0.4 0.3
Daejeon 2003-2007 5 0.1 0.1
Gwangju 2003-2007 8 0.2 0.2
Incheon 2003-2007 12 0.2 0.2
Jejudo 2004-2007 3 0.3 0.2
National 2003-2007 295 0.2 0.2
Seoul 2003-2007 67 0.3 0.2
Ulsan 2003-2007 10 0.4 0.4
Singapore1 National (Indian) 2003-2007 2 0.3 0.3
National 2003-2007 38 0.4 0.3
National (Malay) 2003-2007 4 0.3 0.3
Chiang Mai 2003-2007 13 0.3 0.3
Chonburi 2003-2007 5 0.2 0.2
Khon Kaen 2003-2007 7 0.2 0.1
Lampang 2003-2007 3 0.2 0.1
Songkhla 2004-2007 3 0.1 0.1
Turkey1 Antalya 2003-2007 6 0.2 0.2
Edirne 2004-2007 1 0.1 0.1
Izmir 2003-2007 16 0.2 0.1
Trabzon 2005-2007 2 0.2 0.1
Viet Nam2 Hanoi 1993-1997 8 0.1 0.2


Female
Ho Chi Minh City 1995-1998 16 0.2 0.2
Europe
Tyrol 2003-2007 19 1.1 0.4
Vorarlberg 2003-2007 13 1.4 0.8
Cyprus1 National 2003-2007 3 0.2 0.1
France1 Bas-Rhin 2003-2007 15 0.5 0.3
Calvados 2003-2007 12 0.7 0.4
Doubs 2003-2007 5 0.4 0.2
Haut-Rhin 2003-2007 14 0.7 0.3
Herault 2003-2007 15 0.6 0.3
Isere 2003-2007 14 0.5 0.2
Manche 2003-2007 3 0.2 0.1
Martinique 2003-2007 10 0.9 0.5
Somme 2003-2007 12 0.8 0.3
Tarn 2003-2007 5 0.5 0.2
Vendee 2003-2007 12 0.8 0.3
Bremen 2003-2007 18 1.1 0.3
Hamburg 2003-2007 63 1.4 0.6
Munich 2003-2007 97 1.0 0.4
Saarland 2003-2007 32 1.2 0.5
Italy1 Biella 2003-2007 3 0.6 0.1
Brescia 2003-2006 8 0.4 0.1
Catanzaro 2003-2007 8 1.3 0.5
Como 2003-2007 14 1.0 0.5
Ferrara 2003-2007 11 1.2 0.2
Genoa 2003-2006 18 1.0 0.2
Latina 2003-2007 4 0.3 0.1
Lecco 2003-2007 6 0.7 0.2
Lombardy, South 2003-2005 13 1.2 0.4
Mantua 2003-2005 6 1.0 0.4
Milan 2003-2006 23 0.8 0.3
Modena 2003-2007 9 0.5 0.3
Naples 2003-2007 6 0.4 0.3
Nuoro 2003-2007 2 0.3 0.1


Female
Palermo 2003-2006 17 0.7 0.3
Parma 2003-2007 7 0.7 0.3
Ragusa 2003-2007 6 0.8 0.4
Reggio Emilia 2003-2007 10 0.8 0.3
Romagna 2003-2007 25 0.8 0.3
Salerno 2003-2007 17 0.6 0.3
Sassari 2003-2007 7 0.6 0.3
Sondrio 2003-2007 1 0.2 0.2
South Tyrol 2003-2006 6 0.6 0.3
Syracuse 2003-2007 7 0.7 0.4
Trapani 2003-2006 4 0.4 0.3
Trento 2003-2006 11 1.1 0.5
Turin 2003-2007 20 0.9 0.3
Umbria 2003-2007 25 1.1 0.4
Varese 2003-2007 15 0.7 0.3
Veneto 2003-2006 34 0.7 0.2
Latvia1 National 2004-2007 31 0.6 0.3
Malta1 National 2003-2007 5 0.5 0.2
National 2003-2007 247 0.6 0.3
Norway1 National 2003-2007 77 0.7 0.3
Poland1 Cracow 2003-2006 7 0.4 0.2
Kielce 2003-2007 6 0.2 0.1
Lower Silesia 2003-2007 54 0.7 0.4
Podkarpackie 2003-2007 29 0.5 0.3
Portugal1 Azores 2003-2007 5 0.8 0.4
Serbia1 Central 2003-2007 112 0.8 0.4
Spain1 Albacete 2003-2007 3 0.3 0.2
Asturias 2003-2007 32 1.1 0.5
Basque Country 2003-2007 34 0.6 0.3
Canary Islands 2003-2006 11 0.3 0.2
Ciudad Real 2004-2007 2 0.2 0.1
Cuenca 2003-2007 0 0.0 0.0
Girona 2003-2007 4 0.2 0.1
Granada 2003-2007 11 0.5 0.2
La Rioja 2003-2007 2 0.3 0.1
Mallorca 2003-2007 8 0.4 0.3
Murcia 2003-2007 14 0.4 0.2
Navarra 2003-2007 3 0.2 0.0
Tarragona 2003-2007 5 0.3 0.2
Sweden1 National 2003-2007 205 0.9 0.3
Geneva 2003-2007 5 0.4 0.2
Neuchatel 2003-2007 4 0.9 0.2
Ticino 2003-2007 5 0.6 0.2
Valais 2003-2007 1 0.1 0.1
Vaud 2003-2007 13 0.8 0.3
Zurich 2003-2007 25 0.8 0.4


Female
UK1 England 2003-2007 1001 0.8 0.4
England, Thames 2003-2007 195 0.7 0.4
England, Trent 2005-2007 79 1.0 0.5
Scotland 2003-2007 104 0.8 0.4
Wales 2003-2007 70 0.9 0.4
Oceania
New South Wales 2003-2007 130 0.8 0.4
Queensland 2003-2007 62 0.6 0.4
South 2003-2007 32 0.8 0.4
Tasmania 2003-2007 6 0.5 0.2
Victoria 2003-2007 62 0.5 0.3
Western 2003-2007 53 1.1 0.7
New Zealand1 National (Other) 2003-2007 50 0.6 0.3
National (Maori) 2003-2007 8 0.5 0.7
National 2003-2007 60 0.6 0.4
Please refer to original source (available at http://ci5.iarc.fr/CI5i-ix/ci5i-ix.htm)
b Rates per 100,000 women per year.
Data sources:
Lyon, IARC.
NOTE.
For time trends in vaginal cancer incidence, please refer to individual country data.

3.2.4 Penile cancer
The annual burden of penile cancer has been estimated to be 22,000 cases worldwide with incidence
rates strongly correlating with those of cervical cancer (de Martel C et al. Lancet Oncol 2012;13(6):607-
15). Penile cancer is rare and most commonly affects men aged 50-70 years. Incidence rates are higher
in less developed countries than in more developed countries, accounting for up to 10% of male cancers
in some parts of Africa, South America and Asia. Precursor cancerous penile lesions (PeIN) are rare.
Cancers of the penis are primarily of squamous cell carcinomas (SCC) (95%) and the most common
penile SCC histologic sub-types are keratinising (49%), mixed warty-basaloid (17%), verrucous (8%)
warty (6%), and basaloid (4%). HPV is most commonly detected in basaloid and warty tumours but is
less common in keratinising and verrucous tumours. Approximately 60-100% of PeIN lesions are HPV
DNA positive.
Table 10: Incidence of penile cancer by cancer registry

Male
Africa
Algeria1 Setif 2003-2007 0 0.0 0.0
Egypt1 Gharbiah 2003-2007 3 0.0 0.1
Gambia2 National 1997-1998 5 0.5 0.9
Libya1 Benghazi 2003-2005 0 0.0 0.0
Malawi1 Blantyre 2003-2007 33 1.4 2.6
Mali2 Bamako 1994-1996 0 0.0 0.0
Mozambique3 Lourenco Marques 1956-1960 5 1.9 2.7
Nigeria4 Ibadan 1960-1969 2 0.1 0.2
Senegal5 Dakar 1969-1974 5 0.2 0.4
Tunisia1 North 2003-2005 8 0.1 0.1
Americas
Cordoba 2004-2007 33 1.3 1.2
Mendoza 2003-2007 58 1.5 1.4
Tierra del Fuego 2003-2007 2 0.7 1.2
Brazil1 Aracaju 2003-2006 17 1.8 2.5
Belo Horizonte 2003-2005 24 0.7 0.9
Cuiaba 2003-2006 20 1.3 2.1
Fortaleza 2003-2006 51 1.2 1.7
Goiania 2003-2007 65 2.3 3.3
Sao Paulo 2003-2007 403 1.6 1.7
Canada1 Alberta 2003-2007 77 0.9 0.7
Manitoba 2003-2007 31 1.1 0.6
National 2003-2007 662 0.8 0.5
New Brunswick 2003-2007 32 1.7 1.0
Nova Scotia 2003-2007 30 1.3 0.8
Ontario 2003-2007 233 0.8 0.5
Quebec 2003-2007 147 0.8 0.5
Saskatchewan 2003-2007 34 1.4 0.9
Yukon 2003-2007 0 0.0 0.0
Valdivia 2003-2007 10 1.1 0.9


Male
Cali 2003-2007 54 1.1 1.2
Manizales 2003-2007 20 2.2 2.2
Pasto 2003-2007 11 1.2 1.4
Cuba1 Villa Clara 2004-2007 41 2.5 1.6
Ecuador1 Cuenca 2003-2007 1 0.1 0.1
Quito 2003-2007 18 0.5 0.6
Paraguay6 Asuncion Region 1988-1989 46 2.6 4.2
Peru7 Trujillo 1998-2002 15 1.1 1.8
USA1 Alabama 2003-2007 90 0.8 0.6
Alabama (Black) 2003-2007 20 0.7 0.7
Alabama (White) 2003-2007 69 0.9 0.5
Alaska 2003-2007 13 0.7 0.7
Arizona 2003-2007 106 0.7 0.5
Arizona (Black) 2003-2007 4 0.6 0.9
Arizona (White) 2003-2007 95 0.7 0.5
Arkansas 2003-2007 65 1.0 0.7
Arkansas (White) 2003-2007 61 1.1 0.7
Arkansas (Black) 2003-2007 4 0.4 0.4
California 2003-2007 561 0.6 0.5
White)
Pacific Islander)
Pacific Islander)
White)
Colorado 2003-2007 62 0.5 0.4
Colorado (Black) 2003-2007 4 0.7 0.9
Colorado (White) 2003-2007 57 0.5 0.4
Connecticut 2003-2007 66 0.8 0.5


Male
Delaware 2003-2007 7 0.3 0.2
Delaware (Black) 2003-2007 3 0.7 0.5
Delaware (White) 2003-2007 3 0.2 0.1
Florida 2003-2007 405 0.9 0.5
Florida (White) 2003-2007 336 1.0 0.5
Florida (Black) 2003-2007 60 0.9 1.0
Georgia 2003-2007 120 0.5 0.5
Georgia (Black) 2003-2007 28 0.4 0.5
Georgia (White) 2003-2007 90 0.6 0.4
Georgia, Atlanta 2003-2007 27 0.3 0.3
Hawaii 2003-2007 19 0.6 0.3
Hawaii (Chinese) 2003-2007 1 0.7 0.3
Hawaii (Filipino) 2003-2007 3 0.7 0.4
Hawaii (Japanese) 2003-2007 2 0.3 0.2
Hawaii (White) 2003-2007 9 1.1 0.5
Hawaii (Hawaiian) 2003-2007 4 0.6 0.6
Idaho 2003-2007 22 0.6 0.4
Illinois (Black) 2003-2007 32 0.7 0.7
Illinois (White) 2003-2007 182 0.7 0.5
Illinois 2003-2007 223 0.7 0.5
Indiana 2003-2007 123 0.8 0.6
Indiana (Black) 2003-2007 5 0.4 0.4
Indiana (White) 2003-2007 118 0.9 0.6
Iowa 2003-2007 76 1.0 0.6
Kentucky 2003-2007 119 1.2 0.8
2004,2006-
2007
Louisiana 2003- 76 0.9 0.7
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
2004,2006-
2007
Maine 2003-2007 40 1.3 0.8
Massachusetts 2003-2007 153 1.0 0.6
Michigan 2003-2007 177 0.7 0.5
Michigan (White) 2003-2007 149 0.7 0.4


Male
Michigan (Black) 2003-2007 21 0.6 0.5
Mississippi 2003-2007 61 0.9 0.6
Missouri (Black) 2003-2007 5 0.3 0.3
Missouri (White) 2003-2007 108 0.9 0.5
Missouri 2003-2007 115 0.8 0.5
Montana 2003-2007 18 0.8 0.5
Nebraska 2003-2007 33 0.8 0.5
Nebraska (Black) 2003-2007 0 0.0 0.0
Nebraska (White) 2003-2007 32 0.8 0.5
New Hampshire 2003-2007 21 0.7 0.4
New Jersey 2003-2007 157 0.7 0.5
New Jersey (White) 2003-2007 138 0.8 0.5
New Jersey (Black) 2003-2007 11 0.4 0.3
New Mexico 2003-2007 30 0.6 0.4
New Mexico (White) 2003-2007 25 0.6 0.4
New York State 2003-2007 392 0.8 0.6
Islander)
North Carolina 2003-2007 150 0.7 0.5
North Dakota 2003-2007 11 0.7 0.3
NPCR (42 States) 2003-2007 4858 0.7 0.5
Islander)
Ohio 2003-2007 195 0.7 0.5
Ohio (White) 2003-2007 178 0.7 0.5
Ohio (Black) 2003-2007 15 0.4 0.5
Oklahoma 2003-2007 83 0.9 0.7
Oklahoma (White) 2003-2007 69 1.0 0.6
Oklahoma (Black) 2003-2007 3 0.4 0.5
Oregon (Black) 2003-2007 0 0.0 0.0
Oregon 2003-2007 62 0.7 0.4
Oregon (White) 2003-2007 57 0.7 0.4
Pennsylvania 2003-2007 233 0.8 0.4


Male
Puerto Rico 2003-2007 237 2.5 1.8
Rhode Island 2003-2007 31 1.2 0.8
SEER (18 Registries) 2003-2007 1377 0.7 0.5
Islander)
White)
SEER (9 Registries) 2003-2007 417 0.6 0.4
South Carolina 2003-2007 80 0.8 0.5
South Dakota 2003-2007 22 1.1 0.6
Tennessee 2003-2007 97 0.7 0.5
Tennessee (Black) 2003-2007 11 0.5 0.5
Tennessee (White) 2003-2007 86 0.7 0.5
Texas (Black) 2003-2007 37 0.6 0.6
Texas (White) 2003-2007 384 0.8 0.6
Texas 2003-2007 435 0.8 0.6
Utah 2003-2007 23 0.4 0.3
Vermont 2003-2007 8 0.5 0.3
Virginia 2003-2007 129 0.7 0.5
Virginia (Black) 2003-2007 28 0.8 0.6
Virginia (White) 2003-2007 97 0.7 0.5
West Virginia 2003-2007 53 1.2 0.7
Wisconsin 2003-2007 104 0.8 0.5
Wisconsin (Black) 2003-2007 3 0.4 0.4
Wisconsin (White) 2003-2007 97 0.8 0.5
Wyoming 2003-2007 11 0.9 0.6
Asia
Cixian County 2003-2007 10 0.6 0.8
Haining County 2003-2007 5 0.3 0.2
Hong Kong 2003-2007 72 0.4 0.3
Jiashan County 2003-2007 5 0.5 0.3
Jiaxing City 2005-2007 5 0.7 0.4
Macao 2003-2007 4 0.3 0.3
Qidong County 2003-2007 11 0.4 0.3
Shanghai City 2003-2007 107 0.7 0.3
Wuhan City 2003-2007 40 0.3 0.3
Yanting County 2003-2007 6 0.4 0.4
Zhongshan City 2004-2007 27 1.0 1.0


Male
India1 Bangalore 2005-2007 101 0.9 1.3
Bhopal 2004-2007 12 0.3 0.6
Chennai 2003-2007 179 1.6 1.8
Mizoram 2003-2007 26 1.0 1.7
Mumbai 2003-2007 239 0.7 0.9
New Delhi 2003-2007 246 0.6 0.9
Poona 2003-2007 71 0.7 1.0
Sikkim State 2003-2007 10 0.7 1.0
Trivandrum 2005-2007 12 0.7 0.7
Israel1 National 2003-2007 17 0.1 0.1
National (Jews) 2003-2007 14 0.1 0.1
Hiroshima 2003-2007 21 0.8 0.3
Saga Prefecture 2003-2007 21 1.0 0.4
Kuwait1 National (Non-Kuwaitis) 2003-2007 1 0.0 0.1
National 2003-2007 1 0.0 0.1
Kyrgyzstan6 National 1986-1987 7 0.2 0.3
Penang (Chinese) 2004-2007 6 0.5 0.5
Penang 2004-2007 9 0.3 0.5
Penang (Indian) 2004-2007 2 0.7 1.3
Oman7 Omani 1998-2001 0 0.0 0.0
Rizal 2003-2007 32 0.2 0.4
Rep. Korea1 Busan 2003-2007 24 0.3 0.3
Daegu 2003-2007 11 0.2 0.2
Daejeon 2003-2007 5 0.1 0.1
Gwangju 2003-2007 6 0.2 0.2
Incheon 2003-2007 9 0.1 0.2
Jejudo 2004-2007 3 0.3 0.3
National 2003-2007 282 0.2 0.2
Seoul 2003-2007 44 0.2 0.2
Ulsan 2003-2007 8 0.3 0.4
Singapore1 National 2003-2007 52 0.6 0.5
National (Indian) 2003-2007 3 0.4 0.3
National (Malay) 2003-2007 2 0.2 0.2
Chiang Mai 2003-2007 70 1.9 1.5
Chonburi 2003-2007 32 1.1 1.3


Male
Khon Kaen 2003-2007 72 1.6 1.6
Lampang 2003-2007 26 1.3 1.1
Songkhla 2004-2007 48 1.8 1.8
Turkey1 Antalya 2003-2007 1 0.0 0.0
Edirne 2004-2007 0 0.0 0.0
Izmir 2003-2007 8 0.1 0.1
Trabzon 2005-2007 0 0.0 0.0
Viet Nam2 Hanoi 1993-1997 95 1.7 2.3
Ho Chi Minh City 1995-1998 85 0.9 1.4
Europe
Tyrol 2003-2007 14 0.8 0.6
Vorarlberg 2003-2007 5 0.6 0.4
Cyprus1 National 2003-2007 28 1.5 1.1
France1 Bas-Rhin 2003-2007 42 1.6 1.0
Calvados 2003-2007 22 1.4 0.7
Doubs 2003-2007 18 1.4 0.9
Haut-Rhin 2003-2007 22 1.2 0.7
Herault 2003-2007 37 1.6 0.8
Isere 2003-2007 22 0.8 0.4
Manche 2003-2007 19 1.6 0.9
Martinique 2003-2007 14 1.5 0.9
Somme 2003-2007 19 1.4 1.0
Tarn 2003-2007 17 1.9 0.7
Vendee 2003-2007 10 0.7 0.4
Bremen 2003-2007 23 1.4 0.7
Hamburg 2003-2007 61 1.4 0.8
Munich 2003-2007 116 1.2 0.7
Saarland 2003-2007 46 1.8 0.9
Hungary6 County Szabolcs-Szatmar 1983-1987 12 0.8 0.7
County Vas 1983-1987 4 0.6 0.4
Italy1 Biella 2003-2007 11 2.5 1.0
Brescia 2003-2006 18 0.9 0.5
Catanzaro 2003-2007 9 1.6 0.9
Como 2003-2007 9 0.7 0.3
Ferrara 2003-2007 20 2.4 1.0


Male
Genoa 2003-2006 23 1.4 0.5
Latina 2003-2007 30 2.3 1.3
Lecco 2003-2007 8 1.0 0.6
Lombardy, South 2003-2005 13 1.2 0.5
Mantua 2003-2005 12 2.1 1.1
Milan 2003-2006 21 0.9 0.4
Modena 2003-2007 20 1.2 0.6
Naples 2003-2007 18 1.3 1.0
Nuoro 2003-2007 9 1.5 1.0
Palermo 2003-2006 38 1.6 1.0
Parma 2003-2007 11 1.1 0.6
Ragusa 2003-2007 10 1.3 0.8
Reggio Emilia 2003-2007 9 0.7 0.4
Romagna 2003-2007 44 1.6 0.7
Salerno 2003-2007 53 2.0 1.0
Sassari 2003-2007 9 0.8 0.5
Sondrio 2003-2007 5 1.1 0.6
South Tyrol 2003-2006 10 1.1 0.6
Syracuse 2003-2007 12 1.2 0.8
Trapani 2003-2006 17 2.0 1.1
Trento 2003-2006 15 1.5 0.8
Turin 2003-2007 25 1.2 0.5
Umbria 2003-2007 52 2.5 1.1
Varese 2003-2007 18 0.9 0.4
Veneto 2003-2006 54 1.2 0.6
Latvia1 National 2004-2007 64 1.5 1.0
Malta1 National 2003-2007 15 1.5 0.9
National 2003-2007 560 1.4 0.8
Norway1 National 2003-2007 197 1.7 1.0
Poland1 Cracow 2003-2006 21 1.5 0.9
Kielce 2003-2007 39 1.2 0.8
Lower Silesia 2003-2007 61 0.9 0.7
Podkarpackie 2003-2007 48 0.9 0.7
Portugal1 Azores 2003-2007 7 1.2 0.9
Romania6 County Cluj 1983-1987 17 0.9 0.8
Serbia1 Central 2003-2007 175 1.3 0.8
Spain1 Albacete 2003-2007 20 2.1 1.1
Asturias 2003-2007 53 2.1 1.0
Basque Country 2003-2007 101 2.0 0.9
Canary Islands 2003-2006 51 1.6 1.1
Ciudad Real 2004-2007 21 2.1 1.2
Cuenca 2003-2007 20 3.9 1.9
Girona 2003-2007 24 1.5 0.8
Granada 2003-2007 42 2.0 1.2
La Rioja 2003-2007 11 1.5 0.6
Mallorca 2003-2007 35 1.8 1.1
Murcia 2003-2007 68 2.0 1.3
Navarra 2003-2007 23 1.6 0.8


Male
Tarragona 2003-2007 44 2.5 1.4
Sweden1 National 2003-2007 412 1.8 1.0
Geneva 2003-2007 19 1.9 1.1
Neuchatel 2003-2007 9 2.2 1.4
Ticino 2003-2007 13 1.7 0.8
Valais 2003-2007 6 0.8 0.6
Vaud 2003-2007 24 1.5 0.9
Zurich 2003-2007 36 1.2 0.6
UK1 England 2003-2007 1870 1.5 0.9
England, Thames 2003-2007 320 1.1 0.7
England, Trent 2005-2007 128 1.7 1.0
Scotland 2003-2007 212 1.7 1.0
Wales 2003-2007 135 1.9 1.1
Oceania
New South Wales 2003-2007 139 0.8 0.5
Queensland 2003-2007 68 0.7 0.5
South 2003-2007 30 0.8 0.4
Tasmania 2003-2007 7 0.6 0.3
Victoria 2003-2007 87 0.7 0.4
Western 2003-2007 39 0.8 0.6
New Zealand1 National (Maori) 2003-2007 0 0.0 0.0
National 2003-2007 59 0.6 0.4
National (Other) 2003-2007 57 0.7 0.4
Please refer to original source (available at http://ci5.iarc.fr/CI5i-ix/ci5i-ix.htm)
b Rates per 100,000 men per year.
Data sources:
3 Doll, R.,Payne, P.,Waterhouse, J.A.H., eds (1966). Cancer Incidence in Five Continents, Vol. I. Union Internationale Contre le Cancer, Geneva.
4 Waterhouse, J.,Muir, C.S.,Correa, P.,Powell, J., eds (1976). Cancer Incidence in Five Continents, Vol. III. IARC Scientific Publications No. 15, Lyon, IARC.
5 Waterhouse, J.,Muir, C.S.,Shanmugaratnam, K.,Powell, J., eds (1982). Cancer Incidence in Five Continents, Vol. IV. IARC Scientific Publications No. 42, Lyon, IARC.
6 Parkin, D.M.,Muir, C.S.,Whelan, S.L.,Gao, Y.-T.,Ferlay, J.,Powell, J., eds (1992). Cancer Incidence in Five Continents, Vol. VI. IARC Scientific Publications No. 120, Lyon, IARC.
Lyon, IARC.
NOTE.
For time trends in penile cancer incidence, please refer to individual country data.

3.3 Head and neck cancers

The majority of head and neck cancers are associated with high tobacco and alcohol consumption. How-
ever, increasing trends in the incidence at specific sites suggest that other etiological factors are in-
volved, and infection by certain high-risk types of HPV (i.e. HPV16) have been reported to be associated
with head and neck cancers, in particular with oropharyngeal cancer. Current evidence suggests that
HPV16 is associated with tonsil cancer (including Waldeyer ring cancer), base of tongue cancer and
other oropharyngeal cancer sites. Associations with other head and neck cancer sites such as oral can-
cer are neither strong nor consistent when compared to molecular-epidemiological data on HPV and
oropharyngeal cancer. Association with laryngeal cancer is still unclear (IARC Monograph Vol 100B).
3.3.1 Pharyngeal cancer (excluding nasopharynx)
Table 11: Cancer incidence of pharynx (excluding nasopharynx) by sex, in the World and its regions.
Includes ICD-10 codes: C09-10, C12-14 (estimates for 2012).
MALE FEMALE
Area N cases Crudea ASRa Cum riskb N cases Crudea ASRa Cum riskb
rate (%) ages rate (%) ages
0-74 0-74
World 115131 3.2 3.2 0.4 27256 0. 8 0.7 0.1
Less developed regions 70731 2.4 2.8 0.3 18059 0. 6 0.7 0.1
More developed regions 44400 7.3 4.7 0.6 9197 1. 4 0.8 0.1
Africa 3369 0.6 1.1 0.1 1928 0. 4 0.6 0.1
Eastern Africa 906 0.5 1.0 0.1 567 0. 3 0.6 0.1
Middle Africa 585 0.9 1.7 0.2 208 0. 3 0.6 0.1
Northern Africa 621 0.6 0.8 0.1 611 0. 6 0.7 0.1
Southern Africa 784 2.7 3.9 0.5 392 1. 3 1.5 0.2
Western Africa 473 0.3 0.6 0.1 150 0. 1 0.1 0.0
Americas 17637 3.7 3.3 0.4 4471 0. 9 0.7 0.1
Caribbean 815 3.9 3.6 0.4 227 1. 1 0.9 0.1
Central America 694 0.9 1.0 0.1 218 0. 3 0.3 0.0
Northern America 10493 6.1 4.2 0.5 2756 1. 6 1.0 0.1
South America 5635 2.8 3.0 0.3 1270 0. 6 0.5 0.1
Asia 65016 3.0 3.1 0.4 14997 0. 7 0.7 0.1
Central Asia 717 2.3 3.2 0.4 321 1. 0 1.1 0.1
Eastern Asia 13441 1.6 1.3 0.1 1884 0. 2 0.2 0.0
Southern Asia 43190 4.8 6.3 0.8 10454 1. 2 1.5 0.2
South-Eastern Asia 6933 2.3 2.6 0.3 1965 0. 6 0.7 0.1
Western Asia 735 0.6 0.8 0.1 373 0. 3 0.4 0.0
Europe 28394 7.9 5.2 0.6 5700 1. 5 0.9 0.1
Eastern Europe 10187 7.4 5.3 0.6 1401 0. 9 0.5 0.1
Northern Europe 2594 5.3 3.4 0.4 844 1. 7 1.0 0.1
Southern Europe 4137 5.3 3.4 0.4 731 0. 9 0.5 0.1
Western Europe 11476 12.3 7.5 0.9 2724 2. 8 1.6 0.2
Oceania 715 3.8 3.0 0.4 160 0. 8 0.6 0.1
Australia & New Zealand 633 4.6 3.2 0.4 146 1. 1 0.7 0.1
Melanesia 71 1.5 3.4 0.6 14 0. 3 0.4 0.0
Micronesia 0 0.0 0.0 0.0 0 0. 0 0.0 0.0
Polynesia 11 3.2 3.8 0.5 0 0. 0 0.0 0.0
a Male: Rates per 100,000 men per year. Female: Rates per 100,000 women per year.
b Cumulative risk (incidence) is the probability or risk of individuals getting from the disease during ages 0-74 years. For cancer, it is expressed as the % of new born children who would be
expected to develop from a particular cancer before the age of 75 if they had the rates of cancer observed in the period in the absence of competing causes.
Data sources:
Table 12: Cancer mortality of pharynx (excluding nasopharynx) by sex, in the World and its regions.
Includes ICD-10 codes: C09-10, C12-14 (estimates for 2012).
MALE FEMALE
0-74 0-74
World 77585 2.2 2.2 0.3 18505 0. 5 0.5 0.1


MALE FEMALE
0-74 0-74
Less developed regions 56165 1.9 2.2 0.3 14440 0. 5 0.5 0.1
More developed regions 21420 3.5 2.2 0.3 4065 0. 6 0.3 0.0
Africa 2631 0.5 0.9 0.1 1459 0. 3 0.4 0.1
Eastern Africa 786 0.4 0.9 0.1 496 0. 3 0.5 0.1
Middle Africa 518 0.8 1.6 0.2 191 0. 3 0.6 0.1
Northern Africa 483 0.5 0.6 0.1 494 0. 5 0.6 0.1
Southern Africa 426 1.5 2.2 0.3 145 0. 5 0.6 0.1
Western Africa 418 0.3 0.5 0.1 133 0. 1 0.1 0.0
Americas 8381 1.8 1.5 0.2 2173 0. 5 0.3 0.0
Caribbean 568 2.7 2.4 0.3 159 0. 7 0.6 0.1
Central America 482 0.6 0.7 0.1 153 0. 2 0.2 0.0
Northern America 3145 1.8 1.2 0.1 970 0. 5 0.3 0.0
South America 4186 2.1 2.2 0.3 891 0. 4 0.4 0.0
Asia 51005 2.3 2.4 0.3 12126 0. 6 0.5 0.1
Central Asia 516 1.7 2.4 0.3 231 0. 7 0.8 0.1
Eastern Asia 7867 1.0 0.7 0.1 1352 0. 2 0.1 0.0
Southern Asia 36667 4.1 5.4 0.6 8710 1. 0 1.2 0.1
South-Eastern Asia 5414 1.8 2.1 0.2 1545 0. 5 0.5 0.1
Western Asia 541 0.4 0.6 0.1 288 0. 2 0.3 0.0
Europe 15245 4.3 2.7 0.3 2662 0. 7 0.4 0.0
Eastern Europe 7277 5.3 3.8 0.5 885 0. 6 0.3 0.0
Northern Europe 1118 2.3 1.4 0.2 352 0. 7 0.3 0.0
Southern Europe 2342 3.0 1.8 0.2 430 0. 5 0.3 0.0
Western Europe 4508 4.9 2.7 0.3 995 1. 0 0.5 0.1
Oceania 323 1.7 1.3 0.2 85 0. 5 0.3 0.0
Australia & New Zealand 261 1.9 1.2 0.1 70 0. 5 0.3 0.0
Melanesia 56 1.2 2.8 0.5 14 0. 3 0.4 0.0
Micronesia 0 0.0 0.0 0.0 0 0. 0 0.0 0.0
Polynesia 6 1.7 2.0 0.2 1 0. 3 0.3 0.0
a Male: Rates per 100,000 men per year. Female: Rates per 100,000 women per year.
b Cumulative risk (mortality) is the probability or risk of individuals dying from the disease during ages 0-74 years. For cancer, it is expressed as the % of new born children who would be
expected to die from a particular cancer before the age of 75 if they had the rates of cancer observed in the period in the absence of competing causes.
Data sources:

Figure 27: Comparison of cancer incidence and mortality of pharynx (excluding nasopharynx) by sex
and age group in the World. Includes ICD-10 codes: C09-10,C12-14 (estimates for 2012)
MALE
25 World 25 Less developed regions 25 More developed regions
20 20 20
pharyngeal cancer (excluding nasopharynx) per 100,000
15 15 15
10 10 10
5 5 5
0 0 0
014
1539
4044
4549
5054
5559
6064
6569
7074
>=75
014
1539
4044
4549
5054
5559
6064
6569
7074
>=75
014
1539
4044
4549
5054
5559
6064
6569
7074
>=75
FEMALE
25 World 25 Less developed regions 25 More developed regions
20 20 20
15 15 15
10 10 10
5 5 5
0 0 0
014
1539
4044
4549
5054
5559
6064
6569
7074
>=75
014
1539
4044
4549
5054
5559
6064
6569
7074
>=75
014
1539
4044
4549
5054
5559
6064
6569
7074
>=75
Incidence Mortality

Male: Rates per 100,000 men per year. Female: Rates per 100,000 women per year.
Data sources:

Figure 28: Comparison of cancer incidence and mortality of pharynx (excluding nasopharynx) in males
by age group in the World and its regions. . Includes ICD-10 codes: C09-10,C12-14 (estimates for 2012)
30 World 30 Asia
25 25
20 20
15 15
10 10
5 5
0 0
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
7
7
1
1
3
6
5
5
6
6
4
4
0
0
>=
>=
30 Africa 30 Europe
25 25
20 20
15 15
10 10
5 5
0 0
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
7
7
1
1
3
6
5
5
6
6
4
4
0
0
>=
>=
30 Americas 30 Oceania
25 25
20 20
15 15
10 10
5 5
0 0
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
7
7
1
1
3
6
5
5
6
6
4
4
0
0
>=
>=
Age group (years)
Incidence Mortality

Data sources:

Figure 29: Comparison of cancer incidence and mortality of pharynx (excluding nasopharynx) in females
by age group in the World and its regions. . Includes ICD-10 codes: C09-10,C12-14 (estimates for 2012)
5 World 5 Asia
4 4
3 3
2 2
1 1
0 0
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
7
7
1
1
3
6
5
5
6
6
4
4
0
0
>=
>=
5 Africa 5 Europe
4 4
3 3
2 2
1 1
0 0
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
7
7
1
1
3
6
5
5
6
6
4
4
0
0
>=
>=
5 Americas 5 Oceania
4 4
3 3
2 2
1 1
0 0
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
15 4
40 9
45 4
50 9
55 4
60 9
65 4
70 9
4
75
7
7
1
1
3
6
5
5
6
6
4
4
0
0
>=
>=
Age group (years)
Incidence Mortality

Data sources:

4 HPV RELATED STATISTICS - 79 -
4 HPV related statistics

HPV infection is commonly found in the anogenital tract of men and women with and without clinical
lesions. The aetiological role of HPV infection among women with cervical cancer is well-established,
and there is growing evidence of its central role in other anogenital sites. HPV is also responsible for
other diseases such as recurrent juvenile respiratory papillomatosis and genital warts, both mainly
caused by HPV types 6 and 11(Lacey CJ, Vaccine 2006; 24(S3):35). For this section, the methodologies
used to compile the information on HPV burden are derived from systematic reviews and meta-analyses
of the literature. Due to the limitations of HPV DNA detection methods and study designs used, these
data should be interpreted with caution and used only as a guide to assess the burden of HPV infection
in the population. (Vaccine 2006, Vol. 24, Suppl 3; Vaccine 2008, Vol. 26, Suppl 10; Vaccine 2012, Vol.
30, Suppl 5; IARC Monographs 2007, Vol. 90).
4.1 HPV burden in women with normal cervical cytology, cervical precancerous
lesions or invasive cervical cancer
The statistics shown in this section focus on HPV infection in the cervix uteri. HPV cervical infection re-
sults in cervical morphological lesions ranging from normalcy (cytologically normal women) to different
stages of precancerous lesions (CIN-1, CIN-2, CIN-3/CIS) and invasive cervical cancer. HPV infection
is measured by means of HPV DNA detection in cervical cells (fresh tissue, paraffin embedded or exfo-
liated cells).
The prevalence of HPV increases with severity of the lesion. HPV causes virtually 100% of cases of
cervical cancer, and an underestimation of HPV prevalence in cervical cancer is most likely due to the
limitations of study methodologies. Worldwide, HPV-16 and 18, the two vaccine-preventable types. con-
tribute to over 70% of all cervical cancer cases, between 41%-67% of high-grade cervical lesions and
16-32% of low-grade cervical lesions. After HPV-16/18, the six most common HPV types are the same
in all world regions, namely 31, 33, 35, 45, 52 and 58; these account for an additional 20% of cervical
cancers worldwide (Clifford G et al. Vaccine 2006;24(S3):26-34).
Methods: Prevalence and type distribution of human papillomavirus in cervical carcinoma,

low-grade cervical lesions, high-grade cervical lesions and normal cytology: systematic re-
view and meta-analysis
A systematic review of the literature was conducted regarding the worldwide HPV-prevalence and type
distribution for cervical carcinoma, low-grade cervical lesions, high-grade cervical lesions and normal
cytology from 1990 to data as of indicated in each section. The search terms for the review were HPV
AND cerv* using Pubmed. There were no limits in publication language. References cited in selected
articles were also investigated. Inclusion criteria were: HPV DNA detection by means of PCR or HC2,
a minimum of 20 cases for cervical carcinoma, 20 cases for low-grade cervical lesions, 20 cases for high-
grade cervical lesions and 100 normal cytology and a detailed description of HPV DNA detection and
genotyping techniques used. The number of cases tested and HPV positive extracted for each study
were pooled to estimate the prevalence of HPV DNA and the HPV type distribution globally and by
geographical region. Binomial 95% confidence intervals were calculated for each HPV prevalence. For
more details refer to the methods document.

4.1.1 HPV prevalence in women with normal cervical cytology
Figure 30: Prevalence of HPV among women with normal cervical cytology in the World
Data updated on 14 Dec 2016 (data as of 30 Jun 2015).

The samples for HPV testing come from cervical specimens (fresh / fixed biopsies or exfoliated cells
Data sources: See references in Section 9.

Figure 31: Crude age-specific HPV prevalence (%) and 95% confidence interval in women with normal
cervical cytology in the World and its regions
HPV prevalence (%)
50 Europe 50 Oceania
45 45
40 40
35 35
30 30
25 25
20 20
15 15
10 10
5 5
0 0
<25 2534 3544 4554 5564 65+ <25 2534 3544 4554 5564 65+
HPV prevalence (%)
50 Africa 50 Asia
45 45
40 40
35 35
30 30
25 25
20 20
15 15
10 10
5 5
0 0
<25 2534 3544 4554 5564 65+ <25 2534 3544 4554 5564 65+
HPV prevalence (%)
50 Americas 50 World
45 45
40 40
35 35
30 30
25 25
20 20
15 15
10 10
5 5
0 0
<25 2534 3544 4554 5564 65+ <25 2534 3544 4554 5564 65+
Age group (years)


Figure 32: Prevalence of HPV among women with normal cervical cytology in Africa by country and
study
Country Study Age N % (95% CI)

a
Algeria Hammouda 2011 1865 732 5.3 (3.97.2)
Hammouda 2005 (Algiers) 3180 133 10.5 (6.416.9)
Benin Piras 2011b 1863 258 26.7 (21.732.5)
Burkina Faso Oudraogo 2015c 1519 200 41.5 (34.948.4)
c
Cameroon Catarino 2016 2565 731 39.0 (35.542.6)
Untiet 2014 (Yaound)c 2089 694 16.7 (14.119.7)
c
Tebeu 2015 (Tiko and Yaound) 3065 540 27.0 (23.530.9)
Cte d'Ivoire La Ruche 1998 (Abidjan)d 2050 194 16.5 (11.922.4)
e
La Ruche 1998 (Abidjan) 2050 120 27.5 (20.336.1)
AdjorloloJohnson 2010 (Abidjan) 2369 110 29.1 (21.438.2)
DR Congo SangwaLugoma 2011f >=30 1,138 8.7 (7.210.5)
Hovland 2010 (Bukavu) 287 13.9 (10.418.4)
Egypt Shaltout 2014c 1899 443 10.4 (7.913.6)
Abdel Aziz 2006 (Cairo) 2060 156 10.3 (6.416.0)
Ethiopia LeyhBannurah 2014 (Gurage)c 1564 537 17.5 (14.520.9)
Ruland 2006 (Gurage)c 1865 189 15.9 (11.421.8)
Gabon SiMohamed 2005 (Libreville)c 1844 195 41.5 (34.948.6)
Gambia Wall 2005 (Farafenni) 1554 576 11.5 (9.114.3)
c
Ghana Yar 2016 1859 100 56.0 (46.265.3)
Guinea Keita 2009 (Conakry) 1564 752 47.9 (44.351.4)
c
Kenya Temmerman 1999 (Nairobi) 1954 513 17.0 (14.020.4)
De Vuyst 2010 (Mombasa) >=15 454 40.3 (35.944.9)
De Vuyst 2003 (Nairobi) 2555 369 38.8 (33.943.8)
Yamada 2008 (Nairobi)c 1661 333 16.8 (13.221.2)
Maranga 2013 (Nairobi) 2150 101 41.6 (32.551.3)
Mali Schluterman 2013 (Narna)c 1565 212 23.1 (17.929.2)
c
Tracy 2011 (Bamako) 1565 202 11.9 (8.117.1)
Morocco Alhamany 2010 (Rabat) 1780 785 15.8 (13.418.5)
Bennani 2012 (Fez) 1781 751 42.5 (39.046.0)
Amrani 2003 (Rabat) 2554 306 4.2 (2.57.1)
Belglaiaa 2015 1876 190 17.4 (12.623.4)
Chaouki 1998 (Rabat) 1870 172 21.5 (16.028.2)
Mozambique Castellsagu 2001 (Manhia) 1461 196 32.1 (26.039.0)
Naucler 2011 (Maputo) 2588 183 31.1 (24.938.2)
Nigeria Gage 2012 (Irun) >=15 1,075 10.5 (8.812.5)
Thomas 2004 (Idikan (Ibadan)) 1598 844 24.8 (22.027.8)
g
Pimentel 2013 1985 374 12.3 (9.316.0)
Dareng 2016c >=18 111 10.8 (6.318.0)
c
AkaroloAnthony 2013 (Abuja) 108 10.2 (5.817.3)
Manga 2015c 108 43.5 (34.652.9)
0% 10% 20% 30% 40% 50% 60% 70%

95% CI: 95% Confidence Interval; N: number of women tested;
The samples for HPV testing come from cervical specimens (fresh/fixed biopsies or exfoliated cells). The small triangle points HPV prevalence, the line represents the 95% confidence interval
and the shadowed square is proportional to the sample size.
a Zeralda (Algiers)


b Abomey, Atakora, Cotonou, Djougou, Lagune, Lokossa, Parakou, Porto-Novo and Tanguet
c Women from the general population, including some with cytological cervical abnormalities
d HIV negative women (controls of women with HSIL)
e HIV negative women (controls of women with LSIL)
f Mbuku, Kinshasa
g Okene, Abuja and Katari

Figure 33: Prevalence of HPV among women with normal cervical cytology in Africa by country and
study (continued)

Rwanda Sinayobye 2014a 3060 1,311 8.2 (6.89.8)
a
Singh 2009 >=25 188 14.4 (10.120.1)
Veldhuijzen 2012 (Kigali)a 144 16.7 (11.523.6)
Senegal Hawes 2003 (Dakar)a >=15 3,633 25.3 (23.926.7)
Hanisch 2013 (Dakar)a 1584 2,139 27.1 (25.229.0)
Xi 2003 (Dakar) 3580 1,639 12.5 (11.014.2)
Mbaye 2014 (Dakar) 1880 498 20.9 (17.524.7)
Mbaye 2014 (This) 1880 185 30.3 (24.137.2)
Astori 1999 (Dakar) 2075 158 13.9 (9.420.2)
Mbaye 2014 (SaintLouis)a 1880 145 20.0 (14.327.2)
Mbaye 2014 (Louga) 1880 108 23.1 (16.231.9)
South Africa McDonald 2012 (Khayelitsha) 1765 7,569 16.9 (16.117.8)
Denny 2005 (Khayelitsha)a 3565 6,555 21.4 (20.422.4)
a,b 1683 1,445 74.6 (72.376.8)
Richter 2013
Wright 2000 (Cape Town) 3565 1,269 15.5 (13.617.6)
Allan 2008 (Cape Town) 2159 848 20.4 (17.823.2)
a
Giuliano 2015 1624 391 71.4 (66.775.6)
Jones 2007 (Cape Town) >=18 368 41.0 (36.146.1)
a
Mbulawa 2015 1866 207 36.7 (30.443.5)
Tanzania Dartell 2014c 1582 2,737 12.8 (11.614.1)
Vidal 2011 (Kilimanjaro) >=18 148 13.5 (8.920.0)
WatsonJones 2013 (Mwanza) 1025 117 73.5 (64.980.7)
Tunisia Guettiti 2014 1869 573 3.8 (2.55.7)
Hassen 2003 (Sousse) 2045 96 14.6 (8.923.0)
Uganda Jeronimo 2014 (Kampala) 2560 2,676 15.2 (13.916.7)
Banura 2008 (Kampala)a 1224 868 73.2 (70.176.0)
Safaeian 2007 (Rakai)a 1549 505 15.6 (12.719.1)
a
Asiimwe 2008 (Bushenyi District) 2537 305 15.7 (12.120.2)
Odida 2011 (Kampala) 1874 251 26.3 (21.232.1)
a
Moses 2015 3065 248 29.4 (24.135.4)
Taube 2010 (Kampala) 1830 157 56.7 (48.964.2)
Zimbabwe a,d 1849 1,987 24.5 (22.626.4)
Fukuchi 2009
a,e
Nowak 2011 1835 478 47.5 (43.152.0)
Womack 2000e 2555 186 24.7 (19.131.4)
a
Baay 2004 (Mupfure) 1549 174 27.0 (21.034.1)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

a Women from the general population, including some with cytological cervical abnormalities
b Tshwane District, Gauteng province
c Dar es Salaam, Pwani, Mwanza
d Chitungwiza, Epworth (Harare)
e Chitungwiza and Harare

Figure 34: Prevalence of HPV among women with normal cervical cytology in the Americas by country
and study

Argentina Matos 2003 (Entre Ros) 1378 843 15.4 (13.118.0)
Chouhy 2013a 1477 403 37.5 (32.942.3)
Chouhy 2013 (Buenos Aires) 1569 371 49.9 (44.854.9)
Abba 2003 (La Plata) 1570 152 46.1 (38.354.0)
Badano 2011 (Posadas City) 1862 139 33.1 (25.841.3)
Belize Cathro 2009 (Belize City) 426 10.1 (7.613.3)
Bolivia b,c 1671 135 5.9 (3.011.3)
Cervantes 2003
Brazil Trottier 2006 (Sao Paulo) 1859 1,988 15.1 (13.616.7)
Lorenzi 2013d 1877 1,921 10.5 (9.211.9)
e
Girianelli 2010 2559 1,800 12.3 (10.913.9)
RoteliMartins 2011c 1525 1,509 29.7 (27.432.0)
Magalhes 2015 1464 1,006 25.7 (23.128.5)
Carestiato 2006 (Rio de Janeiro) 1170 672 12.6 (10.315.4)
c
Oliveira 2007 (Pacoti, Ceara) 1349 579 11.7 (9.414.6)
Franco 1995 (Paraiba)c 1565 525 18.3 (15.221.8)
Tomita 2010 2165 453 28.5 (24.532.8)
Noronha 2005 (Para) 3045 433 6.9 (4.99.7)
c
Figueiredo Alves 2013 (Goiana) 1519 432 28.0 (24.032.4)
f 1583 418 6.7 (4.79.5)
da Silva 2012
Miranda 2012g 1865 399 11.0 (8.314.5)
Chagas 2015 390 55.4 (50.460.2)
de Abreu 2012h 1583 370 7.6 (5.310.7)
Augusto 2014 (Niteri City) 1479 338 8.0 (5.511.4)
Coser 2013 (Cruz Alta) 1382 327 32.1 (27.337.4)
Rocha 2013i 1878 314 29.9 (25.135.2)
Pinto 2011 (Par)c >=13 233 15.0 (11.020.2)
Caixeta 2015 1525 227 42.3 (36.048.8)
Vieira 2015 1855 227 23.3 (18.329.3)
Oliveira 2010j 1426 225 28.0 (22.534.2)
Lorenzato 2000 (Recife) 1384 215 19.5 (14.825.3)
Pinto 2011 (Tucuru) >=13 211 14.2 (10.119.6)
Lippman 2010 (Sao Pulo) 1840 209 34.9 (28.841.6)
Muoz 1996 (Sao Paulo) 2677 194 17.0 (12.422.9)
c
Campos 2014 (Campo Grande) 1865 169 23.1 (17.430.0)
de Oliveira 2013 (Rio Grande)c >=14 162 13.6 (9.119.7)
Cassel 2014 (Porto Alegre) 158 12.7 (8.318.7)
Entiauspe 2014 (Pelotas) 1845 136 27.9 (21.136.0)
Silva 2009 (Maric) 1479 130 2.3 (0.86.6)
Silva 2009 (Itabora) 1479 128 21.9 (15.629.8)
TamegoLopes 2014k 120 35.0 (27.143.9)
0% 10% 20% 30% 40% 50% 60% 70%

a Granadero Baigorria City (Santa Fe Province)


b Amazonian lowland
d Barretos (Sao Paulo)
e Duque de Caxias and Nova Iguau (State of Rio de Janeiro)
f Paiand (Paran)
g Ouro Preto city (Minas Gerais)
h Maring, Paiand and Uniao da Vitoria (Paran State)
i Coari (Amazonas State)
j Niteri City (Rio de Janeiro)
k Juruti (Par)

and study (continued)

Brazil Fernandes 2009 (Natal) 1565 110 24.5 (17.533.4)
Canada Louvanto 2014 (Montreal)a 3065 23,739 6.9 (6.67.3)
b
Jiang 2013 1469 13,379 21.6 (20.922.3)
Mayrand 2006c 3069 9,245 5.2 (4.75.6)
a
Ogilvie 2013 (British Columbia) 4,330 12.2 (11.313.3)
Moore 2009 (British Columbia) >=15 4,003 12.3 (11.313.3)
Young 1997 (Winnipeg) 1,132 30.6 (28.033.3)
Sellors 2000 (Ontario) 1549 878 10.3 (8.412.4)
Richardson 2003 (Montreal) 1742 568 27.1 (23.630.9)
Demers 2012 (Manitoba) >=18 517 17.2 (14.220.7)
Kapala 2007 (Ontario) 222 15.8 (11.621.1)
RoteliMartins 2011 1525 185 23.2 (17.729.8)
Chile Ferreccio 2013 (Santiago) 1678 8,127 9.8 (9.110.4)
a
Ferreccio 2008 1697 1,100 28.0 (25.430.7)
Ferreccio 2004 (Santiago) 1586 913 11.2 (9.313.4)
Montalvo 2011 (Arica) 1825 195 2.6 (1.15.9)
Colombia Molano 2002 (Bogota) 1385 1,831 14.6 (13.116.3)
SotoDe Leon 2011d 1477 1,564 49.7 (47.252.2)
Camargo 2014 (Bogot)a 1476 1,159 44.3 (41.447.1)
Leon 2009 (Girardot) 1480 744 19.9 (17.222.9)
Muoz 1996 (Cali) 1974 307 13.4 (10.017.6)
Costa Rica Herrero 2005 (Guanacaste) 1894 7,459 22.4 (21.423.3)
Safaeian 2007 (Guanacaste) 1825 4,857 42.2 (40.943.6)
Cuba Soto 2014 (La Havana) 3069 111 41.4 (32.750.7)
Ecuador Brown 2009 (Guayas) 1878 285 20.7 (16.425.8)
Cecchini 2009 2172 249 2.0 (0.94.6)
Guatemala Valls 2009 (Escuintla) 1849 274 33.2 (27.939.0)
Guyana Kightlinger 2010 1380 1,168 11.5 (9.813.4)
Haiti Walmer 2013a,e 2560 9,769 19.0 (18.319.8)
Mandigo 2015 3050 426 12.7 (9.816.2)
Honduras Tbora 2009 (Tegucigalpa) 1865 562 51.4 (47.355.5)
Ferrera 1999 (Tegucigalpa) 1565 438 38.8 (34.443.5)
Ferrera 2011 (Tegucigalpa)a 1835 393 44.8 (39.949.7)
Tbora 2005 (Tegucigalpa) 1835 100 28.0 (20.137.5)
Jamaica LewisBell 2013 1649 765 50.8 (47.354.4)
Watt 2009 (Western Jamaica)a 99 83.8 (75.389.8)
Mexico f 2070 49,053 8.0 (7.88.3)
LazcanoPonce 2010
Salmern 2003 (Morelos) 1585 7,545 7.8 (7.28.4)
g
IlladesAguiar 2010 1597 3,117 40.9 (39.242.6)
LazcanoPonce 2001 (Morelos) 1882 1,340 12.5 (10.914.4)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%



b Northwest Territories, Nunavut, Labrador, Yukon.
c Montreal and Newfoundland
d Bogot, Leticia, Chaparral, Giradot and Tumaco
e Port-au-Prince, Leogane
f Northern and Southern Mexico City, State of Mexico,Guerrero, Michoacn, Morelos, Jalisco, Nuevo Len,Oaxaca, Quertaro, Veracruz and Yucatn
g Acapulco, Chilpancingo and Iguala (State of Guerrero)


Mexico a,b 1739 1,060 14.2 (12.316.5)
HernndezGirn 2005
Salcedo 2014 1870 1,020 33.7 (30.936.7)
Giuliano 2001 (Sonora) 1579 995 8.8 (7.210.8)
Lpez Rivera 2012 (Mexico City) 1876 916 7.9 (6.39.8)
CarrilloGarca 2014 1774 518 37.8 (33.842.1)
Parada 2010 (State of Mexico)b 1875 504 13.7 (11.017.0)
c
SnchezAnguiano 2006 2069 487 4.1 (2.76.3)
AguilarLemarroy 2015 1887 356 12.4 (9.316.2)
OrozcoColn 2010b,d 1881 336 49.7 (44.455.0)
OrozcoColn 2010 (Acapulco) 1881 335 37.6 (32.642.9)
Monroy 2010 (Mexico City) 1751 272 12.9 (9.417.4)
Giuliano 2005 (Sonora) 4082 258 7.0 (4.510.8)
IlladesAguiar 2009 (Acapulco) 256 35.5 (29.941.6)
HernndezAvila 1997b,e 2575 204 13.2 (9.318.6)
Rojo Contreras 2008f 1855 189 33.9 (27.540.9)
Nicaragua Jeronimo 2014 (Masaya Province) 3049 4,340 9.8 (8.910.7)
Paraguay Mendoza 2011 (Asuncin) 1677 207 20.8 (15.826.8)
Torres 2009 (Asuncin) 1765 159 25.2 (19.132.4)
Roln 2000 (Asuncin) 2573 91 19.8 (12.929.1)
Peru Almonte 2007 (San Martin) 2549 4,218 7.5 (6.88.4)
b,g 1779 2,247 34.5 (32.636.5)
Iwasaki 2014
Garca 2004 1865 501 3.8 (2.45.8)
SilvaCaso 2014 (Cajamarca) 1865 241 17.8 (13.523.2)
h 203 36.0 (29.742.8)
Martorell 2012
Santos 2001 (Lima) 2182 175 17.7 (12.824.0)
b
Suriname Geraets 2014 (Paramaribo) >=18 813 54.2 (50.857.6)
Geraets 2014 2537 813 54.2 (50.857.6)
b
Trinidad & Tob. AndallBrereton 2011 (North) 1865 310 40.6 (35.346.2)
Ragin 2007 (Tobago) 1865 212 35.4 (29.342.0)
USA Cuzick 2015 1565 1,145,450 10.9 (10.911.0)
Castle 2009i 3090 580,289 4.0 (3.94.0)
Monsonego 2015 (23 states) >=25 38,284 9.0 (8.79.3)
Wheeler 2013 (New Mexico) 33,614 24.3 (23.824.8)
Sherman 2003 (Portland) 1694 20,156 12.7 (12.313.2)
b
Castle 2012 (Portland) 1694 19,512 14.2 (13.714.7)
Schiffman 2011 (Portland) 1694 18,450 9.1 (8.79.6)
j 1129 9,231 30.2 (29.331.2)
Dunne 2013
Zhao 2007 (Pittsburgh) 1190 8,070 2.9 (2.53.2)
k 1865 8,055 16.6 (15.817.4)
Datta 2008
Goodman 2008 (Hawaii) 1885 2,356 25.6 (23.927.4)
0% 10% 20% 30% 40% 50% 60%

a Cuernavaca


b Women from the general population, including some with cytological cervical abnormalities
c Durango City
d Lzaro Crdenas
e Mexico City
f Guadalajara
g Iquitos, Cajamarca, Piura, Chiclayo, Lima, Arequipa, Cuzco and Juliana
h Iquitos and Loretos
i Northern California
j San Francisco Bay, Sacramento, Central Valley, Northwest Oregon and Southwest Washington Areas
k Boston, Baltimore, New Orleans, Denver, Seattle, Los Angeles


a
USA Dunne 2007 1459 1,921 26.8 (24.828.8)
Insinga 2007 1623 1,203 12.1 (10.414.1)
Cibas 2007 (Boston) 3045 1,000 3.9 (2.95.3)
Giuliano 1999 (Tucson) 1847 911 10.1 (8.312.2)
Giuliano 2001 (Arizona) 1579 881 12.8 (10.815.2)
Winer 2003 (Seattle)a 1820 553 19.7 (16.623.2)
Moscicki 2001 (San Francisco) 1324 547 80.8 (77.383.9)
Khanna 2007 (Baltimore) 1869 418 10.8 (8.114.1)
Kahn 2008 (Cincinnati)a 1326 409 68.2 (63.672.5)
Kotloff 1998 (Maryland) 1744 390 29.2 (24.933.9)
Evans 2006 (Vermont) 1669 300 27.3 (22.632.6)
Swan 1999 (Texas) 1845 270 20.0 (15.725.2)
Smith 2003 (Iowa) 4285 223 11.7 (8.116.5)
Tarkowski 2004 (Atlanta) 1220 189 52.4 (45.359.4)
Hernandez 2004 (Hawaii) >=18 183 9.8 (6.315.0)
Chaturvedi 2005 (New Orleans) 1870 173 19.1 (13.925.6)
Smith 2004 (Iowa) 4564 105 17.1 (11.125.5)
Uruguay Berois 2014 (Montevideo) 2176 883 20.0 (17.522.8)
Ramas 2013 1862 236 19.1 (14.624.6)
Venezuela Tllez 2015 1569 409 37.4 (32.942.2)
Michelli 2013 1569 238 22.3 (17.428.0)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%


Figure 38: Prevalence of HPV among women with normal cervical cytology in Asia by country and study

Bahrain Hajjaj 2006 2060 91 12.1 (6.920.4)
Bangladesh Nahar 2014 (Dhaka and Mirzapur)a 1364 1,902 7.6 (6.58.9)
Bhutan Tshomo 2014 (Thimphu) 1673 2,272 23.0 (21.324.7)
China Wei 2014b 1881 67,172 1.7 (1.61.8)
Chen 2012 (Chaozhou)a 3560 48,559 7.9 (7.78.1)
a,b
Wang 2012 1860 24,041 45.6 (45.046.2)
c
Mai 2014 >=18 22,114 19.0 (18.519.5)
a
DU 2012 (Shenzhen) 2059 10,017 16.3 (15.617.0)
Zhang 2013 (Shangai)a 1789 10,000 12.6 (11.913.2)
Belinson 2011d 2559 7,525 7.9 (7.38.5)
e
Moy 2010 3054 7,367 9.5 (8.910.2)
Zhao 2013f 2565 7,089 10.9 (10.211.7)
Belinson 2003g 2756 6,643 14.4 (13.615.3)
Zhang 2008 (Shangai)a 1878 6,405 29.1 (28.030.2)
a,h 1865 5,936 8.3 (7.69.1)
Sun 2012
Li 2010 (Beijing) 2554 5,530 6.6 (6.07.3)
Zhao 2014 (Jiangsi Province) 1825 5,416 13.3 (12.514.3)
Ye 2010 (Zhejiang Province)a 2079 4,987 13.3 (12.414.3)
Wang 2013 (Shenzhen)a >=15 4,413 13.8 (12.814.8)
i 1754 3,737 8.9 (8.09.9)
Wu 2013
Li 2013 (Hunan Province) 1774 3,115 14.5 (13.315.8)
Yuan 2011 (Shandong Province) 2061 3,112 9.6 (8.610.7)
j 1965 2,847 7.4 (6.58.4)
Jin 2010
Chan 2009 (Hong Kong) 1583 2,571 5.7 (4.86.6)
Chen 2013 (Urumqi)a 1869 2,269 20.3 (18.722.0)
Qiao 2008k 3055 2,168 10.4 (9.211.8)
a,l 2559 2,000 16.5 (14.918.2)
Wu 2010
Chan 2002 (Hong Kong) 1983 1,962 5.6 (4.66.7)
h 3545 1,784 14.2 (12.615.9)
Belinson 2001
Lin 2008 (Guandong)a 2068 1,705 9.0 (7.810.5)
a
Yip 2010 (Macao) 2060 1,600 8.8 (7.510.2)
Lu 2015 (Beijing)a 1,160 40.5 (37.743.4)
Yeoh 2006 (Hong Kong) 1,090 25.7 (23.228.4)
Zhang 2012a,m 2064 1,032 11.1 (9.413.2)
Wu 2007 (Shenzhen) 1559 942 11.9 (10.014.1)
Sui 2013a,n 1659 883 8.8 (7.110.9)
Ye 2010o 2565 734 20.2 (17.423.2)
Li 2006 (Shenyang) 1759 663 13.7 (11.316.6)
Dai 2006 (Shanxi) 1959 601 10.6 (8.413.4)
a
Wang 2014 (Luoyang (Henan)) 1779 578 44.5 (40.548.5)
0% 10% 20% 30% 40% 50%

b Shenyang (Liaoning Province)
c Shantou City (Guandong Province)


d Guangdong Province
e Shanxi, Jiangxi and Gansu Provinces
f Yangcheng, Xinmi and Tonggu
g Yangcheng and Xiangyuan (Shanxi)
h Qujing (Yunnan Province)
i Beijing, Shanghai, Shanxi, Henan, Xinjiang
j Tibetan Autonomous Region
k Wuxiang and Xiangyuan (Shanxi Province)
l Shenzhen (Guangdong Province)
m Wufeng County (Hubei Province)
n Uyghur (Yutian County, Xingjian Province)
o Lishui County (Zhejiang Province)

(continued)

China He 2008 (Hangzhou) 480 15.2 (12.318.7)
Chui 2012 (Macau)a 2066 402 29.9 (25.634.5)
Bian 2013 (Beijing) 2055 379 20.8 (17.125.2)
Yu 2013a,b 2060 373 12.6 (9.616.4)
Wu 2010 (Fujian Province) 2070 314 19.4 (15.424.2)
Wang 2013 (Huzhou)a 2035 292 19.2 (15.124.1)
Hu 2011 (Jaingsu Province) 1825 257 10.5 (7.314.9)
Ding 2014 (Beijing) 1868 165 9.7 (6.115.2)
Sun 2010 (Liaoning Province) 165 21.8 (16.228.7)
Georgia Alibegashvili 2011 (Tbilisi) 1559 1,247 11.5 (9.813.4)
India Basu 2013 (West Bengal)a 3065 28,039 5.8 (5.56.1)
a,c
Sankaranarayanan 2005 3059 27,301 10.3 (9.910.7)
Mittal 2014 (Kolkata)a 3060 9,630 4.6 (4.25.0)
d
Jeronimo 2014e 3060 4,547 2.3 (1.92.8)
Jeronimo 2014 (Hyderabad) 3049 4,385 4.4 (3.95.1)
Sankaranarayanan 2004f 2565 4,332 4.8 (4.25.5)
g
Sankaranarayanan 2004 (Mumbai) 2565 3,365 6.3 (5.57.1)
Srivastava 2012 (Varanasi)a 1780 2,480 9.7 (8.610.9)
Gravitt 2010a,h >=25 2,331 10.3 (9.111.6)
Dutta 2012 (Eastern India) 2565 2,313 9.2 (8.110.4)
Franceschi 2005 (Tamil Nadu) 1759 1,799 14.0 (12.515.7)
a,i 1624 1,300 11.2 (9.613.0)
Datta 2010
j
Sarkar 2011 (West Bengal) >=15 1,106 9.1 (7.611.0)
Laikangbam 2007 (West Bengal) 1480 1,007 11.6 (9.813.7)
Pandey 2012 (Lucknow)a 2070 890 11.7 (9.714.0)
Gupta 2009 (New Delhi) 1845 769 16.6 (14.219.4)
Laikangbam 2007 (Manipur) 2080 672 6.7 (5.08.8)
Aggarwal 2006 (Chandigarh) 1975 472 36.9 (32.641.3)
Kerkar 2011 (Mumbai) 470 8.1 (5.910.9)
Bhatla 2008 (New Delhi) 3065 458 7.6 (5.510.4)
Laikangbam 2007 (Sikkim) 1975 359 11.1 (8.314.8)
Vinodhini 2012 (Tamil Nadu) 257 30.4 (25.136.2)
k
Kashyap 2013 4658 207 5.8 (3.39.9)
Arora 2005 (New Delhi) 2060 160 10.0 (6.215.6)
Singh 2009 (North India) 109 10.1 (5.717.2)
Indonesia Vet 2008 (Tasikmalaya) 1270 919 8.8 (7.110.8)
Vet 2008 (Bali) 1270 887 11.5 (9.613.8)
Vet 2008 (Jakarta)a 1270 880 13.9 (11.716.3)
0% 10% 20% 30% 40% 50%



b Shiquan County (Shaanxi Province)
c Osnamabad
d Kolkata (2)
e Rural Uttar Pradesh
f Trivandrum
g Kolkata (1)
h Medchal Mandal (Andhra Pradesh)
i Govindpuri (New Delhi)
j Few HPV types tested: 16, 18 only
k Few HPV types tested: 16 only

(continued)

Indonesia de Boer 2006 (Jakarta) 2175 200 31.0 (25.037.7)
Rachmadi 2012a 1860 101 16.8 (10.825.3)
b
Iran Eghbali 2012 (Bushehr Port) 1750 799 0.6 (0.31.5)
Khodakarami 2012 (Tehran) 1859 791 6.6 (5.08.5)
Zavarei 2008 (Tehran) 1555 600 5.7 (4.17.8)
Safaei 2010 (Shiraz) 2072 400 5.5 (3.78.2)
b
Shahramian 2011 (Zabol) 265 32.5 (27.138.3)
Moradi 2011 (Gorgan) 1575 226 18.1 (13.723.7)
b
Zandi 2010 (Bushehr) 200 5.5 (3.19.6)
Japan Inoue 2006 (Ishikawa) 1494 7,564 6.6 (6.07.2)
Maehama 2005 (Okinawa) 2089 4,078 10.6 (9.711.6)
Asato 2004 (Okinawa) 1885 3,249 10.2 (9.311.3)
Takehara 2011c 1598 2,068 9.4 (8.210.7)
d
Sasagawa 2001 1672 1,562 9.7 (8.311.2)
Onuki 2009 (Ibaraki) 1578 1,517 22.5 (20.524.7)
Chen 2013 (Nagasaki)b 1,111 18.2 (16.020.6)
e
Konno 2011 1925 908 26.1 (23.329.1)
Saito 1995 (Osaka) 1872 800 6.6 (5.18.6)
f
Sasagawa 1997 1682 778 4.5 (3.36.2)
Sasagawa 2005 (Hokuriku) 1559 637 16.8 (14.119.9)
Ishi 2004 (Chiba) 1773 420 12.1 (9.415.6)
Masumoto 2004 (Tokyo) 2089 414 16.9 (13.620.8)
Nishiwaki 2008 1970 292 14.7 (11.119.2)
Yoshikawa 1999 <=55 130 14.6 (9.621.7)
Satoh 2013 (Tsukuba, Tokyo) 1988 109 23.9 (16.832.7)
b
Kazakhstan Buleshov 2011 (South) 3560 17,000 11.0 (10.511.5)
Kuwait AlAwadhi 2011 1881 3,011 2.4 (1.93.0)
b
Lebanon Mroueh 2002 (Beirut) 1870 1,026 4.9 (3.76.4)
Karam 2005 2067 246 10.2 (7.014.6)
Malaysia Tay 2009 (Johor and Singapore) 1877 745 22.0 (19.225.1)
Othman 2014g 1983 588 3.1 (1.94.8)
b
Chong 2010 (Southern Selangor) 1969 180 46.7 (39.553.9)
Mongolia Dondog 2008 (Ulaanbaatar) 1559 842 30.5 (27.533.7)
h
Chimeddorj 2008 100 1.0 (0.25.4)
i
Nepal Sherpa 2010 1659 898 8.1 (6.510.1)
Johnson 2014j 1660 211 2.8 (1.36.1)
Pakistan Raza 2010 (Karachi) 1559 877 2.2 (1.43.4)
Philippines Ngelangel 1998 (Manila) 2172 377 9.3 (6.812.6)
Rep. Korea Lee 2012b 1879 60,775 34.2 (33.834.6)
Lee 2012 (Suwon) 26,980 20.3 (19.920.8)
0% 10% 20% 30% 40% 50% 60%

a Jakarta, Tasikmalaya and Bali


c Few HPV types tested: 16, 18, 52, 58 only
d Hokuriku(Fukui, Ishikawa and Toyama)
e Aomori, Tokyo, Fukui, Osaka, Hiroshima, Miyazaki and Kagoshima
f Ishikawa and Toyama
g North-Eastern region os West Malaysia
h Few HPV types tested: 16 only
i Bharatpur (Chitawan Province)
j Sanphebagar Village (Achham District)

(continued)

Rep. Korea Kim 2012 (Seoul) 11,800 6.2 (5.86.6)
Kim 2013 (Seoul) 6,681 17.3 (16.418.2)
Kim 2014 (Cheonan)a 1978 5,494 14.4 (13.515.3)
Oh 2009 (Busan and Suwon) 2069 4,467 7.0 (6.37.8)
Bae 2009 (Gyeonggi, Seoul) 3084 4,111 6.5 (5.87.3)
Kim 2013 (Seoul) 2176 2,146 18.1 (16.619.8)
Park 2014 2883 1,903 13.2 (11.814.8)
Bae 2009a 1575 1,750 27.0 (25.029.2)
Hwang 2004 1862 1,609 37.4 (35.039.7)
Kim 2012 2575 1,214 14.6 (12.716.7)
Oh 2001 (Seoul) 2372 1,144 0.7 (0.41.4)
An 2003 (Kyonggido) 1,143 35.1 (32.437.9)
Lee 2014 (Seoul, Busan, Cheonan)a 2579 912 7.9 (6.39.8)
a
Kim 2010 2059 902 12.6 (10.615.0)
b 2059 902 4.9 (3.76.5)
Kim 2012
Shin 2003 (Busan) 2074 821 8.5 (6.810.6)
Kim 2014 (Gangnam (Seoul))a 2581 799 12.1 (10.114.6)
Lee 2003 (Seoul) 746 7.2 (5.69.3)
Shin 2004 (Busan)a 1629 672 15.2 (12.718.1)
Cho 2011a 624 47.3 (43.451.2)
Bae 2014 (Seoul) 1885 471 21.0 (17.624.9)
Cho 2003 (Kyonggido) 2270 414 31.9 (27.636.5)
a
Kim 2014 (Busan) 2283 315 70.2 (64.974.9)
Shim 2010 (Seoul) 2148 235 22.6 (17.728.3)
Kim 2013 (Gwangju) 206 8.3 (5.212.8)
Hwang 2012a 2177 177 54.8 (47.462.0)
Um 2011 122 23.0 (16.431.2)
Lee 2011 101 20.8 (14.029.7)
Saudi Arabia AlAhdal 2014 (Riyadh) 2074 455 28.6 (24.632.9)
Taiwan Lai 2012 (Taoyuan) 3094 14,724 11.0 (10.611.6)
Wang 2010a,c 1487 10,543 15.0 (14.315.7)
d 3065 10,190 13.8 (13.214.5)
Chen 2011
Lin 2006 (South Taiwan)a 1678 4,383 19.4 (18.220.6)
Huang 2008 2380 1,310 8.2 (6.99.9)
Jeng 2005 (Taipei) 2165 1,279 17.9 (15.920.1)
Liaw 1995 3064 260 9.2 (6.313.4)
Tsai 2005 (Kaohsiung County) >=20 175 16.6 (11.822.8)
Lin 2005 (Kaohsiung) 127 15.0 (9.822.2)
Thailand Swangvaree 2010 (Bangkok) 2077 14,205 6.2 (5.86.6)
Laowahutanont 2014 (Bangkok) >=20 2,735 6.7 (5.87.7)
0% 10% 20% 30% 40% 50% 60% 70% 80%



b Few HPV types tested: 6, 11, 42, 43, 44 only
c Taipei, Taoyuan, Chungli, Hsinchu, Keelung)
d Sanchi, Chutung, Potzu,Kaoshu, Makung, Paihsa and Huhsi

(continued)

Thailand Siriaunkgul 2014 (Chiang Mai) 3060 2,633 4.3 (3.55.1)
Paengchit 2014a 3070 1,961 4.0 (3.25.0)
Chansaenroj 2010 (Bangkok) 1,622 7.8 (6.69.2)
Marks 2011b,c 2037 1,070 19.8 (17.522.3)
Sukvirach 2003 (Lampang) 1576 972 5.9 (4.67.5)
Sukvirach 2003 (Songkla) 1585 687 3.3 (2.25.0)
c
Wongworapat 2008 (ChiangMai) 2065 531 11.5 (9.014.5)
Chandeying 2006c,d 1547 430 4.7 (3.07.1)
c
Thomas 2001 (Bangkok) 2460 291 6.9 (4.510.4)
Chichareon 1998 (Songkla) 1978 261 15.7 (11.820.6)
Suwannarurk 2009 (Pathumthani)e 225 28.9 (23.435.1)
Natphopsuk 2013 (Khon Kaen) 2681 198 14.1 (10.019.7)
Chopjitt 2009 (Khon Kaen) 160 33.8 (26.941.4)
Ekalaksananan 2010 (Khon Kaen) 1854 155 40.6 (33.248.5)
Chaiwongkot 2007 (Khon Kaen) 140 38.6 (30.946.8)
Sriamporn 2006 (Khon Kaen) >=35 113 10.6 (6.217.6)
Siritantikorn 1997 (Bangkok) 1677 102 4.9 (2.111.0)
f 2570 100 13.0 (7.821.0)
SettheethamIshida 2005
Turkey Inal 2007 (Izmir) 1545 1,344 1.5 (1.02.3)
Yuce 2012 (Ankara) 3070 640 21.4 (18.424.7)
Ozalp 2012 (Eskisehir region) 564 3.4 (2.25.2)
Kasap 2011 (Izmir) 1565 546 32.1 (28.336.1)
Demir 2012g 1568 530 17.9 (14.921.4)
Sahiner 2014 1781 517 22.4 (19.126.2)
Bayram 2011 (Gaziantep) 1856 502 15.1 (12.318.5)
zcan 2011 1664 480 3.5 (2.25.6)
Eren 2010 (Istanbul) 1985 469 13.6 (10.817.0)
c
Altun 2011 (Adana) 2068 460 5.2 (3.57.6)
Akcali 2013 (Manisa)c 410 8.5 (6.211.6)
Tezcan 2014 (Mersin Province) 1876 380 18.9 (15.323.2)
Sahiner 2014 (Ankara)c 1774 315 19.7 (15.724.4)
Dursun 2009 2067 310 19.7 (15.624.5)
Oztrk 2004 1862 192 2.1 (0.85.2)
Uzbekistan Inamova 2009 (Tashkent) 1840 2,295 37.9 (35.939.9)
Viet Nam Vu 2012 (Can Tho)c 1865 1,000 10.2 (8.512.2)
Vu 2012 (Hue)c 1869 1,000 8.6 (7.010.5)
Vu 2012 (Thai Nguyen) 1869 1,000 9.2 (7.611.2)
Pham 2003 (Hanoi) 1569 983 1.5 (0.92.5)
Pham 2003 (Ho Chi Minh City) 1569 914 9.6 (7.911.7)
Vu 2011 (Ho Chi Minh)c 1869 750 8.3 (6.510.5)
0% 10% 20% 30% 40% 50%

a Lampang Province


b Chiang Mai, Khon Kaen, Bangkok, Songkla and Hat Yai
d Hat Yai (South Thailand)
e Few HPV types tested: 16, 18, 31, 33 only
f Khon Kaen
g Istanbul, Ankara, Antalya, Nigde and Elazig

(continued)
Viet Nam Vu 2011 (Hanoi) 1869 750 6.1 (4.68.1)
0% 10%


Figure 44: Prevalence of HPV among women with normal cervical cytology in Europe by country and
study

Belarus Rogovskaya 2013 (Minsk) 1563 322 23.6 (19.328.5)
Belgium Depuydt 2010 (Flanders)a 1497 57,876 14.8 (14.515.1)
Arbyn 2009 (Antwerp) 1585 8,729 11.9 (11.312.6)
Merckx 2014a,b 418 4,180 15.7 (14.616.8)
Baay 2005 (Antwerp) 2050 2,293 6.9 (5.98.0)
Depuydt 2012 3070 1,142 8.4 (6.910.2)
Schmitt 2013 (Flanders) 1586 913 33.3 (30.336.4)
Weyn 2013 (Brussels) >=20 906 10.8 (9.013.0)
Depuydt 2003 (Flanders) 1785 287 24.0 (19.529.3)
Baay 2001 (Antwerp) 1778 286 10.8 (7.715.0)
Bulgaria Kovachev 2013a,c 1555 1,120 38.8 (36.041.7)
Croatia Kaliterna 2013 (Dalmatia County)a 1758 1,160 35.0 (32.337.8)
Kaliterna 2007a,d 1862 570 35.1 (31.339.1)
Grahovac 2007 (Zagreb,Rijeka) 205 35.6 (29.442.4)
Czech Rep. Tachezy 2013 1479 1,302 25.6 (23.328.0)
Denmark Kjr 2014 (Copenhagen)e 1495 37,958 20.4 (20.020.8)
Nielsen 2008 (Copenhagen) 2029 10,220 15.9 (15.216.6)
f 1688 4,642 33.3 (32.034.7)
Bonde 2014
Nielsen 2008 (Copenhagen) 4050 1,443 4.4 (3.45.5)
Svare 1998 2039 119 21.8 (15.430.1)
Estonia Uuskla 2010 (Tartu)a 1835 326 36.8 (31.842.2)
Europe Joura 2015 1626 13,862 27.5 (26.728.2)
Paavonen 2008g 1624 9,162 15.9 (15.216.7)
Finland Malila 2013a 2565 66,457 7.9 (7.78.1)
a
Auvinen 2005 (Helsinki) 1947 1,469 33.0 (30.735.5)
France Clavel 2001 (Reims) 1576 7,339 10.5 (9.911.3)
Monsonego 2011 (Paris) 2065 4,004 12.6 (11.613.7)
Boulanger 2004 (Amiens) 2062 3,617 12.6 (11.613.7)
Heard 2013h 1688 3,023 18.1 (16.819.5)
Vaucel 2011 (Nantes) 1786 980 13.1 (11.115.3)
Baudu 2014 (FrancheComt) 1523 948 24.1 (21.426.9)
Dalstein 2003 (Besanon) 1676 652 27.0 (23.730.5)
Haguenoer 2014 2065 634 15.6 (13.018.6)
BebyDefaux 2004 (Poitiers) 1777 613 5.2 (3.77.3)
i 1676 426 25.1 (21.229.4)
Riethmuller 1999
Casalegno 2011 (Lyon) 1588 302 48.3 (42.854.0)
PannierStockman 2008 (Amiens) 1878 289 28.7 (23.834.2)
Monsonego 2005 (Paris) 1979 221 28.5 (23.034.8)
Germany Luyten 2014 (Wolfsburg) 23,093 6.8 (6.57.2)
Petry 2003j 3085 7,832 5.9 (5.46.4)
0% 10% 20% 30% 40% 50% 60%



b Flanders and Brussels
c Sofia, Plovdiv, Varna, Burgas, Pleven and Vidin
d Split and Dalmatian County
e HPV prevalence for high-risk HPV types
f Copenhagen and Frederiksberg
g Czech Republic, Denmark, England, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Netherlands, Norway, Poland, Portugal, Spain, and Sweden
h Alsace, Auvergne, Centre - Pays de Loire, Ile-de-France and Vaucluse
i Besanon, Belfort
j Hannover and Tuebingen

study (continued)

Germany Schneider 2000 (East Thuringia) 1870 4,604 7.1 (6.47.9)
Iftner 2010 1030 1,692 22.3 (20.424.3)
de Jonge 2013a >=20 1,463 29.8 (27.532.2)
Petry 2013 (Wolfsburg) 2527 659 25.5 (22.329.0)
b
Petry 2013 (Wolfsburg) 2022 599 27.5 (24.131.3)
Greece Agorastos 2014b 5,107 5.8 (5.26.5)
c
Agorastos 2015 2555 3,783 10.4 (9.511.4)
Argyri 2013 (Athens) 1470 2,218 15.7 (14.217.3)
Tsiodras 2011 1,348 39.5 (36.942.1)
d
Agorastos 2004 1769 1,272 2.0 (1.43.0)
Tsiodras 2010 (Athens) 2145 1,029 10.2 (8.512.2)
Paraskevaidis 2001 (Ioannina) 1779 738 6.4 (4.88.4)
Panotopoulou 2007 (Athens) 1848 639 26.4 (23.230.0)
Hungary Nyri 2006 2060 491 5.5 (3.87.9)
Ireland Anderson 2013 (Northern Ireland) 2064 5,068 13.2 (12.314.2)
Keegan 2007 (Dublin) 1672 886 11.4 (9.513.7)
b
Italy Del Mistro 2014 (Veneto) 2564 46,694 6.9 (6.77.1)
e
Carozzi 2014 2560 13,660 4.5 (4.24.9)
Agarossi 2009 1573 9,148 11.3 (10.712.0)
Giorgi Rossi 2011f 2564 3,151 9.7 (8.810.8)
Tenti 1997 (Pavia) 1647 1,064 12.3 (10.514.4)
Ronco 2005 (Turin) 2570 997 7.8 (6.39.7)
g
Giambi 2013 1826 907 13.6 (11.515.9)
Ammatuna 2008 (Sicily) 1824 894 22.4 (19.825.2)
b
Del Prete 2008 (Apulia) >=20 871 23.2 (20.526.1)
Verteramo 2009 (Rome) 1757 737 21.7 (18.924.8)
h 1626 566 18.2 (15.221.6)
Panatto 2013
Centurioni 2005 (Genova) 2081 500 15.4 (12.518.8)
Salfa 2011 (Asti) 2565 452 9.5 (7.112.6)
Sammarco 2013 (Molise) 1863 398 32.4 (28.037.2)
Barzon 2010 (Padova) 1774 333 40.8 (35.746.2)
Carozzi 2000 (Florence) 2564 332 5.1 (3.28.0)
Masia 2009 (Sardinia) 1846 309 17.8 (13.922.5)
Bellaminutti 2014b 305 40.0 (34.745.6)
Piana 2011 (North Sardinia) 1554 242 32.2 (26.738.4)
Zappacosta 2009 (Molise) 2164 220 6.4 (3.810.4)
Astori 1997 (Udine) 1867 197 20.3 (15.326.5)
Tornesello 2006 (Milan, Naples) 1863 183 19.7 (14.626.0)
Tornesello 2008 (Naples) 107 11.2 (6.518.6)
Latvia b 1889 237 8.0 (5.212.2)
Silins 2004
0% 10% 20% 30% 40% 50%

a Nordrhein-Westfalen, Niedersachsen, Schleswig-Holstein, Bremen and Hamburg


c Athens, Thessaloniki, Larissa, Patrasand Alexandroupolis
d Thessaloniki, Thermi, Mihaniona, Corfu, Veria and Serres
e Turin, Padua, Trento and Florence
f Abruzzo, Campania, Lazio, Sardinia and Sicily
g Abruzzo, Campania, Lazio, Tuscany, Emilia-Romagna and Piedmont
h Turin, Milan and Genoa

study (continued)

a
Lithuania Kliucinskas 2006 1850 1,001 25.1 (22.527.9)
Gudleviciene 2005 (Vilnius) 1664 332 24.1 (19.829.0)
Simanaviciene 2014 (Vilnius) 1881 277 24.2 (19.529.6)
Bumbuliene 2012 (Vilnius)a 1522 169 23.1 (17.430.0)
a
Montenegro Vujosevic 2012 (Podgorica) 2368 189 20.1 (15.026.4)
Netherlands Rijkaart 2012 (Utrecht) 2961 25,196 4.1 (3.84.3)
Bulkmans 2004 (Amsterdam) 3060 21,245 3.6 (3.33.9)
Rijkaart 2012 3056 19,373 4.0 (3.74.2)
Jacobs 2000 (Amsterdam) 1668 3,299 4.4 (3.85.2)
Rozendaal 2000 (Amsterdam) 3454 2,250 5.4 (4.56.4)
Lenselink 2008a,b 1829 2,065 19.0 (17.420.8)
Boers 2014 3060 900 3.8 (2.75.2)
Hesselink 2013 (Utrecht region) 3160 858 8.2 (6.510.2)
Zielinski 2001 (Zeeland) 3454 114 6.1 (3.012.1)
Norway Molden 2005 (Oslo) 3069 3,970 9.3 (8.410.2)
a,c
Skjeldestad 2008 1624 896 25.9 (23.128.9)
Molden 2006 (Oslo) <=30 275 30.9 (25.736.6)
Gjoen 1996 (Oslo) 2044 222 15.3 (11.220.6)
Poland Bardin 2008 (Warsaw) 1859 799 14.4 (12.117.0)
Portugal Pista 2011 1864 2,172 16.5 (15.018.1)
Vieira 2013 1876 463 17.1 (13.920.8)
Pista 2011d 1867 425 25.4 (21.529.8)
a
Dutra 2008 (Aores) 1681 286 10.5 (7.414.6)
Romania Moga 2014 (Brasov County) 1757 801 34.3 (31.137.7)
Ursu 2011 (Northeast) 2061 164 25.6 (19.532.8)
Russia Bdaizieva 2010 (Moscow)a 1569 33,112 25.7 (25.226.1)
Kubanov 2005 (Moscow) 8,533 15.0 (14.315.8)
Goncharevskaya 2011 (Moscow) 1577 5,182 13.4 (12.514.4)
Rogovskaya 2013e 1676 833 25.9 (23.129.0)
Shipitsyna 2011 (St Petersburg) 3065 741 9.9 (7.912.2)
Komarova 2010 (Moscow) 1676 352 48.3 (43.153.5)
Alexandrova 1999f 1545 309 29.1 (24.334.4)
Shargorodskaya 2011 (Moscow) 1830 266 28.2 (23.133.9)
Shipulina 2011 (Moscow) 1319 177 40.1 (33.247.5)
Slovenia Ucakar 2012 2064 4,199 10.7 (9.811.7)
Ucakar 2014 2064 944 8.8 (7.110.8)
Spain Castellsagu 2012 1865 3,059 13.0 (11.914.2)
Martorell 2010 (Valencia)a 1864 1,956 13.0 (11.614.5)
Bernal 2008 (Zaragoza) 1,200 17.5 (15.519.8)
Dillner 2008 (Maresme) 1482 939 7.3 (5.89.2)
0% 10% 20% 30% 40% 50% 60%



b Arnhem, Nijmegen, and Den Bosch
c Oslo, Trondheim, and Levanger
d Lisbon area and southern region
e Moscow and Novgorod
f St. Petersburg

study (continued)

Spain Lloveras 2013 (Barcelona) 2389 898 14.7 (12.517.2)
de Sanjose 2003 (Barcelona) 1475 847 1.3 (0.72.3)
Ortiz 2006 (Madrid and Alicante)a 1467 818 10.8 (8.813.1)
Gonzlez 2006 (Alicante) 703 7.8 (6.110.0)
b 1875 329 5.2 (3.38.1)
Muoz 1996
Sweden Naucler 2007c 2946 5,877 5.5 (4.96.1)
c
Elfstrm 2014 2340 5,584 8.1 (7.48.8)
Gyllensten 2012 (Uppsala County)a 5576 2,106 6.2 (5.27.3)
Ylitalo 2000 (Uppsala) 1549 617 5.8 (4.28.0)
d
Kjellberg 1998 2063 295 4.1 (2.37.0)
Stenvall 2007 (Uppsala)a 3550 117 25.6 (18.634.2)
Switzerland Bigras 2005e 1793 13,349 6.3 (5.96.7)
UK Kitchener 2006 (Manchester) 2064 21,380 10.4 (10.010.8)
Hibbitts 2014 (Wales) 2022 10,890 20.6 (19.921.4)
f 3060 9,709 5.5 (5.16.0)
Cuzick 2003
Hibbitts 2008 (South Wales) 2065 8,434 7.0 (6.57.6)
Peto 2004 (Manchester) 1564 6,128 7.2 (6.67.9)
Kavanagh 2014 (Scotland)a 2021 4,679 58.3 (56.959.7)
Cuschieri 2004 (Edinburgh) 1678 3,089 12.7 (11.613.9)
Cuzick 1999 (London) 3470 2,855 3.3 (2.74.0)
HowellJones 2010g 2564 2,404 10.2 (9.011.5)
Cuzick 1995 (London) 1759 1,818 3.5 (2.84.5)
Geraets 2014 (Scotland)a 2068 998 16.9 (14.719.4)
Herbert 2007 (London) 2049 813 12.9 (10.815.4)
Grainge 2005 (Nottingham) 2151 656 13.6 (11.216.4)
0% 10% 20% 30% 40% 50% 60%

b Alava, Girona, Guipuzcoa, Murcia, Navarra, Salamanca, Sevilla, Vizcaya, Zaragoza
c Gothenburg, Malm, Uppsala, Ume, and Stockholm
d Vsterbotten County
e Geneve, Vaud, Neuchatel, Fribourg, Valais and Tessin
f Birmingham, Edinburg, London, Manchester and Mansfield
g Gateshead, Birmingham, London, Gloucestershire and Norfolk

Figure 48: Prevalence of HPV among women with normal cervical cytology in Oceania by country and
study

Australia Tabrizi 2014 1566 2,271 33.0 (31.134.9)
a,b 1619 161 11.2 (7.217.0)
Bowden 2005
b,c 1824 149 55.7 (47.763.4)
Tabrizi 2014
Fiji Foliaki 2014 (Suva)b 1663 1,244 24.0 (21.726.4)
Vanuatu Aruhuri 2012d 1865 726 22.7 (19.825.9)
e
McAdam 2010 3050 379 5.3 (3.48.0)
0% 10% 20% 30% 40% 50% 60% 70%

a Australian Capital Territory
c Sydney, Melbourne, Perth
d Santo Urban (Espiritu Santo Island) and Porto Vila (Efate Island)
e Port Vila (Efate Island)

4.1.2 HPV type distribution among women with normal cervical cytology, precancerous cer-
vical lesions and cervical cancer
Table 13: Prevalence of HPV 16/18 in women with normal cervical cytology, precancerous cervical le-
sions and invasive cervical cancer by World region and sub-regions
Normal cytology Low-grade lesions High-grade lesions Cervical cancer
Country /Region No. HPV Prev No. HPV Prev No. HPV Prev No. HPV Prev
tested (95% CI) tested (95% CI) tested (95% CI) tested (95% CI)
World 514,928 4.1 (4.0-4.2) 38,394 25.7 (25.3-26.1) 50,475 51.8 (51.4-52.2) 59,149 69.4 (69.0-69.8)
Less developed regions 177,536 4.4 (4.3-4.5) 9,864 25.0 (24.1-25.9) 13,668 46.6 (45.8-47.4) 25,364 69.5 (68.9-70.1)
More developed regions 334,356 3.9 (3.8-4.0) 28,530 25.9 (25.4-26.4) 33,704 54.1 (53.6-54.6) 25,245 71.8 (71.2-72.4)
Africa 20,672 3.7 (3.5-4.0) 620 22.7 (19.6-26.2) 540 38.5 (34.5-42.7) 3,890 67.2 (65.7-68.7)
Eastern Africa 4,298 4.8 (4.2-5.5) 151 29.8 (23.1-37.5) 164 43.9 (36.5-51.6) 1,359 68.1 (65.5-70.5)
Middle Africa - -- 24 12.5 (4.3-31.0) 38 34.2 (21.2-50.1) - --
Northern Africa 2,987 2.7 (2.2-3.4) 27 18.5 (8.2-36.7) 11 45.5 (21.3-72.0) 673 78.8 (75.5-81.7)
Southern Africa 8,661 3.2 (2.8-3.6) 57 21.1 (12.5-33.3) 115 34.8 (26.7-43.9) 810 62.2 (58.8-65.5)
Western Africa 4,726 4.3 (3.8-4.9) 361 21.1 (17.2-25.6) 212 36.8 (30.6-43.5) 945 55.3 (52.2-58.5)
Americas 110,268 5.4 (5.3-5.5) 9,909 26.7 (25.8-27.6) 13,624 56.8 (56.0-57.6) 10,105 68.3 (67.4-69.2)
Caribbean 323 15.8 (12.2-20.2) 263 7.6 (5.0-11.5) 294 33.7 (28.5-39.3) 137 60.6 (52.2-68.4)
Central America 18,421 4.7 (4.4-5.0) 1,424 15.0 (13.3-17.0) 559 40.8 (36.8-44.9) 2,913 63.1 (61.3-64.8)
Northern America 77,952 4.4 (4.3-4.5) 6,022 27.1 (26.0-28.2) 10,247 58.6 (57.6-59.6) 3,723 71.3 (69.8-72.7)
South America 13,771 12.1 (11.6-12.7) 2,200 35.5 (33.5-37.5) 2,524 56.3 (54.4-58.2) 6,286 62.7 (61.5-63.9)
Asia 145,664 3.4 (3.3-3.5) 7,972 21.2 (20.3-22.1) 13,530 42.3 (41.5-43.1) 20,858 68.9 (68.3-69.5)
Central Asia - -- - -- - -- - --
Eastern Asia 116,022 3.2 (3.1-3.3) 6,990 20.3 (19.4-21.3) 10,574 41.0 (40.1-41.9) 15,293 65.0 (64.2-65.7)
South-Eastern Asia 8,755 3.0 (2.7-3.4) 474 27.4 (23.6-31.6) 1,067 33.3 (30.5-36.2) 3,134 71.6 (70.0-73.2)
Southern Asia 14,520 4.4 (4.1-4.7) 229 30.1 (24.6-36.4) 319 64.6 (59.2-69.6) 2,780 80.3 (78.8-81.7)
Western Asia 6,367 2.3 (2.0-2.7) 279 24.0 (19.4-29.4) 1,570 52.1 (49.6-54.6) 936 72.4 (69.5-75.2)
Europe 232,291 3.8 (3.7-3.9) 19,420 27.1 (26.5-27.7) 21,152 54.5 (53.8-55.2) 18,508 74.0 (73.4-74.6)
Eastern Europe 7,818 9.7 (9.1-10.4) 1,058 31.8 (29.0-34.6) 661 60.5 (56.7-64.2) 1,687 84.8 (83.0-86.5)
Northern Europe 119,652 4.5 (4.4-4.6) 4,949 30.6 (29.3-31.9) 8,448 54.9 (53.8-56.0) 5,956 76.9 (75.8-78.0)
Southern Europe 50,059 3.2 (3.0-3.4) 10,538 25.4 (24.6-26.2) 5,878 53.2 (51.9-54.5) 4,072 68.0 (66.6-69.4)
Western Europe 57,216 2.6 (2.5-2.7) 2,875 25.2 (23.7-26.8) 3,062 59.4 (57.7-61.1) 3,050 78.7 (77.2-80.1)
Oceania 2,997 8.3 (7.4-9.4) 473 27.1 (23.3-31.2) 1,629 59.1 (56.7-61.5) 855 76.6 (73.7-79.3)
Australia & New Zealand 2,271 8.5 (7.4-9.7) 473 27.1 (23.3-31.2) 1,517 58.4 (55.9-60.9) 785 76.1 (72.9-78.9)
Melanesia 726 7.7 (6.0-9.9) - -- 112 68.8 (59.7-76.6) 70 82.9 (72.4-89.9)
Micronesia - -- - -- - -- - --
Polynesia - -- - -- - -- - --
Data updated on 14 Dec 2016 (data as of 30 Jun 2014 / 30 Jun 2015).
95% CI: 95% Confidence Interval; High-grade lesions: CIN-2, CIN-3, CIS or HSIL; Low-grade lesions: LSIL or CIN-1;

Figure 49: Prevalence of HPV 16 among women with normal cervical cytology in Africa by country and
study
Country Study N % (95% CI)

Algeria Hammouda 2011 732 0.5 (0.21.4)
Hammouda 2005 133 6.8 (3.612.4)
Benin Piras 2011 258 4.3 (2.47.5)
Guinea Keita 2009 752 6.6 (5.18.7)
Kenya De Vuyst 2010 454 7.5 (5.410.3)
De Vuyst 2003 369 3.5 (2.15.9)
Morocco Alhamany 2010 785 2.2 (1.43.4)
Amrani 2003 306 1.3 (0.53.3)
Belglaiaa 2015 190 2.1 (0.85.3)
Chaouki 1998 172 4.1 (2.08.2)
Mozambique Castellsagu 2001 187 4.8 (2.68.9)
Naucler 2011 183 6.6 (3.811.1)
Nigeria Gage 2012 1,075 1.5 (0.92.4)
Thomas 2004 844 3.0 (2.04.3)
Senegal Xi 2003 1,639 1.0 (0.61.7)
Astori 1999 158 5.7 (3.010.5)
South Africa McDonald 2012 7,445 2.0 (1.72.3)
Allan 2008 848 2.0 (1.33.2)
Jones 2007 368 1.6 (0.73.5)
Tanzania Dartell 2014 2,737 1.8 (1.32.3)
WatsonJones 2013 117 12.8 (7.920.1)
Tunisia Guettiti 2014 573 1.6 (0.83.0)
Hassen 2003 96 5.2 (2.211.6)
Uganda Odida 2011 251 2.8 (1.45.6)
0% 10% 20% 30%
Data updated on 14 Dec 2016 (data as of 31 Oct 2014).


Figure 50: Prevalence of HPV 16 among women with normal cervical cytology in the Americas by
country and study

Argentina Matos 2003 843 3.2 (2.24.6)
Chouhy 2013 774 8.3 (6.510.4)
Abba 2003 152 15.1 (10.321.7)
Badano 2011 139 6.5 (3.411.8)
Belize Cathro 2009 426 1.2 (0.52.7)
Brazil 448 3.8 (2.46.0)
Noronha 2005 433 0.5 (0.11.7)
da Silva 2012 418 1.2 (0.52.8)
Miranda 2012 399 5.0 (3.37.6)
Chagas 2015 390 8.5 (6.111.6)
de Abreu 2012 370 1.4 (0.63.1)
Augusto 2014 338 1.5 (0.63.4)
Coser 2013 327 2.8 (1.55.1)
Rocha 2013 314 9.6 (6.813.3)
Oliveira 2010 225 4.4 (2.48.0)
Lorenzato 2000 215 7.0 (4.311.2)
Muoz 1996 194 5.2 (2.89.2)
Cassel 2014 158 8.9 (5.414.3)
TamegoLopes 2014 120 9.2 (5.215.7)
Canada Jiang 2013 13,379 3.6 (3.34.0)
Moore 2009 4,003 8.7 (7.99.6)
Demers 2012 517 1.9 (1.13.5)
Chile Ferreccio 2004 913 2.1 (1.33.2)
Colombia Molano 2002 1,831 3.3 (2.64.3)
SotoDe Leon 2011 1,564 36.6 (34.239.0)
Muoz 1996 307 5.5 (3.58.7)
Costa Rica Herrero 2005 7,459 2.2 (1.92.6)
Cuba Soto 2014 111 35.1 (26.944.4)
Greenland Svare 1998 118 21.2 (14.829.4)
Guatemala Valls 2009 274 3.3 (1.76.1)
Honduras Ferrera 1999 438 11.0 (8.414.2)
Tbora 2005 100 6.0 (2.812.5)
Mexico IlladesAguiar 2010 3,117 2.3 (1.92.9)
LazcanoPonce 2001 1,340 1.7 (1.12.6)
Salcedo 2014 1,020 6.2 (4.97.8)
Giuliano 2001 995 1.2 (0.72.1)
Lpez Rivera 2012 916 1.0 (0.51.9)
CarrilloGarca 2014 518 11.2 (8.814.2)
SnchezAnguiano 2006 487 2.9 (1.74.8)
AguilarLemarroy 2015 356 3.1 (1.75.4)
Monroy 2010 272 1.1 (0.43.2)
Giuliano 2005 258 0.8 (0.22.8)
IlladesAguiar 2009 256 11.3 (8.015.8)
Rojo Contreras 2008 189 9.0 (5.713.9)
Paraguay Mendoza 2011 202 4.5 (2.48.2)
Roln 2000 91 5.5 (2.412.2)
Peru Garca 2004 501 2.4 (1.44.1)
Martorell 2012 203 12.3 (8.517.5)
Santos 2001 175 4.0 (2.08.0)
Trinidad & Tob. Ragin 2007 212 2.4 (1.05.4)
0% 10% 20% 30% 40% 50%


Figure 51: Prevalence of HPV 16 among women with normal cervical cytology in the Americas by
country and study (continued)

USA Wheeler 2013 33,614 2.6 (2.42.8)
Schiffman 2011 18,450 2.2 (2.02.4)
Goodman 2008 2,356 4.7 (3.95.6)
Insinga 2007 1,203 6.8 (5.58.4)
Cibas 2007 1,000 0.5 (0.21.2)
Wideroff 1998 958 2.7 (1.93.9)
Giuliano 2001 881 2.6 (1.73.9)
Moscicki 2001 547 26.7 (23.230.6)
Evans 2006 300 9.7 (6.813.5)
Swan 1999 270 3.0 (1.55.7)
Hernandez 2004 183 1.6 (0.64.7)
Chaturvedi 2005 173 1.2 (0.34.1)
Uruguay Berois 2014 883 3.4 (2.44.8)
Ramas 2013 236 2.1 (0.94.9)
Venezuela Tllez 2015 409 14.9 (11.818.7)
0% 10% 20% 30% 40%


Figure 52: Prevalence of HPV 16 among women with normal cervical cytology in Asia by country and
study

Bahrain Hajjaj 2006 91 1.1 (0.26.0)
Bhutan Tshomo 2014 2,272 3.4 (2.84.3)
China Mai 2014 22,114 3.6 (3.43.9)
Zhao 2014 5,416 2.1 (1.72.5)
Zhao 2009 5,284 1.7 (1.42.0)
Wu 2013 3,737 1.0 (0.71.4)
Li 2013 3,115 2.9 (2.33.5)
Yuan 2011 3,112 2.3 (1.82.9)
Jin 2010 2,847 1.0 (0.71.4)
Chan 2009 2,571 0.9 (0.61.3)
Wu 2007 942 1.9 (1.23.0)
Li 2006 663 2.1 (1.33.5)
Dai 2006 601 3.5 (2.35.3)
Bian 2013 379 4.7 (3.07.4)
Wu 2010 314 3.5 (2.06.2)
Sun 2010 165 10.9 (7.016.6)
Georgia Alibegashvili 2011 1,247 0.5 (0.21.0)
India Dutta 2012 2,313 0.5 (0.30.9)
Laikangbam 2007 2,038 4.7 (3.95.7)
Franceschi 2005 1,799 2.8 (2.23.7)
Gupta 2009 769 10.1 (8.212.5)
Aggarwal 2006 472 3.6 (2.35.7)
Kerkar 2011 470 1.5 (0.73.0)
Bhatla 2008 458 2.2 (1.24.0)
Vinodhini 2012 257 8.9 (6.013.1)
Arora 2005 160 9.4 (5.814.9)
Singh 2009 109 8.3 (4.415.0)
Indonesia de Boer 2006 200 2.0 (0.85.0)
Iran Khodakarami 2012 791 1.8 (1.12.9)
Safaei 2010 400 2.0 (1.03.9)
Moradi 2011 226 4.0 (2.17.4)
Japan Inoue 2006 7,260 1.2 (1.01.5)
Maehama 2005 4,078 0.3 (0.20.5)
Asato 2004 3,249 0.5 (0.30.8)
Takehara 2011 2,068 1.5 (1.02.1)
Sasagawa 2001 1,562 1.3 (0.82.0)
Onuki 2009 1,517 2.6 (1.93.6)
Konno 2011 908 4.1 (3.05.6)
Sasagawa 1997 778 1.0 (0.52.0)
Nishiwaki 2008 292 4.5 (2.67.5)
Yoshikawa 1999 130 0.8 (0.14.2)
Korea, Rep. Kim 2013 6,681 1.6 (1.31.9)
Park 2014 1,903 0.8 (0.51.3)
Hwang 2004 1,609 6.3 (5.27.6)
Kim 2012 1,214 9.9 (8.311.7)
Oh 2001 1,144 0.6 (0.31.3)
An 2003 1,143 22.4 (20.124.9)
Shin 2003 821 0.7 (0.31.6)
Lee 2003 746 4.3 (3.16.0)
Cho 2003 414 22.9 (19.227.2)
0% 10% 20% 30%


Figure 53: Prevalence of HPV 16 among women with normal cervical cytology in Asia by country and
study (continued)

Kuwait AlAwadhi 2011 3,011 0.2 (0.10.5)
Malaysia Othman 2014 588 0.9 (0.42.0)
Mongolia Dondog 2008 842 4.8 (3.56.4)
Nepal Sherpa 2010 898 1.4 (0.82.5)
Johnson 2014 211 0.9 (0.33.4)
Pakistan Raza 2010 877 0.5 (0.21.2)
Philippines Ngelangel 1998 377 1.3 (0.63.1)
Taiwan Lai 2012 14,724 0.2 (0.20.3)
Chen 2011 10,067 1.4 (1.21.6)
Huang 2008 1,310 1.1 (0.61.8)
Tsai 2005 175 2.9 (1.26.5)
Lin 2005 127 3.1 (1.27.8)
Thailand Laowahutanont 2014 2,735 1.2 (0.91.7)
Sukvirach 2003 1,659 0.7 (0.41.3)
Chichareon 1998 261 4.6 (2.67.9)
Suwannarurk 2009 225 4.0 (2.17.4)
Natphopsuk 2013 198 5.6 (3.19.7)
Chopjitt 2009 160 5.6 (3.010.3)
Chaiwongkot 2007 140 12.9 (8.319.4)
Sriamporn 2006 113 7.1 (3.613.4)
Siritantikorn 1997 102 1.0 (0.25.3)
SettheethamIshida 2005 100 8.0 (4.115.0)
Turkey Ozalp 2012 564 1.4 (0.72.8)
Demir 2012 530 3.6 (2.35.5)
Tezcan 2014 380 4.2 (2.66.7)
Dursun 2009 310 7.1 (4.710.5)
Bayram 2011 234 2.6 (1.25.5)
Viet Nam Pham 2003 1,897 1.5 (1.02.1)
0% 10% 20%


Figure 54: Prevalence of HPV 16 among women with normal cervical cytology in Europe by country and
study

Belarus Rogovskaya 2013 322 7.1 (4.810.5)
Belgium Arbyn 2009 8,729 2.3 (2.12.7)
Baay 2005 2,293 2.1 (1.62.8)
Depuydt 2012 1,142 1.4 (0.92.3)
Schmitt 2013 913 5.6 (4.37.3)
Weyn 2013 906 2.1 (1.33.3)
Depuydt 2003 287 4.2 (2.47.2)
Baay 2001 286 2.8 (1.45.4)
Croatia Grahovac 2007 205 15.6 (11.321.2)
Czech Rep. Tachezy 2013 1,302 4.8 (3.86.1)
Denmark Kjr 2014 37,958 4.2 (4.04.4)
Nielsen 2008 11,663 4.0 (3.64.3)
Bonde 2014 4,642 5.4 (4.86.1)
Svare 1998 119 8.4 (4.614.8)
France Heard 2013 3,023 3.0 (2.53.7)
Vaucel 2011 980 3.6 (2.64.9)
Casalegno 2011 302 10.6 (7.614.6)
PannierStockman 2008 289 9.3 (6.513.3)
BebyDefaux 2004 170 1.8 (0.65.1)
Germany Klug 2007 7,833 1.1 (0.91.4)
Iftner 2010 1,692 6.6 (5.57.8)
de Jonge 2013 1,463 4.9 (3.96.2)
Greece Agorastos 2015 3,783 2.1 (1.72.6)
Argyri 2013 2,218 2.6 (2.03.4)
Tsiodras 2011 1,348 4.0 (3.15.2)
Agorastos 2004 1,272 0.4 (0.20.9)
Tsiodras 2010 1,029 0.0 (0.00.4)
Panotopoulou 2007 639 0.5 (0.21.4)
Ireland Anderson 2013 5,068 3.2 (2.73.7)
Keegan 2007 579 1.7 (0.93.1)
Italy Carozzi 2014 13,660 1.8 (1.62.1)
Agarossi 2009 9,148 3.0 (2.73.4)
Giorgi Rossi 2011 3,151 2.1 (1.72.7)
Ronco 2005 997 2.7 (1.93.9)
Panatto 2013 566 2.8 (1.74.5)
Centurioni 2005 500 8.8 (6.611.6)
Salfa 2011 452 0.9 (0.32.3)
Barzon 2010 333 6.0 (3.99.1)
Sammarco 2013 244 6.6 (4.110.4)
Astori 1997 197 5.1 (2.89.1)
Tornesello 2006 183 8.7 (5.513.7)
Tornesello 2008 107 2.8 (1.07.9)
Lithuania Gudleviciene 2005 332 6.9 (4.710.2)
Simanaviciene 2014 277 4.3 (2.57.4)
Netherlands Bulkmans 2007 21,245 1.0 (0.91.1)
Jacobs 2000 3,299 0.9 (0.71.3)
Rozendaal 2000 2,250 2.7 (2.13.4)
Zielinski 2001 114 1.8 (0.56.2)
Norway Molden 2005 3,970 1.3 (1.01.7)
Gjoen 1996 222 6.3 (3.810.3)
0% 10% 20% 30%


Figure 55: Prevalence of HPV 16 among women with normal cervical cytology in Europe by country and
study (continued)

Poland Bardin 2008 799 2.8 (1.84.1)
Portugal Pista 2011 425 5.2 (3.47.7)
Romania Moga 2014 801 7.5 (5.99.5)
Russia Rogovskaya 2013 833 7.1 (5.59.0)
Shipitsyna 2011 741 2.7 (1.84.1)
Alexandrova 1999 309 7.4 (5.010.9)
Komarova 2010 257 24.1 (19.329.7)
Slovenia Ucakar 2012 4,199 2.5 (2.13.0)
Spain Castellsagu 2012 3,059 2.5 (2.03.1)
de Sanjose 2003 847 0.4 (0.11.0)
Dillner 2008 721 3.1 (2.04.6)
Gonzlez 2006 447 1.3 (0.62.9)
Muoz 1996 329 1.8 (0.83.9)
Sweden Naucler 2007 5,877 1.7 (1.42.0)
Elfstrm 2014 5,584 2.0 (1.62.3)
Ylitalo 2000 617 5.8 (4.28.0)
Kjellberg 1998 295 1.0 (0.32.9)
UK Sargent 2008 21,364 1.5 (1.31.7)
Hibbitts 2014 10,890 4.3 (3.94.7)
Cuschieri 2004 3,089 4.4 (3.75.2)
Cuzick 1999 2,855 0.1 (0.00.3)
Cuzick 1995 1,818 1.3 (0.92.0)
Hibbitts 2006 1,777 1.4 (0.92.0)
Grainge 2005 656 1.4 (0.72.6)
0% 10% 20% 30%


Figure 56: Prevalence of HPV 16 among women with normal cervical cytology in Oceania by country
and study

Australia Tabrizi 2014 2,271 5.8 (4.96.8)
Vanuatu Aruhuri 2012 726 6.5 (4.98.5)
0% 10%


Figure 57: Prevalence of HPV 16 among women with low-grade cervical lesions in Africa by country and
study

Cte d'Ivoire La Ruche 1998 151 10.6 (6.616.5)
DR Congo Hovland 2010 10 0.0 (0.027.8)
Ethiopia Abate 2013 11 100.0 (74.1100.0)
Guinea Keita 2009 16 18.8 (6.643.0)
Kenya De Vuyst 2003 30 13.3 (5.329.7)
De Vuyst 2010 12 8.3 (1.535.4)
De Vuyst 2012 1 0.0 (0.079.3)
Nigeria Thomas 2004 34 5.9 (1.619.1)
Gage 2012 32 6.3 (1.720.1)
Senegal Xi 2003 86 8.1 (4.015.9)
Chabaud 1996 42 40.5 (27.055.5)
South Africa Allan 2008 57 12.3 (6.123.2)
Zimbabwe Sawaya 2008 97 19.6 (12.928.6)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

95% CI: 95% Confidence Interval; Low-grade lesions: LSIL or CIN-1; N: number of women tested;

Figure 58: Prevalence of HPV 16 among women with low-grade cervical lesions in the Americas by
country and study

Argentina Abba 2003 279 26.5 (21.732.0)
Venezuela 2012 120 14.2 (9.021.5)
Tonon 1999 55 74.5 (61.784.2)
Eiguchi 2008 37 18.9 (9.534.2)
Deluca 2004 36 8.3 (2.921.8)
Chouhy 2006 22 18.2 (7.338.5)
Belize Cathro 2009 10 10.0 (1.840.4)
Brazil Tomita 2010 143 28.7 (21.936.6)
Fernandes 2009 82 18.3 (11.428.0)
Resende 2014 82 23.2 (15.433.4)
Ribeiro 2011 66 27.3 (18.039.0)
Lorenzato 2000 62 19.4 (11.430.9)
Carestiato 2006 55 29.1 (18.842.1)
Franco 1999 27 25.9 (13.244.7)
Pitta 2010 22 0.0 (0.014.9)
Freitas 2007 15 20.0 (7.045.2)
Krambeck 2008 9 0.0 (0.029.9)
Canada Coutle 2011 508 27.6 (23.931.6)
Moore 2009 505 35.2 (31.239.5)
Antonishyn 2008 344 14.2 (10.918.3)
Jiang 2011 108 19.4 (13.127.9)
TranThanh 2003 80 15.0 (8.824.4)
Koushik 2005 53 26.4 (16.439.6)
Richardson 2003 44 18.2 (9.532.0)
Sellors 2000 24 37.5 (21.257.3)
Sellors 2000 22 50.0 (30.769.3)
Chile Lpez M 2010 116 22.4 (15.830.8)
Ili 2011 90 55.6 (45.365.4)
Colombia Molano 2002 70 10.0 (4.919.2)
Del RoOspina 2015 59 42.4 (30.655.1)
Garca 2011 56 80.4 (68.288.7)
Cuba Soto 2007 15 6.7 (1.229.8)
Ecuador Tornesello 2008 29 34.5 (19.952.7)
Honduras Ferreira 2008 44 11.4 (5.024.0)
Jamaica Strickler 1999 186 4.3 (2.28.3)
Rattray 1996 62 6.5 (2.515.4)
Mexico IlladesAguiar 2010 784 10.6 (8.612.9)
VelzquezMrquez 2009 233 12.9 (9.217.8)
GonzlezLosa 2004 104 5.8 (2.712.0)
PiaSnchez 2006 95 25.3 (17.634.8)
Giuliano 2001 33 15.2 (6.730.9)
Carrillo 2004 21 19.0 (7.740.0)
TorroellaKouri 1998 21 4.8 (0.822.7)
Nicaragua Hindryckx 2006 79 7.6 (3.515.6)
Tonon 1999 55 74.5 (61.784.2)
Peru Martorell 2012 22 22.7 (10.143.4)
USA Wheeler 2006 1,273 21.3 (19.123.6)
Wentzensen 2009 431 22.5 (18.826.7)
Vidal 2014 239 10.0 (6.814.5)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%


Figure 59: Prevalence of HPV 16 among women with low-grade cervical lesions in the Americas by

USA Einstein 2007 207 6.3 (3.710.4)
Evans 2006 200 15.5 (11.121.2)
Schiff 2000 190 5.8 (3.310.1)
TortoleroLuna 1998 175 12.6 (8.518.3)
Liaw 1999 173 7.5 (4.412.4)
Kulasingam 2002 166 15.7 (10.922.0)
Adam 2000 161 45.3 (37.853.1)
Stoler 2011 158 10.8 (6.816.6)
Moscicki 2008 157 19.7 (14.326.7)
Swan 1999 149 10.1 (6.215.9)
Castle 2011 106 8.5 (4.515.4)
Jarboe 2004 95 7.4 (3.614.4)
Lee 2009 76 3.9 (1.411.0)
Wheeler 2009 67 26.9 (17.738.5)
Zuna 2007 67 14.9 (8.325.3)
Voss 2009 59 18.6 (10.730.4)
Hu 2005 45 8.9 (3.520.7)
Park 2007 30 16.7 (7.333.6)
Evans 2002 28 7.1 (2.022.6)
Guo 2007 27 0.0 (0.012.5)
Brown 2002 25 40.0 (23.459.3)
Bell 2007 12 8.3 (1.535.4)
Kong 2007 11 27.3 (9.756.6)
Giuliano 2001 7 14.3 (2.651.3)
Uruguay Ramas 2013 227 23.8 (18.729.7)
Venezuela Correnti 2011 200 21.0 (15.927.2)
0% 10% 20% 30% 40% 50% 60%


Figure 60: Prevalence of HPV 16 among women with low-grade cervical lesions in Asia by country and
study

Bangladesh Banik 2013 13 15.4 (4.342.2)
China Chan 2006 769 14.0 (11.816.7)
Chan 2012 769 14.0 (11.816.7)
Yuan 2011 302 15.9 (12.220.4)
Zhao 2014 207 20.8 (15.826.8)
Guo 2010 201 20.4 (15.426.5)
Liu 2010 180 34.4 (27.941.6)
Li 2013 165 12.7 (8.518.7)
Ding 2014 152 7.9 (4.613.3)
Li 2012 143 16.1 (11.023.0)
Wu 2010 129 11.6 (7.218.3)
Hong 2008 105 13.3 (8.121.1)
Tao 2006 101 21.8 (14.830.8)
Zhang 2013 94 17.0 (10.825.9)
Liu 2008 90 5.6 (2.412.4)
Sun 2014 81 21.0 (13.531.1)
Wu 2013 77 18.2 (11.228.2)
Zhao 2008 56 12.5 (6.223.6)
Chan 1999 51 21.6 (12.534.6)
Jin 2010 44 9.1 (3.621.2)
India Singh 2009 80 23.8 (15.834.1)
Nair 1999 37 18.9 (9.534.2)
Franceschi 2005 26 30.8 (16.550.0)
Berlin Grace 2009 20 0.0 (0.016.1)
Nagpal 2002 14 35.7 (16.361.2)
Iran Esmaeili 2008 23 39.1 (22.259.2)
Ghaffari 2006 12 41.7 (19.368.0)
Khodakarami 2012 3 0.0 (0.056.1)
Japan Matsumoto 2011 479 9.2 (6.912.1)
Takehara 2011 447 11.4 (8.814.7)
Onuki 2009 318 8.5 (5.912.1)
Saito 2001 151 2.6 (1.06.6)
Sasagawa 2001 145 9.0 (5.314.7)
Inoue 2006 128 17.2 (11.624.7)
Yamasaki 2011 125 19.2 (13.327.0)
Nishiwaki 2008 120 13.3 (8.420.6)
Konno 2011 75 20.0 (12.530.4)
Yoshida 2004 12 8.3 (1.535.4)
Tsuda 2003 9 11.1 (2.043.5)
Kuwait AlAwadhi 2011 71 18.3 (11.028.8)
AlAwadhi 2013 71 18.3 (11.028.8)
Malaysia Sharifah 2009 23 26.1 (12.546.5)
Myanmar MuMuShwe 2014 15 60.0 (35.780.2)
Pakistan Raza 2010 1 100.0 (20.7100.0)
Rep. Korea An 2003 200 36.5 (30.143.4)
Lee 2007 167 19.2 (13.925.8)
Cho 2003 150 26.7 (20.234.3)
Kang 2009 90 17.8 (11.226.9)
Oh 2001 28 17.9 (7.935.6)
Hwang 2003 24 16.7 (6.735.9)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 61: Prevalence of HPV 16 among women with low-grade cervical lesions in Asia by country and
study (continued)

Taiwan Ding 2008 542 6.1 (4.48.4)
Chao 2008 51 3.9 (1.113.2)
Huang 2008 13 0.0 (0.022.8)
Thailand Chansaenroj 2014 200 27.0 (21.333.5)
Chaiwongkot 2007 140 14.3 (9.421.0)
Ekalaksananan 2001 45 4.4 (1.214.8)
Bhattarakosol 2002 27 0.0 (0.012.5)
Chansaenroj 2010 12 0.0 (0.024.2)
Suwannarurk 2009 12 25.0 (8.953.2)
Turkey Yuce 2012 51 19.6 (11.032.5)
Sahiner 2012 45 22.2 (12.536.3)
Ergnay 2008 14 28.6 (11.754.6)
Tezcan 2014 14 7.1 (1.331.5)
Ozgul 2008 13 15.4 (4.342.2)
0% 10% 20% 30% 40% 50% 60%


Figure 62: Prevalence of HPV 16 among women with low-grade cervical lesions in Europe by country
and study

Belarus Kulmala 2007 94 35.1 (26.245.2)
Belgium Depuydt 2003 369 20.3 (16.524.7)
Beerens 2005 324 18.5 (14.723.1)
Arbyn 2009 243 23.5 (18.629.2)
Weyn 2013 211 10.0 (6.614.7)
Baay 2001 58 24.1 (15.036.5)
Croatia Grce 2001 1,028 11.6 (9.813.7)
Grce 1997 183 6.0 (3.410.4)
Grce 2004 60 8.3 (3.618.1)
Czech Rep. Tachezy 2011 676 28.4 (25.131.9)
Denmark Kjr 2014 287 17.1 (13.221.9)
Kjaer 2008 86 12.8 (7.321.5)
Hording 1995 41 31.7 (19.647.0)
France Prtet 2008 397 21.4 (17.725.7)
Vaucel 2011 117 14.5 (9.322.0)
Bergeron 1992 48 20.8 (11.734.3)
Humbey 2002 40 30.0 (18.145.4)
Monsonego 2008 37 5.4 (1.517.7)
Germany de Jonge 2013 441 17.5 (14.221.3)
Meyer 2001 130 13.1 (8.319.9)
Klug 2007 52 11.5 (5.423.0)
Nindl 1999 49 12.2 (5.724.2)
MerkelbachBruse 1999 16 68.8 (44.485.8)
Greece Argyri 2013 821 14.5 (12.317.1)
Panotopoulou 2007 516 6.8 (4.99.3)
Tsiodras 2011 314 17.8 (14.022.4)
Kroupis 2007 235 23.4 (18.429.2)
Labropoulou 1997 51 11.8 (5.523.4)
Mammas 2008 46 21.7 (12.335.6)
Adamopoulou 2009 7 14.3 (2.651.3)
Ireland Keegan 2014 49 40.8 (28.254.8)
Murphy 2003 29 72.4 (54.385.3)
Butler 2000 26 0.0 (0.012.9)
Italy Voglino 2000 1,499 24.7 (22.627.0)
Spinillo 2014 1,240 25.6 (23.228.1)
Chironna 2010 385 13.0 (10.016.7)
Agarossi 2009 383 19.8 (16.224.1)
Spinillo 2009 343 36.7 (31.842.0)
Capra 2008 149 11.4 (7.217.5)
Astori 1997 111 24.3 (17.333.1)
Tornesello 2006 101 36.6 (27.946.4)
Agodi 2009 96 32.3 (23.842.2)
Gargiulo 2007 83 15.7 (9.425.0)
Giorgi Rossi 2010 76 21.1 (13.431.5)
Sandri 2009 47 21.3 (12.034.9)
Zerbini 2001 43 14.0 (6.627.3)
Venturoli 2002 40 7.5 (2.619.9)
Menegazzi 2009 21 23.8 (10.645.1)
Laconi 2000 20 30.0 (14.551.9)
Venturoli 2008 10 20.0 (5.751.0)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%


Figure 63: Prevalence of HPV 16 among women with low-grade cervical lesions in Europe by country

Latvia Kulmala 2007 94 35.1 (26.245.2)
Netherlands Bollen 1997 134 12.7 (8.119.4)
Prinsen 2007 38 7.9 (2.720.8)
ReesinkPeters 2001 35 28.6 (16.345.1)
Norway Roberts 2006 40 5.0 (1.416.5)
Molden 2005 20 25.0 (11.246.9)
Portugal Medeiros 2005 416 44.2 (39.549.0)
Nobre 2010 28 10.7 (3.727.2)
Romania Ursu 2011 107 5.6 (2.611.7)
Anton 2011 87 11.5 (6.419.9)
Russia Kulmala 2007 94 35.1 (26.245.2)
Spain de Oa 2010 1,356 12.2 (10.614.1)
Martn 2011 387 24.8 (20.829.3)
HerraezHernandez 2013 236 39.8 (33.846.2)
GarcaSierra 2009 108 17.6 (11.625.8)
ConesaZamora 2009 75 29.3 (20.240.4)
DomnechPeris 2010 21 23.8 (10.645.1)
de Mndez 2009 3 66.7 (20.893.9)
Sweden SderlundStrand 2011 1,035 24.2 (21.626.9)
BrismarWendel 2009 223 20.6 (15.826.4)
Kalantari 1997 141 17.7 (12.324.9)
Andersson 2005 50 20.0 (11.233.0)
Zehbe 1996 45 40.0 (27.054.5)
Switzerland Dobec 2011 136 25.0 (18.532.9)
UK Sargent 2008 878 17.3 (15.020.0)
HowellJones 2010 697 20.5 (17.723.7)
Anderson 2013 417 24.0 (20.128.3)
Cuschieri 2004 243 28.0 (22.733.9)
Hibbitts 2008 126 27.8 (20.736.2)
Giannoudis 1999 118 12.7 (7.919.9)
Jamison 2009 97 27.8 (19.937.5)
Woo 2010 60 41.7 (30.154.3)
Cuzick 1999 50 12.0 (5.623.8)
Southern 2001 49 10.2 (4.421.8)
Arends 1993 20 15.0 (5.236.0)
Cuzick 1994 13 23.1 (8.250.3)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 64: Prevalence of HPV 16 among women with low-grade cervical lesions in Oceania by country
and study

Australia Garland 2011 239 24.3 (19.330.1)
Stevens 2009 196 13.3 (9.218.7)
Brestovac 2005 38 28.9 (17.044.8)
0% 10% 20% 30% 40% 50%


Figure 65: Prevalence of HPV 16 among women with high-grade cervical lesions in Africa by country
and study

Cameroon Untiet 2014 6 16.7 (3.056.4)
Cte d'Ivoire La Ruche 1998 49 30.6 (19.544.5)
DR Congo Hovland 2010 16 31.3 (14.255.6)
Eq. Guinea GarcaEspinosa 2009 16 18.8 (6.643.0)
Ethiopia Abate 2013 13 61.5 (35.582.3)
Guinea Keita 2009 15 20.0 (7.045.2)
Kenya De Vuyst 2003 29 34.5 (19.952.7)
De Vuyst 2010 7 28.6 (8.264.1)
De Vuyst 2012 2 50.0 (9.590.5)
Nigeria Haghshenas 2013 32 21.9 (11.038.8)
Gage 2012 27 22.2 (10.640.8)
Rwanda Singh 2009 6 0.0 (0.039.0)
Senegal Xi 2003 66 19.7 (11.930.8)
Chabaud 1996 23 43.5 (25.663.2)
South Africa Allan 2008 53 18.9 (10.631.4)
van Aardt Unpublished 45 31.1 (19.545.7)
De Vuyst 2012 9 55.6 (26.781.1)
Said 2009 8 12.5 (2.247.1)
Sudan Abate 2013 1 100.0 (20.7100.0)
Tanzania Dartell 2014 96 30.2 (21.940.0)
Zimbabwe Sawaya 2008 11 9.1 (1.637.7)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

95% CI: 95% Confidence Interval; High-grade lesions: CIN-2, CIN-3, CIS or HSIL; N: number of women tested;

Figure 66: Prevalence of HPV 16 among women with high-grade cervical lesions in the Americas by
country and study

Argentina Abba 2003 82 48.8 (38.359.4)
Alonio 2003 50 54.0 (40.467.0)
Venezuela 2012 42 21.4 (11.735.9)
Chouhy 2006 12 58.3 (32.080.7)
Deluca 2004 5 60.0 (23.188.2)
Belize Cathro 2009 15 46.7 (24.869.9)
Brazil Resende 2014 443 49.2 (44.653.9)
Tomita 2010 367 59.9 (54.964.8)
Chagas 2015 113 35.4 (27.244.6)
Fernandes 2010 102 61.8 (52.170.6)
Camara 2003 95 30.5 (22.240.4)
Pitta 2010 85 51.8 (41.362.1)
Ribeiro 2011 83 48.2 (37.858.8)
Lorenzato 2000 60 56.7 (44.168.4)
Fernandes 2009 56 53.6 (40.766.0)
Terra 2007 33 69.7 (52.782.6)
Krambeck 2008 16 25.0 (10.249.5)
Freitas 2007 10 40.0 (16.868.7)
Carestiato 2006 3 66.7 (20.893.9)
Canada Coutle 2011 365 65.5 (60.570.2)
Antonishyn 2008 305 46.9 (41.452.5)
Moore 2009 63 52.4 (40.364.2)
Jiang 2011 21 38.1 (20.859.1)
Chile Ili 2011 110 55.5 (46.164.4)
Colombia Muoz 1992 135 34.8 (27.343.2)
Bosch 1993 125 32.8 (25.241.4)
Garca 2011 49 91.8 (80.896.8)
Costa Rica Herrero 2005 108 45.4 (36.354.8)
Cuba Soto 2007 45 31.1 (19.545.7)
Ecuador Meja 2016 109 33.9 (25.743.2)
Rattray 1996 66 24.2 (15.535.8)
Mexico IlladesAguiar 2010 91 27.5 (19.437.4)
PiaSnchez 2006 59 42.4 (30.655.1)
VelzquezMrquez 2009 51 13.7 (6.825.7)
TorroellaKouri 1998 24 58.3 (38.875.5)
Giuliano 2001 22 27.3 (13.248.2)
Peru Martorell 2012 32 50.0 (33.666.4)
USA Hariri 2012 3,058 47.2 (45.449.0)
Joste 2015 1,880 54.1 (51.856.3)
Wheeler 2009 1,230 56.3 (53.559.0)
Wentzensen 2009 626 58.8 (54.962.6)
Castle 2010 608 59.9 (55.963.7)
Castle 2011 367 44.4 (39.449.5)
Wheeler 2006 331 47.7 (42.453.1)
Adam 1998 257 51.0 (44.957.0)
Evans 2006 199 49.2 (42.456.1)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 67: Prevalence of HPV 16 among women with high-grade cervical lesions in the Americas by

USA Hariri 2012 180 48.9 (41.756.1)
Moscicki 2008 122 47.5 (38.956.3)
Zuna 2007 122 43.4 (35.052.3)
Einstein 2007 97 41.2 (32.051.2)
Hu 2005 97 40.2 (31.050.2)
Vidal 2014 88 29.5 (21.039.8)
Stoler 2011 80 51.2 (40.561.9)
Guo 2007 61 36.1 (25.248.6)
Voss 2009 26 61.5 (42.577.6)
Evans 2003 22 68.2 (47.383.6)
Kong 2007 14 50.0 (26.873.2)
Bell 2007 10 40.0 (16.868.7)
Lee 2009 10 60.0 (31.383.2)
Giuliano 2001 8 12.5 (2.247.1)
Venezuela SnchezLander 2012 233 53.6 (47.259.9)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%


Figure 68: Prevalence of HPV 16 among women with high-grade cervical lesions in Asia by country and
study

China Chan 2006 1,577 35.7 (33.438.1)
Chan 2012 1,577 35.8 (33.438.2)
Yuan 2011 518 47.5 (43.251.8)
Li 2012 457 44.6 (40.149.2)
Singh 2015 399 10.5 (7.913.9)
Ding 2014 256 49.2 (43.255.3)
Guo 2010 156 35.3 (28.243.0)
Tao 2006 153 39.9 (32.547.8)
Li 2013 147 42.9 (35.150.9)
Zhao 2008 140 32.1 (25.040.3)
Liu 2008 99 36.4 (27.646.2)
Chan 1999 89 25.8 (17.935.8)
Wu 2013 72 59.7 (48.270.3)
Zhang 2013 68 64.7 (52.875.0)
Li 2011 63 34.9 (24.347.2)
Sun 2014 50 44.0 (31.257.7)
Zhao 2014 46 63.0 (48.675.5)
Chan 1996 45 24.4 (14.238.7)
Wu 1994 34 35.3 (21.552.1)
Jin 2010 33 15.2 (6.730.9)
India Deodhar 2012 146 65.1 (57.072.3)
Singh 2009 62 45.2 (33.457.5)
Nagpal 2002 25 48.0 (30.066.5)
Franceschi 2005 20 35.0 (18.156.7)
Iran Esmaeili 2008 38 63.2 (47.376.6)
Ghaffari 2006 7 71.4 (35.991.8)
Khodakarami 2012 2 50.0 (9.590.5)
Israel Bassal 2015 886 65.9 (62.769.0)
Laskov 2013 32 71.9 (54.684.4)
Japan Azuma 2014 832 41.8 (38.545.2)
Takehara 2011 449 28.1 (24.132.4)
Onuki 2009 307 22.8 (18.527.8)
Sasagawa 2001 137 35.8 (28.244.1)
Yamasaki 2011 128 43.8 (35.552.4)
Okadome 2014 122 27.0 (20.035.5)
Nakamura 2015 99 38.4 (29.448.2)
Matsumoto 2011 91 15.4 (9.424.2)
Inoue 2006 83 33.7 (24.544.4)
Nishiwaki 2008 73 28.8 (19.740.0)
Nagai 2000 58 37.9 (26.650.8)
Yoshida 2004 33 33.3 (19.850.4)
Ichimura 2003 31 41.9 (26.459.2)
Tsuda 2003 26 11.5 (4.029.0)
Niwa 2003 22 36.4 (19.757.0)
Konno 2011 7 57.1 (25.084.2)
Kuwait AlAwadhi 2011 12 33.3 (13.860.9)
AlAwadhi 2013 12 33.3 (13.860.9)
Malaysia Quek 2013 73 41.1 (30.552.6)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 69: Prevalence of HPV 16 among women with high-grade cervical lesions in Asia by country and
study (continued)

Pakistan Raza 2010 2 50.0 (9.590.5)
Philippines Quek 2013 6 0.0 (0.039.0)
Rep. Korea Kang 2009 317 39.7 (34.545.2)
Kahng 2014 100 45.0 (35.654.8)
Quek 2013 100 36.0 (27.345.8)
Hwang 2003 73 24.7 (16.235.6)
Cho 2003 72 51.4 (40.162.6)
Oh 2001 42 40.5 (27.055.5)
Singapore Quek 2013 106 39.6 (30.849.1)
Sri Lanka Karunaratne 2014 8 50.0 (21.578.5)
Taiwan Chao 2010 1,086 24.1 (21.726.8)
Lai 2003 131 27.5 (20.635.7)
Ho 2005 97 18.6 (12.127.4)
Chao 2008 57 17.5 (9.829.4)
Lin 2005 20 35.0 (18.156.7)
Yang 2004 2 50.0 (9.590.5)
Thailand Swangvaree 2013 355 12.4 (9.416.2)
Chansaenroj 2014 200 36.5 (30.143.4)
Sukasem 2011 166 33.7 (27.041.2)
Limpaiboon 2000 21 33.3 (17.254.6)
Chansaenroj 2010 8 25.0 (7.159.1)
Suwannarurk 2009 3 33.3 (6.179.2)
Turkey Baser 2014 584 25.3 (22.029.0)
Sahiner 2012 20 60.0 (38.778.1)
Yuce 2012 16 25.0 (10.249.5)
Tezcan 2014 8 25.0 (7.159.1)
Viet Nam Quek 2013 123 34.1 (26.442.9)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 70: Prevalence of HPV 16 among women with high-grade cervical lesions in Europe by country
and study

Austria Rssler 2013 204 55.9 (49.062.5)
Belarus Kulmala 2007 91 56.0 (45.865.8)
Belgium Depuydt 2003 134 50.0 (41.758.3)
Beerens 2005 123 43.1 (34.751.9)
Arbyn 2009 109 34.9 (26.644.2)
Baay 2001 97 56.7 (46.866.1)
Croatia Grce 2001 783 17.1 (14.619.9)
Grce 2004 158 20.3 (14.727.2)
Denmark Kjr 2014 1,156 52.1 (49.254.9)
Thomsen 2015 732 35.8 (32.439.3)
Kirschner 2013 225 46.2 (39.852.7)
Kjaer 2008 177 48.0 (40.855.3)
Bonde 2014 106 34.9 (26.544.4)
Sebbelov 1994 34 85.3 (69.993.6)
Hording 1995 30 50.0 (33.266.8)
Europe Tjalma 2013 3,103 47.2 (45.549.0)
France Prtet 2008 493 62.3 (57.966.4)
Vaucel 2011 141 42.6 (34.750.8)
Monsonego 2008 54 33.3 (22.246.6)
Germany Meyer 2001 288 46.2 (40.552.0)
de Jonge 2013 247 34.4 (28.840.5)
MerkelbachBruse 1999 88 61.4 (50.970.9)
Nindl 1997 85 36.5 (27.047.1)
Nindl 1999 65 56.9 (44.868.2)
Klug 2007 46 54.3 (40.267.8)
Greece Argyri 2013 78 37.2 (27.348.3)
Panotopoulou 2007 60 36.7 (25.649.3)
Tsiodras 2011 54 50.0 (37.162.9)
Labropoulou 1997 50 36.0 (24.149.9)
Agorastos 2005 43 58.1 (43.371.6)
Daponte 2006 29 51.7 (34.468.6)
Paraskevaidis 2001 28 35.7 (20.754.2)
Kroupis 2007 26 50.0 (32.167.9)
Hungary Szoke 2003 75 57.3 (46.167.9)
Iceland Sigurdsson 2007 441 51.2 (46.655.9)
Ireland Keegan 2014 242 69.4 (63.474.9)
Murphy 2003 64 78.1 (66.686.5)
Butler 2000 27 70.4 (51.584.1)
O'Leary 1998 20 95.0 (76.499.1)
Italy Spinillo 2014 1,344 48.4 (45.851.1)
Carozzi 2010 529 62.9 (58.867.0)
Carozzi 2014 204 53.9 (47.160.6)
Zerbini 2001 89 50.6 (40.460.7)
Sandri 2009 76 73.7 (62.882.3)
Agarossi 2009 73 53.4 (42.164.4)
Gargiulo 2007 67 38.8 (28.050.8)
Tornesello 2006 65 47.7 (36.059.6)
Venturoli 2008 56 60.7 (47.672.4)
Laconi 2000 36 50.0 (34.565.5)
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 71: Prevalence of HPV 16 among women with high-grade cervical lesions in Europe by country

Italy Capra 2008 14 42.9 (21.467.4)
Giorgi Rossi 2010 8 37.5 (13.769.4)
Latvia Kulmala 2007 91 56.0 (45.865.8)
Lithuania Simanaviciene 2014 157 51.6 (43.859.3)
Gudleviciene 2005 29 48.3 (31.465.6)
Netherlands Tang 2009 253 70.8 (64.976.0)
Bulkmans 2005 236 60.6 (54.266.6)
ReesinkPeters 2001 216 56.9 (50.363.4)
Cornelissen 1992 89 52.8 (42.562.8)
Prinsen 2007 41 51.2 (36.565.7)
van Duin 2003 20 65.0 (43.381.9)
Norway Roberts 2006 885 44.1 (40.847.4)
Sjoeborg 2010 630 20.6 (17.724.0)
Kraus 2004 67 49.3 (37.760.9)
Molden 2005 25 28.0 (14.347.6)
Portugal Pista 2013 518 55.6 (51.359.8)
Pista 2011 191 27.7 (21.934.5)
Medeiros 2005 132 74.2 (66.280.9)
Nobre 2010 34 32.4 (19.149.2)
Romania Anton 2011 52 48.1 (35.161.3)
Ursu 2011 41 31.7 (19.647.0)
Russia Kulmala 2007 91 56.0 (45.865.8)
Slovenia Kovanda 2009 261 62.5 (56.468.1)
Spain de Oa 2010 306 28.8 (24.034.1)
Bosch 1993 157 49.0 (41.356.8)
Muoz 1992 157 51.0 (43.258.7)
Martn 2011 82 48.8 (38.359.4)
ConesaZamora 2009 39 33.3 (20.649.0)
Darwich 2011 34 61.8 (45.076.1)
GarcaSierra 2009 25 36.0 (20.255.5)
de Mndez 2009 4 75.0 (30.195.4)
Sweden Kalantari 1997 164 35.4 (28.542.9)
Andersson 2005 116 37.1 (28.846.1)
Zehbe 1996 103 50.5 (41.059.9)
Switzerland Dobec 2011 33 57.6 (40.872.8)
UK HowellJones 2010 1,425 54.1 (51.556.7)
Sargent 2008 562 46.8 (42.750.9)
Cuzick 2014 354 31.1 (26.536.1)
Geraets 2014 99 43.4 (34.153.3)
Cuschieri 2004 94 48.9 (39.158.9)
Hibbitts 2008 93 40.9 (31.451.0)
Cuzick 1994 73 63.0 (51.573.2)
Anderson 2013 72 56.9 (45.467.7)
Jamison 2009 51 49.0 (35.962.3)
Arends 1993 40 50.0 (35.264.8)
Herrington 1995 38 57.9 (42.272.1)
Southern 1998 26 61.5 (42.577.6)
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 72: Prevalence of HPV 16 among women with high-grade cervical lesions in Oceania by country
and study

Australia Stevens 2009 533 51.4 (47.255.6)
Stevens 2006 302 37.1 (31.842.7)
Callegari 2014 169 56.2 (48.763.5)
Brestovac 2005 48 33.3 (21.747.5)
Garland 2011 47 51.1 (37.264.7)
Fiji Tabrizi 2011 112 64.3 (55.172.6)
New Zealand Kang 2015 418 54.3 (49.559.0)
20% 30% 40% 50% 60% 70% 80%


Figure 73: Prevalence of HPV 16 among women with invasive cervical cancer in Africa by country and
study

Africa de Sanjose 2010(a) 667 38.4 (34.842.1)
Bosch 1995 12 33.3 (13.860.9)
Benin Bosch 1995 6 50.0 (18.881.2)
Botswana Ermel 2014 117 32.5 (24.741.4)
Ethiopia Fanta 2005 163 71.8 (64.478.1)
Abate 2013 136 86.0 (79.290.9)
Ghana Awua 2016 227 7.5 (4.711.7)
Denny 2014 121 55.4 (46.563.9)
Guinea Keita 2009 66 42.4 (31.254.4)
Bosch 1995 18 38.9 (20.361.4)
Kenya De Vuyst 2008 153 43.8 (36.251.7)
De Vuyst 2012 85 54.1 (43.664.3)
Mali Bayo 2002 65 47.7 (36.059.6)
Bosch 1995 58 34.5 (23.647.3)
Morocco Chaouki 1998 152 58.6 (50.666.1)
El khair 2010 113 56.6 (47.465.4)
Mozambique Naucler 2004 72 55.6 (44.166.5)
Nigeria Denny 2014 145 52.4 (44.360.4)
Senegal Lin 2001 51 37.3 (25.351.0)
Xi 2003 20 35.0 (18.156.7)
South Africa Pegoraro 2002 190 46.8 (39.953.9)
Denny 2014 181 47.5 (40.454.8)
van Aardt 2015 154 48.1 (40.355.9)
Williamson 1994 67 44.8 (33.556.6)
De Vuyst 2012 51 52.9 (39.565.9)
Kay 2003 50 82.0 (69.290.2)
Sudan Abate 2013 84 77.4 (67.485.0)
Tanzania ter Meulen 1992 53 37.7 (25.951.2)
Bosch 1995 49 44.9 (31.958.7)
Tunisia KrennHrubec 2011 141 61.0 (52.868.7)
Uganda Odida 2008 112 48.2 (39.257.4)
Bosch 1995 42 52.4 (37.766.6)
Zimbabwe Stanczuk 2003 98 61.2 (51.370.3)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

a Includes cases from Algeria, Mozambique, Nigeria, and Uganda

Figure 74: Prevalence of HPV 16 among women with invasive cervical cancer in the Americas by country
and study

Argentina Turazza 1997 139 61.9 (53.669.5)
Bosch 1995 57 59.6 (46.771.4)
Alonio 2003 39 56.4 (41.070.7)
Golijow 2005 35 68.6 (52.081.4)
Bolivia Bosch 1995 47 34.0 (22.248.3)
Brazil Serrano 2014 526 51.7 (47.456.0)
Cambruzzi 2005 229 27.1 (21.733.2)
ElufNeto 1994 186 58.6 (51.465.4)
de Oliveira 2013 172 76.7 (69.982.4)
Tomita 2010 109 58.7 (49.367.5)
Lorenzato 2000 59 59.3 (46.670.9)
RabeloSantos 2003 53 56.6 (43.369.0)
Bosch 1995 46 52.2 (38.165.9)
RabeloSantos 2009 13 53.8 (29.176.8)
Canada Duggan 1995 76 35.5 (25.746.7)
TranThanh 2003 50 54.0 (40.467.0)
Bosch 1995 45 60.0 (45.573.0)
Chile Roa 2009 293 76.8 (71.681.3)
Valdivia L 2010 90 61.1 (50.870.5)
Bosch 1995 80 45.0 (34.655.9)
Colombia Murillo 2009 217 51.2 (44.557.7)
Muoz 1992 111 54.1 (44.863.0)
MorenoAcosta 2008 59 57.6 (44.969.4)
Bosch 1995 38 52.6 (37.367.5)
Costa Rica Herrero 2005 35 45.7 (30.561.8)
Cuba Bosch 1995 45 57.8 (43.371.0)
Ecuador Meja 2016 58 37.9 (26.650.8)
Greenland Sebbelov 2000 32 81.3 (64.791.1)
Mexico GuardadoEstrada 2014 924 51.3 (48.154.5)
Serrano 2014 545 47.9 (43.752.1)
CarrilloGarca 2014 287 56.4 (50.762.1)
IlladesAguiar 2009 133 66.9 (58.574.3)
AguilarLemarroy 2015 121 62.8 (53.970.9)
PiaSnchez 2006 108 72.2 (63.179.8)
FloresMiramontes 2015 87 48.3 (38.158.6)
TorroellaKouri 1998 66 43.9 (32.655.9)
Meyer 1998 60 43.3 (31.655.9)
AlarcnRomero 2009 15 66.7 (41.784.8)
GonzlezLosa 2004 15 26.7 (10.952.0)
VelzquezMrquez 2009 8 75.0 (40.992.9)
Panama Bosch 1995 71 46.5 (35.458.0)
Paraguay Kasamatsu 2012 417 48.0 (43.252.8)
Roln 2000 113 59.3 (50.167.9)
Peru Santos 2001 196 56.1 (49.162.9)
Martorell 2012 53 50.9 (37.963.9)
Suriname De Boer 2005 116 35.3 (27.244.4)
Trinidad & Tob. Hosein 2013 78 47.4 (36.758.4)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 75: Prevalence of HPV 16 among women with invasive cervical cancer in the Americas by country

USA Wheeler 2009 808 53.2 (49.856.6)
Hopenhayn 2014 777 50.8 (47.354.3)
Schwartz 2001 452 59.1 (54.563.5)
Burger 1996 393 51.4 (46.556.3)
de Sanjose 2010 173 65.3 (58.072.0)
Joste 2015 163 49.1 (41.556.7)
Wentzensen 2009 107 55.1 (45.764.2)
Hariri 2012 93 53.8 (43.763.5)
Zuna 2007 93 55.9 (45.865.6)
Pirog 2000 82 36.6 (27.047.4)
Patel 2009 77 59.7 (48.670.0)
Sebbelov 2000 53 77.4 (64.586.5)
Paquette 1993 45 48.9 (35.063.0)
Quint 2009 40 60.0 (44.673.7)
Resnick 1990 33 75.8 (59.087.2)
Guo 2007 29 69.0 (50.882.7)
Ferguson 1998 27 25.9 (13.244.7)
Bryan 2006 24 58.3 (38.875.5)
Burnett 1992 20 70.0 (48.185.5)
Wistuba 1997 20 60.0 (38.778.1)
Bosch 1995 11 54.5 (28.078.7)
Venezuela SnchezLander 2012 96 67.7 (57.876.2)
10% 20% 30% 40% 50% 60% 70% 80% 90%


Figure 76: Prevalence of HPV 16 among women with invasive cervical cancer in Asia by country and
study

Asia de Sanjose 2010(a) 940 58.0 (54.861.1)
China Wang 2015 1,336 38.3 (35.841.0)
Lo 2002 809 66.9 (63.670.0)
Chen 2009 630 76.7 (73.279.8)
Chan 2012 444 59.0 (54.463.5)
Chan 2009 435 56.1 (51.460.7)
Wu 2008 300 68.7 (63.273.7)
Yuan 2011 198 65.2 (58.371.4)
Wu 2008 190 73.7 (67.079.4)
Hong 2008 181 65.2 (58.071.8)
Qiu 2007 145 78.6 (71.384.5)
Liu 2010 134 73.1 (65.179.9)
Lo 2001 121 48.8 (40.057.6)
Ding 2014 116 56.9 (47.865.5)
Cai 2009 112 81.3 (73.087.4)
Cai 2008 110 81.8 (73.687.9)
Shah 2009 108 66.7 (57.374.8)
Liu 2004 106 50.0 (40.659.4)
Peng 1991 101 31.7 (23.441.3)
Zhao 2008 100 52.0 (42.361.5)
Liu 2008 96 45.8 (36.255.8)
Li 2013 78 53.8 (42.964.5)
Lin 1998 77 48.1 (37.359.0)
Wu 2009 77 83.1 (73.289.9)
Gao 2003 65 40.0 (29.052.1)
Liu 2005 50 66.0 (52.277.6)
Yu 2003 50 70.0 (56.280.9)
Huang 1997 40 27.5 (16.142.8)
Stephen 2000 31 58.1 (40.873.6)
Tao 2006 27 55.6 (37.372.4)
Georgia Alibegashvili 2011 91 58.2 (48.067.8)
India Basu 2009 273 65.9 (60.171.3)
Munjal 2014 270 73.7 (68.178.6)
Franceschi 2003 191 62.8 (55.869.4)
Gheit 2009 180 81.7 (75.486.6)
Nambaru 2009 121 72.7 (64.279.9)
Peedicayil 2006 119 60.5 (51.568.8)
Deodhar 2012 113 76.1 (67.583.0)
Nair 1999 110 69.1 (59.977.0)
Bhatla 2006 106 73.6 (64.581.0)
Nagpal 2002 71 60.6 (48.971.1)
Neyaz 2008 60 86.7 (75.893.1)
Munagala 2009 43 65.1 (50.277.6)
Munirajan 1998 43 53.5 (38.967.5)
Sowjanya 2005 41 58.5 (43.472.2)
Peedicayil 2009 28 78.6 (60.589.8)
Indonesia De Boer 2005 74 33.8 (24.045.1)
Schellekens 2004 74 43.2 (32.654.6)
Bosch 1995 47 31.9 (20.446.2)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

a Includes cases from Bangladesh, India, Israel, Kuwait, Lebanon and Turkey

study (continued)

Indonesia Tobing 2014 40 90.0 (76.996.0)
Iran SalehiVaziri 2015 112 27.7 (20.236.6)
Esmaeili 2008 70 54.3 (42.765.4)
Mortazavi 2002 69 73.9 (62.582.8)
Khodakarami 2012 45 60.0 (45.573.0)
Hamkar 2002 42 28.6 (17.243.6)
Ghaffari 2006 7 85.7 (48.797.4)
Israel Bassal 2015 84 66.7 (56.175.8)
Laskov 2013 38 60.5 (44.774.4)
Japan Maehama 2005 383 29.0 (24.733.7)
Asato 2004 356 37.1 (32.242.2)
Azuma 2014 296 48.0 (42.353.7)
Nakagawa 1996 146 37.7 (30.245.8)
Onuki 2009 140 37.9 (30.246.1)
Takehara 2011 105 41.9 (32.951.5)
Kashiwabara 1992 91 42.9 (33.253.1)
Harima 2002 84 26.2 (18.036.5)
Sasagawa 2001 84 42.9 (32.853.5)
Yamasaki 2011 71 42.3 (31.553.8)
Saito 2000 66 34.8 (24.546.9)
Imajoh 2012 64 12.5 (6.522.8)
Yamakawa 1994 64 32.8 (22.645.0)
Watari 2011 60 83.3 (72.090.7)
Tsuda 2003 53 28.3 (18.041.6)
Ishikawa 2001 52 53.8 (40.566.7)
Fujinaga 1991 39 48.7 (33.963.8)
Maki 1991 29 44.8 (28.462.5)
Nakagawa 2002 28 39.3 (23.657.6)
Kanao 2004 25 32.0 (17.251.6)
Nawa 1995 23 73.9 (53.587.5)
Yoshida 2009 20 35.0 (18.156.7)
Yoshida 2004 15 33.3 (15.258.3)
Inoue 2006 12 33.3 (13.860.9)
Jordan Sughayer 2010 41 68.3 (53.080.4)
Kuwait AlAwadhi 2013 7 57.1 (25.084.2)
Malaysia Hamzi Abdul Raub 2014 280 57.5 (51.663.2)
Quek 2013 101 36.6 (27.946.4)
Yadav 1995 23 73.9 (53.587.5)
Sharifah 2009 13 15.4 (4.342.2)
Cheah 2008 11 72.7 (43.490.3)
Mongolia Chimeddorj 2008 147 48.3 (40.456.3)
Nepal Sherpa 2010 61 60.7 (48.171.9)
Pakistan Raza 2010 91 75.8 (66.183.5)
Khan 2007 60 95.0 (86.398.3)
Philippines Ngelangel 1998 356 38.8 (33.843.9)
Quek 2013 103 31.1 (22.940.5)
Bosch 1995 24 45.8 (27.964.9)
Rep. Korea Kim 2009 169 65.7 (58.272.4)
Lee 2007 160 51.9 (44.259.5)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


study (continued)

Rep. Korea An 2005 135 44.4 (36.352.9)
Quek 2013 97 58.8 (48.868.0)
Tong 2007 97 51.5 (41.761.2)
Hwang 2003 72 52.8 (41.463.9)
An 2003 50 64.0 (50.175.9)
Cho 2003 49 61.2 (47.273.6)
Hwang 1999 40 37.5 (24.253.0)
Kim 1995 30 53.3 (36.169.8)
Song 2007 29 65.5 (47.380.1)
Saudi Arabia Alsbeih 2011 100 67.0 (57.375.4)
Singapore Quek 2013 65 36.9 (26.249.1)
Sri Lanka Samarawickrema 2011 108 77.8 (69.184.6)
Karunaratne 2014 98 67.3 (57.675.8)
Syria Darnel 2010 44 47.7 (33.862.1)
Taiwan Lai 2007 2,106 50.3 (48.252.4)
Chen 1994 430 46.0 (41.450.8)
Ding 2008 263 43.7 (37.949.8)
Huang 2004 152 65.8 (57.972.9)
Huang 2004 149 98.7 (95.299.6)
Su 2007 137 58.4 (50.066.3)
Yang 1997 134 64.2 (55.871.8)
Lai 1999 93 51.6 (41.661.5)
Ho 2005 81 30.9 (21.941.6)
Chen 1993 43 46.5 (32.561.1)
Lin 2005 28 53.6 (35.870.5)
Chao 2009 25 72.0 (52.485.7)
Yang 2004 25 36.0 (20.255.5)
Thailand Chansaenroj 2014 832 51.0 (47.654.3)
Chichareon 1998 377 54.6 (49.659.6)
Natphopsuk 2013 198 48.0 (41.154.9)
Bhattarakosol 1996 100 35.0 (26.444.7)
Siriaunkgul 2008 99 77.8 (68.684.8)
SettheethamIshida 2005 90 61.1 (50.870.5)
Chopjitt 2009 40 75.0 (59.885.8)
Bosch 1995 27 59.3 (40.775.5)
Siritantikorn 1997 23 56.5 (36.874.4)
Turkey Usubtn 2009 508 58.7 (54.362.9)
Ozgul 2008 23 52.2 (33.070.8)
Viet Nam Quek 2013 134 48.5 (40.256.9)
20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 79: Prevalence of HPV 16 among women with invasive cervical cancer in Europe by country and
study

Austria Bachtiary 2002 106 65.1 (55.673.5)
Widschwendter 2003 94 75.5 (66.083.1)
Belarus Kulmala 2007 26 65.4 (46.280.6)
Belgium Baay 2001 111 68.5 (59.376.4)
Beerens 2005 9 33.3 (12.164.6)
Bulgaria Todorova 2010 127 70.9 (62.478.1)
Croatia Hadzisejdic 2006 66 30.3 (20.642.2)
Dabic 2008 51 62.7 (49.074.7)
Slama 2009 49 61.2 (47.273.6)
Tachezy 1999 49 59.2 (45.271.8)
Denmark Kirschner 2013 245 60.8 (54.666.7)
Hording 1997 50 18.0 (9.830.8)
Sebbelov 2000 34 70.6 (53.883.2)
Kjr 2014 27 40.7 (24.559.3)
Kjaer 2008 6 33.3 (9.770.0)
Europe Tjalma 2013 2,881 55.9 (54.157.7)
de Sanjose 2010(a) 2,302 57.4 (55.459.4)
Finland Iwasawa 1996 460 63.5 (59.067.7)
France Prtet 2008 516 72.9 (68.976.5)
de Cremoux 2009 515 55.5 (51.259.8)
Lombard 1998 297 50.5 (44.856.1)
Riou 1990 106 54.7 (45.263.9)
Germany MildeLangosch 1995 51 51.0 (37.764.1)
Bosch 1995 17 76.5 (52.790.4)
Klug 2007 1 100.0 (20.7100.0)
Greece Panotopoulou 2007 165 24.2 (18.331.3)
Dokianakis 1999 77 2.6 (0.79.0)
Koffa 1994 39 35.9 (22.751.6)
Labropoulou 1997 35 54.3 (38.269.5)
Adamopoulou 2009 17 47.1 (26.269.0)
Daponte 2006 9 100.0 (70.1100.0)
Hungary Knya 1995 44 56.8 (42.270.3)
Iceland Sigurdsson 2007 140 57.1 (48.965.0)
Ireland Skyldberg 1999 38 23.7 (13.039.2)
Butler 2000 29 93.1 (78.098.1)
O'Leary 1998 20 80.0 (58.491.9)
Fay 2009 10 80.0 (49.094.3)
Italy Sideri 2009 268 63.4 (57.569.0)
Carozzi 2010 193 67.9 (61.074.1)
Spinillo 2014 176 54.5 (47.261.7)
Tornesello 2011 171 58.5 (51.065.6)
Voglino 2000 145 71.0 (63.277.8)
Ciotti 2006 102 57.8 (48.167.0)
Tornesello 2006 65 60.0 (47.971.0)
Del Mistro 2006 45 71.1 (56.682.3)
Garzetti 1998 32 50.0 (33.666.4)
Gargiulo 2007 31 61.3 (43.876.3)
Rolla 2009 18 66.7 (43.783.7)
Lillo 2008 13 61.5 (35.582.3)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

a Includes cases from Bosnia-Herzegovina, Croatia, Czech Republic, France, Greece, Italy, Netherlands, Poland, Portugal, and Spain

study (continued)

Italy Venturoli 2008 6 50.0 (18.881.2)
Latvia Silins 2004 221 60.6 (54.166.8)
Kulmala 2007 26 65.4 (46.280.6)
Simanaviciene 2014 75 50.7 (39.661.7)
Luxembourg Ressler 2007 58 79.3 (67.287.7)
Netherlands Tang 2009 340 63.5 (58.368.5)
Baay 1996 162 61.7 (54.168.9)
Bulk 2006 153 54.2 (46.361.9)
Krul 1999 128 58.6 (49.966.8)
Baalbergen 2013 113 32.7 (24.841.8)
De Boer 2005 105 43.8 (34.753.4)
Zielinski 2003 77 32.5 (23.143.5)
Van Den Brule 1991 50 84.0 (71.591.7)
Resnick 1990 33 75.8 (59.087.2)
Bulkmans 2005 8 62.5 (30.686.3)
Norway Karlsen 1996 361 68.4 (63.573.0)
Bertelsen 2006 89 52.8 (42.562.8)
Poland Kwasniewska 2009 570 58.4 (54.362.4)
Baay 2009 113 85.8 (78.291.1)
Bardin 2008 88 73.9 (63.881.9)
Biesaga 2012 85 80.0 (70.387.1)
Pirog 2000 82 36.6 (27.047.4)
Dybikowska 2002 53 47.2 (34.460.3)
Bosch 1995 23 78.3 (58.190.3)
Portugal Pista 2013 64 70.3 (58.280.1)
Medeiros 2005 60 80.0 (68.288.2)
Nobre 2010 44 61.4 (46.674.3)
Russia Kleter 1999 180 64.4 (57.271.1)
Kulmala 2007 26 65.4 (46.280.6)
Slovenia Jancar 2009 264 65.2 (59.270.6)
Spain Muoz 1992 159 54.1 (46.361.6)
Martr 2012 73 47.9 (36.959.2)
Darwich 2011 72 79.2 (68.486.9)
Rodriguez 1998 54 61.1 (47.873.0)
Bosch 1995 46 54.3 (40.267.8)
Mazarico 2012 37 43.2 (28.759.1)
GonzlezBosquet 2008 21 52.4 (32.471.7)
Sweden Du 2011 154 58.4 (50.565.9)
Andersson 2001 131 23.7 (17.231.6)
Graflund 2004 110 79.1 (70.685.6)
Wallin 1999 104 47.1 (37.856.6)
Andersson 2003 82 34.1 (24.844.9)
Hagmar 1992 71 38.0 (27.649.7)
Andersson 2005 45 66.7 (52.178.6)
Zehbe 1997 45 53.3 (39.167.1)
Skyldberg 1999 38 23.7 (13.039.2)
UK Mesher 2015 1,235 63.0 (60.365.6)
HowellJones 2010 555 62.5 (58.466.5)
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


study (continued)

UK Cuschieri 2014 370 55.9 (50.960.9)
Cuschieri 2010 363 56.5 (51.361.5)
Powell 2009 269 67.7 (61.973.0)
Tawfik ElMansi 2006 119 46.2 (37.555.2)
Cuzick 2000 116 65.5 (56.573.5)
Arends 1993 47 53.2 (39.266.7)
Giannoudis 1999 43 81.4 (67.490.3)
Crook 1992 28 71.4 (52.984.7)
Sargent 2008 9 33.3 (12.164.6)
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 82: Prevalence of HPV 16 among women with invasive cervical cancer in Oceania by country
and study

Australia Stevens 2006 191 52.9 (45.859.8)
Chen 1999 170 55.9 (48.463.1)
de Sanjose 2010 160 60.0 (52.367.3)
Thompson 1994 103 65.0 (55.573.6)
Liu 2004 79 64.6 (53.674.2)
Plunkett 2003 50 28.0 (17.541.7)
Brestovac 2005 32 68.8 (51.482.0)
Papua N. Guinea Tabone 2012 70 57.1 (45.568.1)
10% 20% 30% 40% 50% 60% 70% 80% 90%


Figure 83: Comparison of the ten most frequent HPV oncogenic types among women with and without
cervical lesions by World compared to developing and developed regions
World Less developed regions More developed regions
16 2.9 16 3.0 16 2.8

Normal cytology
52 1.5 52 1.7 53 1.5

31 1.3 58 1.4 51 1.4
1.3 1.4 1.4
HPVtype
53 18 52
18 1.2 53 1.0 31 1.4
70 1.1 31 1.0 18 1.1
51 1.1 70 1.0 70 1.1
66 1.0 33 1.0 66 1.1
58 1.0 51 0.7 39 1.0
39 0.9 68 0.7 56 0.9
16 19.2 16 18.8 16 19.4

Lowgrade lesions
52 8.8 52 10.1 51 10.2

51 8.7 58 9.1 31 8.8
7.6 6.2 8.6
HPVtype
31 18 53
53 7.3 33 5.9 52 8.4
66 6.9 51 4.8 66 7.8
58 6.7 66 4.5 56 7.4
18 6.5 53 4.4 18 6.5
56 6.5 31 4.1 39 5.9
39 5.3 56 4.0 58 5.7
16 45.0 16 40.1 16 46.8

Highgrade lesions
52 11.0 52 12.7 31 12.4

31 10.4 58 12.2 52 11.2
8.1 6.5 7.6
HPVtype
58 18 33
33 7.3 31 6.3 18 7.3
18 6.8 33 6.3 58 7.0
51 5.7 51 4.0 51 6.9
53 3.5 53 3.1 39 4.1
35 3.3 66 2.3 35 4.0
39 3.3 45 2.3 53 3.7
16 55.1 16 55.6 16 55.6

Cervical Cancer
18 14.3 18 13.9 18 16.2

45 5.0 45 5.9 33 4.7
4.2 4.9 3.9
HPVtype
33 58 45
58 3.9 52 4.0 58 3.7
31 3.5 33 3.8 31 3.7
52 3.5 31 3.4 52 3.2
35 1.7 59 2.0 35 1.4
39 1.5 35 2.0 39 1.4
59 1.4 39 1.5 51 1.0
0 20 40 60 0 20 40 60 0 20 40 60
Prevalence (%) Prevalence (%) Prevalence (%)

High-grade lesions: CIN-2, CIN-3, CIS or HSIL; Low-grade lesions: LSIL or CIN-1;
The samples for HPV testing come from cervical specimens (fresh / fixed biopsies or exfoliated cells).

Figure 84: Comparison of the ten most frequent HPV types among women with invasive cervical cancer
by histology by World, developing and developed regions
World Less developed regions More developed regions
16 55.1 16 55.6 16 55.6

18 14.3 18 13.9 18 16.2
Any Histology
45 5.0 45 5.9 33 4.7

4.2 4.9 3.9
HPVtype
33 58 45
58 3.9 52 4.0 58 3.7
31 3.5 33 3.8 31 3.7
52 3.5 31 3.4 52 3.2
35 1.7 59 2.0 35 1.4
39 1.5 35 2.0 39 1.4
59 1.4 39 1.5 51 1.0
Squamous cell carcinoma
16 56.8 16 56.1 16 58.9

18 11.6 18 12.5 18 12.3
45 4.8 45 5.8 33 5.1
4.3 4.7 4.2
HPVtype
33 58 58
58 3.9 52 4.1 31 3.8
52 3.7 33 3.8 45 3.7
31 3.6 31 3.4 52 3.6
35 1.7 35 2.0 39 1.5
39 1.5 59 2.0 35 1.4
59 1.4 39 1.6 56 1.1
16 35.8 18 35.8 18 37.5

Adenocarcinoma
18 35.0 16 35.5 16 36.9

45 5.9 45 6.1 45 5.2
1.9 2.4 2.0
HPVtype
33 33 31
31 1.7 52 2.1 33 1.9
52 1.5 59 1.5 52 1.6
58 1.2 31 1.5 58 1.5
39 1.0 58 1.4 39 1.2
51 0.8 56 1.0 51 1.1
59 0.6 39 0.9 35 0.6
16 58.9 16 60.5 16 57.2

18 13.9 18 13.4 18 14.5
Unespecified
45 5.4 58 6.4 33 5.4

5.1 6.1 4.4
HPVtype
33 45 45
58 4.9 33 4.8 31 4.3
31 4.0 52 4.1 58 3.0
52 3.6 31 3.7 52 2.9
35 2.5 35 2.7 35 2.2
59 1.7 59 2.0 39 1.8
39 1.5 51 1.4 59 1.4
0 20 40 60 0 20 40 60 0 20 40 60
Prevalence (%) Prevalence (%) Prevalence (%)

The samples for HPV testing come from cervical specimens (fresh / fixed biopsies or exfoliated cells).

Table 14: Type-specific HPV prevalence in women with normal cervical cytology, precancerous cervical
lesions and invasive cervical cancer
Normal cytology Low-grade lesions High-grade lesions Cervical cancer
HPV Type No. HPV Prev No. HPV Prev No. HPV Prev No. HPV Prev
tested % (95% CI) tested % (95% CI) tested % (95% CI) tested % (95% CI)
ONCOGENIC HPV TYPES
High-risk HPV types
16 514,928 2.9 (2.9-3.0) 38,380 19.2 (18.8-19.6) 50,475 45.0 (44.6-45.4) 59,149 55.1 (54.7-55.5)
18 503,242 1.2 (1.1-1.2) 37,942 6.5 (6.2-6.7) 50,008 6.8 (6.6-7.0) 58,724 14.3 (14.0-14.5)
31 473,568 1.3 (1.3-1.4) 36,373 7.6 (7.4-7.9) 48,783 10.4 (10.1-10.7) 52,732 3.5 (3.4-3.7)
33 471,894 0.7 (0.7-0.8) 35,933 4.7 (4.5-4.9) 48,812 7.3 (7.1-7.6) 54,130 4.2 (4.0-4.3)
35 452,480 0.5 (0.5-0.5) 31,275 3.0 (2.8-3.2) 44,924 3.3 (3.2-3.5) 47,883 1.7 (1.6-1.8)
39 445,908 0.9 (0.9-0.9) 29,012 5.3 (5.0-5.5) 43,949 3.3 (3.2-3.5) 46,640 1.5 (1.3-1.6)
45 453,127 0.8 (0.7-0.8) 31,476 3.2 (3.0-3.4) 45,018 3.0 (2.8-3.1) 47,305 5.0 (4.8-5.2)
51 442,755 1.1 (1.1-1.2) 27,464 8.7 (8.4-9.1) 44,091 5.7 (5.5-6.0) 44,908 1.0 (0.9-1.1)
52 452,302 1.5 (1.5-1.6) 29,335 8.8 (8.5-9.2) 44,947 11.0 (10.7-11.3) 50,242 3.5 (3.3-3.6)
56 449,467 0.8 (0.8-0.8) 28,721 6.5 (6.2-6.8) 43,352 2.5 (2.3-2.6) 46,261 1.0 (0.9-1.1)
58 462,570 1.0 (1.0-1.0) 30,408 6.7 (6.4-7.0) 45,019 8.1 (7.9-8.4) 51,078 3.9 (3.8-4.1)
59 437,025 0.7 (0.6-0.7) 27,234 3.8 (3.6-4.1) 41,754 2.1 (1.9-2.2) 46,937 1.4 (1.3-1.5)
Probable/possible carcinogen
26 182,611 0.1 (0.1-0.1) 14,114 0.5 (0.4-0.7) 22,823 0.6 (0.5-0.7) 29,645 0.3 (0.2-0.3)
30 58,319 0.2 (0.2-0.3) 3,971 0.5 (0.3-0.8) 2,746 0.3 (0.1-0.6) 14,868 0.3 (0.2-0.4)
34 129,047 0.1 (0.1-0.1) 8,077 0.3 (0.2-0.4) 12,751 0.1 (0.0-0.2) 21,904 0.1 (0.1-0.1)
53 309,365 1.3 (1.3-1.3) 23,456 7.3 (7.0-7.7) 33,387 3.5 (3.3-3.7) 34,132 0.5 (0.5-0.6)
66 374,745 1.0 (0.9-1.0) 26,982 6.9 (6.6-7.2) 39,598 2.6 (2.5-2.8) 40,335 0.4 (0.4-0.5)
67 156,556 0.4 (0.3-0.4) 11,115 1.7 (1.5-2.0) 18,576 0.9 (0.8-1.0) 22,826 0.3 (0.2-0.3)
68 434,494 0.6 (0.6-0.7) 25,794 2.8 (2.6-3.0) 37,961 1.9 (1.8-2.1) 40,411 0.8 (0.8-0.9)
69 150,267 0.1 (0.1-0.1) 11,367 0.3 (0.2-0.4) 19,824 0.3 (0.2-0.4) 20,431 0.2 (0.1-0.3)
70 237,308 1.1 (1.0-1.1) 17,543 2.0 (1.8-2.2) 25,811 1.3 (1.2-1.5) 33,216 0.2 (0.2-0.3)
73 183,558 0.4 (0.4-0.4) 16,756 2.2 (2.0-2.4) 23,546 1.6 (1.4-1.7) 29,094 0.5 (0.4-0.6)
82 206,140 0.3 (0.3-0.3) 16,491 1.5 (1.4-1.7) 25,975 1.9 (1.7-2.0) 30,357 0.2 (0.1-0.2)
85 81,113 0.1 (0.1-0.2) 3,806 0.3 (0.2-0.5) 7,951 0.2 (0.1-0.3) - -
97 1,751 3.1 (2.4-4.0) - - - - 781 0.1 (0.0-0.7)
NON-ONCOGENIC HPV TYPES
6 429,489 1.2 (1.1-1.2) 27,175 6.2 (5.9-6.5) 34,773 2.3 (2.2-2.5) 38,548 0.5 (0.4-0.6)
11 414,741 0.5 (0.4-0.5) 26,370 2.9 (2.7-3.1) 33,740 1.3 (1.2-1.5) 38,643 0.4 (0.4-0.5)
32 77,668 0.1 (0.1-0.2) 977 0.1 (0.0-0.6) - - 2,954 0.1 (0.0-0.2)
40 205,350 0.3 (0.3-0.3) 4,379 1.5 (1.2-1.9) 11,887 0.4 (0.3-0.5) 23,471 0.0 (0.0-0.0)
42 336,041 0.6 (0.6-0.6) 4,932 7.1 (6.4-7.8) 9,550 1.3 (1.1-1.6) 25,826 0.2 (0.2-0.3)
43 266,911 0.2 (0.2-0.2) 3,258 1.7 (1.3-2.2) 5,556 0.4 (0.3-0.6) 21,404 0.1 (0.0-0.1)
44 336,765 0.5 (0.5-0.5) 5,764 5.7 (5.1-6.3) 11,850 1.9 (1.7-2.2) 24,340 0.2 (0.2-0.3)
54 223,182 0.8 (0.8-0.9) 3,316 2.2 (1.8-2.8) 11,924 1.3 (1.1-1.5) 25,312 0.2 (0.2-0.3)
55 - - - - - - - -
57 63,790 0.0 (0.0-0.0) 1,021 0.2 (0.1-0.7) 2,194 0.3 (0.2-0.7) 6,821 0.0 (0.0-0.1)
61 155,276 0.9 (0.9-1.0) 3,183 1.8 (1.4-2.3) 9,040 1.2 (1.0-1.5) 23,743 0.3 (0.2-0.3)
62 123,056 1.4 (1.3-1.5) 2,713 4.2 (3.5-5.0) 8,244 1.6 (1.4-1.9) 7,093 0.4 (0.3-0.5)
64 - - - - - - - -
71 144,438 0.3 (0.3-0.3) 2,175 0.7 (0.5-1.2) 8,901 0.2 (0.2-0.4) 9,390 0.2 (0.1-0.3)
72 152,315 0.4 (0.4-0.4) 2,320 0.6 (0.3-1.0) 8,256 0.2 (0.2-0.4) 10,056 0.1 (0.1-0.2)
74 110,914 0.6 (0.6-0.7) 1,255 1.0 (0.6-1.8) 2,945 0.6 (0.4-1.0) 16,398 0.0 (0.0-0.1)
81 248,265 0.8 (0.7-0.8) 2,862 3.4 (2.8-4.1) 8,952 1.0 (0.8-1.2) 9,553 0.2 (0.1-0.3)
83 163,772 0.6 (0.5-0.6) 2,402 0.9 (0.6-1.3) 9,222 0.4 (0.3-0.6) 9,789 0.1 (0.1-0.2)
84 164,918 0.9 (0.8-0.9) 2,750 2.2 (1.7-2.8) 9,245 0.7 (0.6-0.9) 8,130 0.3 (0.2-0.5)
86 33,106 0.2 (0.1-0.2) - - - - - -
87 17,000 0.2 (0.2-0.3) 750 0.1 (0.0-0.8) - - - -
89 120,768 0.9 (0.8-0.9) 1,755 1.4 (0.9-2.0) 7,456 1.0 (0.8-1.2) 7,833 0.1 (0.1-0.3)
90 40,195 0.6 (0.5-0.7) 750 0.8 (0.4-1.7) - - 2,401 0.0 (0.0-0.2)
91 21,230 0.1 (0.1-0.2) 750 0.5 (0.2-1.4) - - 12,790 0.0 (0.0-0.1)
Data updated on 14 Dec 2016 (data as of 30 Jun 2014 / 30 Jun 2015).
95% CI: 95% Confidence Interval; High-grade lesions: CIN-2, CIN-3, CIS or HSIL; Low-grade lesions: LSIL or CIN-1;
a Kahng 2014 includes lesions CIN2 or worse

Table 15: Type-specific HPV prevalence among invasive cervical cancer cases by histology
Any Histology Squamous cell carcinoma Adenocarcinoma Unespecified
HPV Type No. HPV Prev No. HPV Prev No. HPV Prev No. HPV Prev
tested % (95% CI) tested % (95% CI) tested % (95% CI) tested % (95% CI)
ONCOGENIC HPV TYPES
High-risk HPV types
16 59,149 55.1 (54.7-55.5) 43,209 56.8 (56.4-57.3) 5,917 35.8 (34.6-37.1) 11,486 58.9 (58.0-59.8)
18 58,724 14.3 (14.0-14.5) 42,930 11.6 (11.3-11.9) 5,908 35.0 (33.7-36.2) 11,349 13.9 (13.3-14.6)
31 52,732 3.5 (3.4-3.7) 39,468 3.6 (3.4-3.8) 4,813 1.7 (1.4-2.1) 9,914 4.0 (3.6-4.4)
33 54,130 4.2 (4.0-4.3) 40,500 4.3 (4.1-4.5) 5,081 1.9 (1.5-2.3) 10,012 5.1 (4.7-5.5)
35 47,883 1.7 (1.6-1.8) 36,078 1.7 (1.5-1.8) 4,425 0.5 (0.4-0.8) 8,565 2.5 (2.2-2.9)
39 46,640 1.5 (1.3-1.6) 36,355 1.5 (1.4-1.6) 4,193 1.0 (0.7-1.3) 7,025 1.5 (1.2-1.8)
45 47,305 5.0 (4.8-5.2) 36,107 4.8 (4.6-5.0) 4,671 5.9 (5.3-6.6) 7,990 5.4 (4.9-5.9)
51 44,908 1.0 (0.9-1.1) 34,541 1.0 (0.9-1.1) 4,197 0.8 (0.6-1.1) 7,147 1.1 (0.9-1.4)
52 50,242 3.5 (3.3-3.6) 38,794 3.7 (3.5-3.9) 4,609 1.5 (1.1-1.8) 8,302 3.6 (3.2-4.0)
56 46,261 1.0 (0.9-1.1) 36,023 1.0 (0.9-1.1) 4,292 0.5 (0.3-0.7) 7,365 0.8 (0.7-1.1)
58 51,078 3.9 (3.8-4.1) 39,034 3.9 (3.8-4.1) 4,437 1.2 (0.9-1.6) 9,070 4.9 (4.4-5.3)
59 46,937 1.4 (1.3-1.5) 36,718 1.4 (1.3-1.6) 4,323 0.6 (0.4-0.9) 7,315 1.7 (1.5-2.1)
Probable/possible carcinogen
26 29,645 0.3 (0.2-0.3) - - - - - -
30 14,868 0.3 (0.2-0.4) 12,564 0.3 (0.2-0.4) 1,103 0.1 (0.0-0.5) 1,262 0.1 (0.0-0.4)
34 21,904 0.1 (0.1-0.1) 17,035 0.1 (0.1-0.2) 1,992 0.1 (0.0-0.3) 3,012 0.1 (0.1-0.3)
53 34,132 0.5 (0.5-0.6) - - - - - -
66 40,335 0.4 (0.4-0.5) 31,216 0.4 (0.4-0.5) 3,861 0.2 (0.1-0.3) 6,051 0.6 (0.4-0.8)
67 22,826 0.3 (0.2-0.3) 18,236 0.3 (0.2-0.4) 1,806 0.1 (0.0-0.3) 3,238 0.2 (0.1-0.4)
68 40,411 0.8 (0.8-0.9) 30,946 0.8 (0.7-0.9) 3,845 0.3 (0.2-0.5) 5,753 0.8 (0.6-1.0)
69 20,431 0.2 (0.1-0.3) - - - - - -
70 33,216 0.2 (0.2-0.3) - - - - - -
73 29,094 0.5 (0.4-0.6) - - - - - -
82 30,357 0.2 (0.1-0.2) 22,888 0.2 (0.1-0.2) 2,327 0.0 (0.0-0.2) 4,919 0.3 (0.2-0.5)
97 781 0.1 (0.0-0.7) 781 0.1 (0.0-0.7) - - - -
NON-ONCOGENIC HPV TYPES
6 38,548 0.5 (0.4-0.6) - - - - - -
11 38,643 0.4 (0.4-0.5) - - - - - -
32 2,954 0.1 (0.0-0.2) - - - - - -
40 23,471 0.0 (0.0-0.0) - - - - - -
42 25,826 0.2 (0.2-0.3) 20,986 0.2 (0.1-0.2) 1,917 0.1 (0.0-0.3) 3,713 0.4 (0.2-0.6)
43 21,404 0.1 (0.0-0.1) - - - - - -
44 24,340 0.2 (0.2-0.3) 20,154 0.2 (0.1-0.3) 1,915 0.1 (0.0-0.4) 3,157 0.4 (0.2-0.7)
54 25,312 0.2 (0.2-0.3) - - - - - -
55 - - - - - - - -
57 6,821 0.0 (0.0-0.1) - - - - - -
61 23,743 0.3 (0.2-0.3) - - - - - -
62 7,093 0.4 (0.3-0.5) - - - - - -
64 - - - - - - - -
71 9,390 0.2 (0.1-0.3) - - - - - -
72 10,056 0.1 (0.1-0.2) - - - - - -
74 16,398 0.0 (0.0-0.1) - - - - - -
81 9,553 0.2 (0.1-0.3) - - - - - -
83 9,789 0.1 (0.1-0.2) - - - - - -
84 8,130 0.3 (0.2-0.5) - - - - - -
89 7,833 0.1 (0.1-0.3) - - - - - -
90 2,401 0.0 (0.0-0.2) - - - - - -
91 12,790 0.0 (0.0-0.1) - - - - - -
95% CI: 95% Confidence Interval;

4.1.3 Terminology
Cytologically normal women

No abnormal cells are observed on the surface of their cervix upon cytology.
Cervical Intraepithelial Neoplasia (CIN) / Squamous Intraepithelial Lesions (SIL)

SIL and CIN are two commonly used terms to describe precancerous lesions or the abnormal
growth of squamous cells observed in the cervix. SIL is an abnormal result derived from cervical
cytological screening or Pap smear testing. CIN is a histological diagnosis made upon analysis of
cervical tissue obtained by biopsy or surgical excision. The condition is graded as CIN 1, 2 or 3,
according to the thickness of the abnormal epithelium (1/3, 2/3 or the entire thickness).
Low-grade cervical lesions (LSIL/CIN-1)

Low-grade cervical lesions are defined by early changes in size, shape, and number of ab-
normal cells formed on the surface of the cervix and may be referred to as mild dysplasia,
LSIL, or CIN-1.
High-grade cervical lesions (HSIL/ CIN-2 / CIN-3 / CIS)

High-grade cervical lesions are defined by a large number of precancerous cells on the sur-
face of the cervix that are distinctly different from normal cells. They have the potential
to become cancerous cells and invade deeper tissues of the cervix. These lesions may be
referred to as moderate or severe dysplasia, HSIL, CIN-2, CIN-3 or cervical carcinoma in
situ (CIS).
Carcinoma in situ (CIS)

Preinvasive malignancy limited to the epithelium without invasion of the basement membrane.
CIN 3 encompasses the squamous carcinoma in situ.
Invasive cervical cancer (ICC) / Cervical cancer

If the high-grade precancerous cells invade the basement membrane is called ICC. ICC stages
range from stage I (cancer is in the cervix or uterus only) to stage IV (the cancer has spread to
distant organs, such as the liver).
Invasive squamous cell carcinoma

Invasive carcinoma composed of cells resembling those of squamous epithelium.
Adenocarcinoma
Invasive tumour with glandular and squamous elements intermingled.

4.2 HPV burden in anogenital cancers other than the cervix

Methods: Prevalence and type distribution of human papillomavirus in carcinoma of the
vulva, vagina, anus and penis: systematic review and meta-analysis
A systematic review of the literature was conducted regarding the worldwide HPV-prevalence and type
distribution for anogenital carcinomas other than cervix from January 1986 to data as of indicated in
each section. The search terms for the review were HPV AND (anus OR anal) OR (penile) OR vagin*
OR vulv* using Pubmed. There were no limits in publication language. References cited in selected
articles were also investigated. Inclusion criteria were: HPV DNA detection by means of PCR, a mini-
mum of 10 cases by lesion and a detailed description of HPV DNA detection and genotyping techniques
used. The number of cases tested and HPV positive extracted for each study were pooled to estimate the
prevalence of HPV DNA and the HPV type distribution globally and by geographical region. Binomial
95% confidence intervals were calculated for each HPV prevalence.
4.2.1 Anal cancer and precancerous anal lesions
Anal cancer is similar to cervical cancer with respect to overall HPV DNA positivity, with approximately
88% of cases associated with HPV infection worldwide (de Martel C et al. Lancet Oncol 2012;13(6):607-
15). HPV16 is the most common type detected, representing 73% of all HPV-positive tumours. HPV18
is the second most common type detected and is found in approximately 5% of cases. HPV DNA is also
detected in the majority of precancerous anal lesions (AIN) (91.5% in AIN1 and 93.9% in AIN2/3) (De
Vuyst H et al. Int J Cancer 2009; 124: 1626-36). In this section, the HPV prevalence among anal cancer
cases in the World is presented.
Table 16: Studies on HPV prevalence among anal cancer cases

HPV detection Prevalence of 5 most
method and targeted HPV prevalence frequent HPVs
Study HPV types No. Tested % (95% CI) HPV type (%)
Alemany 2015a PCR-SPF10, EIA, (HPV 6, 11, 52 80.8 (68.1-89.2) HPV 16 (67.3%)
(Asia) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 18 (3.8%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 35 (3.8%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 56 (1.9%)
73, 74, 82, 83, 87, 89, 91) HPV 58 (1.9%)
Hillman 2014 PCR L1-Consensus primer, 105 97.1 (91.9-99.0) HPV 16 (77.1%)
(Australia) (HPV 6, 11, 16, 18, 26, 31, 33, 35, HPV 52 (13.3%)
39, 40, 43, 44, 45, 51, 52, 53, 54, HPV 6 (10.5%)
56, 58, 59, 66, 68, 69, 70, 71, 73, HPV 54 (9.5%)
74, 82) HPV 11 (5.7%)
Ouhoummane , PCR L1-Consensus primer, 96 91.7 (84.4-95.7) HPV 16 (82.3%)
2013 (Canada) LBA (HPV 6, 11, 16, 18, 26, 31, HPV 6 (3.1%)
33, 34, 35, 39, 40, 42, 45, 51, 52, HPV 33 (3.1%)
53, 54, 56, 58, 59, 61, 62, 66, 67, HPV 18 (2.1%)
68, 69, 70, 71, 72, 73, 81, 82, 83, HPV 58 (2.1%)
84, 89)
Lai 1998 (China) PCR MY09/11 and DBH (HPV6, 72 1.4 (0.2-7.5) -
11, 16, 18 and 33)


Tachezy 2011 , PCR L1-Consensus primer, , 26 73.1 (53.9-86.3) HPV 16 (73.1%)
(Czech Rep.) Sequencing (HPV 6, 11, 16, 18,
20, 21, 22, 23, 26, 30, 31, 32, 33,
34, 35, 38, 39, 40, 42, 43, 44, 45,
51, 52, 53, 54, 56, 57, 58, 59, 60,
61, 62, 66, 67, 68, 69, 70, 71, 72,
73, 74, 80, 81, 82, 83, 84, 85, 86,
87, 89, 90, 91)
Serup-Hansen PCR-E6, PCR-E7, PCR- 137 87.6 (81.0-92.1) HPV 16 (81.0%)
2014 (Denmark) MULTIPLEX (HPV 16, 18, 31, HPV 33 (5.1%)
33, 45, 52, 58) HPV 18 (2.2%)
HPV 58 (0.7%)
Alemany 2015b PCR-SPF10, EIA, (HPV 6, 11, 169 87.6 (81.8-91.7) HPV 16 (73.4%)
(Europe) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 6 (3.6%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (3.6%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 11 (3.0%)
73, 74, 82, 83, 87, 89, 91) HPV 33 (2.4%)
Abramowitz 2011 PCR-SPF10, (HPV 6, 11, 16, 18, 728 96.7 (95.1-97.8) HPV 16 (75.5%)
(France) 26, 31, 33, 35, 39, 40, 43, 44, 45, HPV 18 (5.9%)
51, 52, 53, 54, 56, 58, 59, 66, 68, HPV 11 (3.7%)
69, 70, 71, 73, 82) HPV 6 (3.0%)
HPV 52 (2.6%)
Valmary-Degano PCR-E6, (HPV 6, 11, 16, 18, 26, 73 98.6 (92.6-99.8) HPV 16 (89.0%)
2013 (France) 31, 33, 35, 39, 40, 43, 44, 45, 51, HPV 39 (4.1%)
52, 53, 54, 56, 58, 59, 66, 68, 69, HPV 33 (2.7%)
70, 71, 73, 74, 82) HPV 6 (1.4%)
HPV 11 (1.4%)
Vincent-Salomon PCR L1-Consensus primer, 27 74.1 (55.3-86.8) HPV 16 (63.0%)
1996 (France) PCR-E6, TS (HPV 6, 11, 16, 18, HPV 18 (7.4%)
33)
Kreuter 2010 PCR-A5/A10, A6/A8, EIA,RHA, 11 100.0 (74.1-100.0) -
(Germany) (HPV 6, 11, 16, 18, 26, 31, 33-35,
39, 40, 42-45, 51-59, 61, 66, 68,
70-73, 81-84, 89)
Rdel 2015 (Ger- , PCR-SPF10, PCR- 91 100.0 (95.9-100.0) HPV 16 (94.5%)
many) MULTIPLEX, (HPV 6, 11, 16, HPV 11 (2.2%)
18, 26, 31, 33, 35, 39, 40, 42, 43, HPV 31 (2.2%)
44, 45, 51, 52, 53, 54, 56, 58, 59, HPV 35 (2.2%)
66, 68, 69, 70, 71, 73, 74, 81, 82) HPV 18 (1.1%)
Varnai 2006 (Ger- , PCR-MY09/11, TS, Sequencing 47 83.0 (69.9-91.1) HPV 16 (74.5%)
many) (HPV 6, 11, 16, 18, 31, 33, 45, 58) HPV 33 (6.4%)
HPV 18 (2.1%)
HPV 31 (2.1%)
HPV 45 (2.1%)
Indinnimeo 1999 PCR, TS (HPV 6, 11, 16, 18) 14 64.3 (38.8-83.7) HPV 16 (42.9%)
(Italy)
Alemany 2015
(Latin America
& Caribbean) PCR-SPF10, EIA, (HPV 6, 11, 157 90.4 (84.8-94.1) HPV 16 (70.1%)
16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (5.7%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 58 (3.2%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 18 (2.5%)
73, 74, 82, 83, 87, 89, 91) HPV 31 (1.9%)
Frisch 1997 c PCR-GP5+/6+, TS (HPV 6, 11, 388 87.6 (84.0-90.5) -
(Northern Eu- 16, 18, 31, 33)
rope)


Yhim 2011 (Rep. PCR, TS (HPV 6, 11, 16, 18, 31, 47 74.5 (60.5-84.7) HPV 16 (66.0%)
Korea) 33, 34, 35, 39, 40, 42, 43, 44, 45, HPV 58 (6.4%)
51, 52, 56, 58, 59, 66, 68, 69) HPV 35 (2.1%)
Youk 2001 (Rep. PCR-MY09/11, PCR-L1C1/C2, 21 100.0 (84.5-100.0) HPV 16 (100.0%)
Korea) PCR-E6, PCR-E7, TS (HPV 16,
18)
Laytragoon-Lewin , PCR-MY09/11, Sequencing 72 90.3 (81.3-95.2) HPV 16 (69.4%)
2007 (Sweden) (HPV 16, 18, 33) HPV 18 (34.7%)
HPV 33 (2.8%)
Poletti 1998 PCR-PU-1M-31B (Fujinaga 91)- 33 39.4 (24.7-56.3) -
(Switzerland) (HPV 6, 11, 16, 18, 31, 33, 52, 58)
Baricevic 2015 PCR-L1C1/C2, PCR 151 95.4 (90.7-97.7) HPV 16 (88.7%)
(UK) L1-Consensus primer, PCR-E6, HPV 6 (11.9%)
PCR-E7, PCR- MULTIPLEX HPV 33 (6.6%)
(HPV 6, 11, 16, 18, 31, 33, 45, 52, HPV 18 (4.6%)
58) HPV 58 (4.6%)
Crook 1991 (UK) SBH, PCR-TS (HPV 16,18) 50 84.0 (71.5-91.7) -
Ogunbiyi 1993 PCR- E6/E7, TS (HPV 16) 46 73.9 (59.7-84.4) -
(UK)
Alemany 2015 PCR-SPF10, EIA, (HPV 6, 11, 96 95.8 (89.8-98.4) HPV 16 (81.3%)
(USA) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 18 (7.3%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 31 (4.2%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 39 (3.1%)
73, 74, 82, 83, 87, 89, 91) HPV 52 (3.1%)
Daling 2004 PCR-MY09/11, PCR 199 86.9 (81.5-90.9) HPV 16 (69.8%)
(USA) L1-Consensus primer, RFLP, TS HPV 18 (8.5%)
(HPV 16, 18)
Noffsinger 1995 PCR primers for HPV 6, 16, 18 56 46.4 (34.0-59.3) -
(USA)
Palefsky 1991 PCR-E6, TS (HPV 06/11, 16, 18, 13 84.6 (57.8-95.7) HPV 16 (76.9%)
(USA) 31, 33) HPV 31 (23.1%)
HPV 6/11 (15.4%)
HPV 33 (7.7%)
Shroyer 1995 PCR MY09/11 and SBH (HPV6, 27 81.5 (63.3-91.8) -
(USA) 11, 16, 18, 31 and 33)
Zaki 1992 (USA) PCR L1-Consensus primer, TS 11 72.7 (43.4-90.3) HPV 16 (18.2%)
(HPV 6, 11, 16, 18, 16/18) HPV 6 (9.1%)
HPV 11 (9.1%)
HPV 16/18 (9.1%)
Alemany 2015d PCR-SPF10, EIA, (HPV 6, 11, 21 61.9 (40.9-79.2) HPV 16 (28.6%)
(Western Africa) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 6 (9.5%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (9.5%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 31 (4.8%)
73, 74, 82, 83, 87, 89, 91) HPV 35 (4.8%)
DBH: Dot Blot Hybridization; EIA: Enzyme ImmunoAssay; LBA: Line-Blot Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; RHA: Reverse
Hybridization Assay; SBH: Southern Blot Hybridization; SPF: Short Primer Fragment; TS: Type Specific;
a Includes cases from Bangladesh, India and South Korea
b Includes cases from Bosnia-Herzegovina, Czech Republic, France, Germany, Poland, Portugal, Slovenia, Spain and United Kingdom
c Includes cases from Denmark and Sweden. Includes both in situ and invasive SCC cases.
d Includes cases from Mali, Nigeria and Senegal

Table 17: Studies on HPV prevalence among AIN 2/3 cases

Hillman 2012 HC2, LBA (HPV 16, 18, 31, 33) 21 95.2 (77.3-99.2) HPV 16 (33.3%)
(Australia) HPV 31 (19.0%)
HPV 18 (4.8%)
Gohy 2008a PCR-MY09/11, (HPV 6, 11, 16, 62 93.5 (84.6-97.5) HPV 16 (35.5%)
(Canada) 18, 26, 31, 33, 34, 35, 39, 40, 42, HPV 18 (16.1%)
44, 45, 51, 52, 53, 54, 56, 58, 59, HPV 58 (16.1%)
61, 62, 66, 67, 68, 69, 70, 71, 72, HPV 42 (9.7%)
73, 81, 82, 83, 84, 89) HPV 45 (9.7%)
Salit 2009a PCR-PGMY09/11, PCR 74 100.0 (95.1-100.0) HPV 16 (52.7%)
(Canada) L1-Consensus primer, LBA (HPV HPV 18 (32.4%)
6, 11, 16, 18, 26, 31, 33, 35, 39, HPV 31 (31.1%)
40, 42, 44, 45, 51, 52, 53, 54, 56, HPV 6 (28.4%)
57, 58, 59, 66, 68) HPV 52 (27.0%)
(Europe) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 6 (8.7%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (8.7%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 51 (8.7%)
73, 74, 82, 83, 87, 89, 91) HPV 74 (8.7%)
Hampl 2006 (Ger- , PCR-MY09/11, Sequencing 16 87.5 (64.0-96.5) -
many) (HPV 6, 11, 20, 21, 22, 23, 26, 30,
32)
Hampl 2007 (Ger- PCR-MY09/11, GP5/GP6, TS 24 100.0 (86.2-100.0) -
many) (HPV 6, 11, 16, 18, 31, 33, 35, 40,
42, 44, 45, 51, 52, 53, 55, 56, 58,
61, 66-68, 73, 74, 91,
IS887/MM4, HPVIA18)
Kreuter 2010 PCR-A5/A10, A6/A8, EIA, RHA, 156 98.1 (94.5-99.3) -
(Germany) TS (HPV 6, 11, 16, 18, 26, 31, 33,
34, 35, 39, 40, 42-45, 51-59, 61,
66, 68, 70-73, 81-84, 89)
Silling 2012a PCR- MULTIPLEX (HPV 6, 11, 42 100.0 (91.6-100.0) HPV 16 (69.0%)
(Germany) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 11 (23.8%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (23.8%)
56, 57, 58, 59, 61, 66, 67, 68, 70, HPV 6 (19.0%)
71, 72, 73, 81, 82, 83, 84, 89) HPV 67 (19.0%)
Varnai 2006 (Ger- , PCR-MY09/11, TS, Sequencing 24 95.8 (79.8-99.3) HPV 16 (70.8%)
many) (HPV 6, 11, 16, 18, 31, 33, 45, 58) HPV 11 (12.5%)
HPV 6 (8.3%)
HPV 58 (4.2%)
Wieland 2006a PCR, EIA (HPV 6, 11, 16, 18, 31, 18 100.0 (82.4-100.0) HPV 16 (88.9%)
(Germany) 33, 34, 35, 42, 44, 45, 52, 53, 54, HPV 18 (44.4%)
56, 58, 59, 66, 68, 70, 72, 73, 81, HPV 83 (38.9%)
82, 83, 84, 89) HPV 52 (33.3%)
HPV 58 (27.8%)
Tanzi 2009a PCR-MY09/11, PCR 62 91.9 (82.5-96.5) HPV 6 (38.7%)
(Italy) L1-Consensus primer, RFLP HPV 16 (37.1%)
(HPV 6, 11, 16, 18, 20, 21, 22, 23, HPV 11 (27.4%)
26, 30, 31, 32, 33, 34, 35, 38, 39, HPV 58 (8.1%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (4.8%)
56, 57, 58, 59, 60, 61, 62, 66, 67,
68, 69, 70, 71, 72, 81, 83, 84)
Alemany 2015 c
(Latin America


& Caribbean) PCR-SPF10, EIA, (HPV 6, 11, 12 100.0 (75.8-100.0) -
16, 18, 26, 30, 31, 33, 34, 35, 39,
40, 42, 43, 44, 45, 51, 52, 53, 54,
56, 58, 59, 61, 66, 67, 68, 69, 70,
73, 74, 82, 83, 87, 89, 91)
Richel 2014a PCR L1-Consensus primer, 17 100.0 (81.6-100.0) HPV 16 (58.8%)
(Netherlands) PCR-SPF10, EIA, (HPV 6, 11, HPV 31 (17.6%)
16, 18, 26, 31, 33, 34, 35, 39, 40, HPV 18 (11.8%)
42, 43, 44, 45, 51, 52, 53, 54, 56, HPV 53 (11.8%)
58, 59, 66, 67, 68, 69, 70, 73, 74) HPV 58 (11.8%)
Caadas 2010a PCR-E6/E7, TS (HPV 6, 11, 16, 30 100.0 (88.6-100.0) -
(Spain) 18, 31, 33, 35, 39, 45, 51, 52, 56,
58, 59, 68)
Garca-Espinosa PCR-GP5/6, PCR L1-Consensus 20 100.0 (83.9-100.0) HPV 16 (50.0%)
2013a (Spain) primer, DBH (HPV 6, 11, 16, 18, HPV 44 (35.0%)
26, 31, 33, 35, 39, 40, 42, 43, 44, HPV 58 (35.0%)
45, 51, 52, 53, 54, 56, 57, 58, 59, HPV 6 (30.0%)
61, 66, 68, 70, 71, 72, 73, 81, 82, HPV 31 (30.0%)
84)
Sirera 2013a PCR- MULTIPLEX (HPV 6, 11, 69 84.1 (73.7-90.9) HPV 16 (55.1%)
(Spain) 16, 18, 31, 33, 35, 39, 45, 51, 52, HPV 58 (34.8%)
56, 58, 59, 68) HPV 33 (29.0%)
HPV 51 (23.2%)
HPV 18 (21.7%)
Torres 2013a LBA (HPV 6, 11, 16, 18, 26, 31, 44 97.7 (88.2-99.6) HPV 16 (59.1%)
(Spain) 33, 34, 35, 39, 40, 42, 44, 45, 51, HPV 6 (34.1%)
52, 53, 54, 56, 58, 59, 61, 62, 66, HPV 66 (31.8%)
67, 68, 69, 70, 71, 72, 73, 81, 82, HPV 52 (29.5%)
83, 84) HPV 53 (29.5%)
Phanuphak 2013a PCR L1-Consensus primer, 41 82.9 (68.7-91.5) HPV 40 (51.2%)
(Thailand) PCR-E6, PCR-E7, LBA (HPV 6, HPV 53 (26.8%)
11, 16, 18, 26, 31, 33, 34, 35, 39, HPV 16 (24.4%)
40, 42, 44, 45, 51, 52, 53, 54, 56, HPV 11 (19.5%)
58, 59, 61, 62, 66, 67, 68, 69, 70, HPV 58 (17.1%)
71, 72, 73, 81, 82, 83, 84)
Fox 2005a (UK) , PCR-MY09/11, (HPV 16, 18, 31, 74 97.3 (90.7-99.3) HPV 16 (64.9%)
33, 35, 39, 45, 51, 52, 56, 58, 59) HPV 18 (25.7%)
HPV 33 (24.3%)
HPV 58 (21.6%)
HPV 31 (18.9%)
Ogunbiyi 1993 PCR- E6/E7,TS (HPV 16) 27 66.7 (47.8-81.4) -
(UK)
Ogunbiyi 1994 PCR- E6/E7,TS (HPV 16) 11 90.9 (62.3-98.4) -
(UK)
Sahasrabuddhe PCR-PGMY09/11, LBA (HPV 6, 104 99.0 (94.8-99.8) HPV 16 (54.8%)
2013a (USA) 11, 16, 18, 26, 31, 33, 34, 35, 39, HPV 6 (26.0%)
40, 42, 44, 45, 51, 52, 53, 54, 56, HPV 31 (22.1%)
58, 59, 61, 62, 66, 67, 68, 69, 70, HPV 42 (22.1%)
71, 72, 73, 81, 82, 83, 84) HPV 66 (21.2%)
95% CI: 95% Confidence Interval; AIN 2/3: Anal intraepithelial neoplasia of grade 2/3;
DBH: Dot Blot Hybridization; EIA: Enzyme ImmunoAssay; HC2: Hybrid Capture 2; LBA: Line-Blot Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymor-
phism; RHA: Reverse Hybridization Assay; SPF: Short Primer Fragment; TS: Type Specific;
a HIV positive cases
b Includes cases from Bosnia-Herzegovina, Czech Republic, France, Germany, Poland, Portugal, Slovenia, Spain and United Kingdom
c Includes cases from Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico and Paraguay

Figure 85: Comparison of the ten most frequent HPV types in anal cancer cases in Africa and the rest
of the World
Africa (a) World (b)
16 28.6 16 71.4
18 9.5 18 4.2
6 9.5 33 3.0
31 4.8 6 2.4
35 4.8 31 2.0
45 4.8 35 1.6
51 4.8 58 1.6
8th* 11 1.4
9th* 39 1.2
10th* 52 1.2
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80
Typespecific HPV prevalence (%) of

anal cancer cases
*No data available. No more types than shown were tested or were positive.
Data updated on 20 Mar 2015 (data as of 30 Jun 2014).
AIN 2/3: Anal intraepithelial neoplasia of grade 2/3;
a Includes cases from Mali, Nigeria and Senegal.
b Includes cases from Europe (Bosnia-Herzegovina, Czech Republic, France, Germany, Poland, Portugal, Slovenia, Spain and United Kingdom); America (Chile, Colombia, Ecuador,
Guatemala, Honduras, Mexico, Paraguay and United States); Africa (Mali, Nigeria and Senegal); Asia (Bangladesh,India and South Korea)
Figure 86: Comparison of the ten most frequent HPV types in anal cancer cases in the Americas and
the rest of the World
Americas (a) World (b)
16 74.3 16 71.4
18 4.3 18 4.2
33 4.3 33 3.0
31 2.8 6 2.4
58 2.8 31 2.0
39 2.4 35 1.6
52 2.0 58 1.6
6 1.6 11 1.4
45 1.2 39 1.2
11 0.8 52 1.2
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80

anal cancer cases

a Includes cases from Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay and United States

Figure 87: Comparison of the ten most frequent HPV types in anal cancer cases in Asia and the rest of
the World
Asia (a) World (b)
16 67.3 16 71.4
18 3.8 18 4.2
35 3.8 33 3.0
56 1.9 6 2.4
58 1.9 31 2.0
6 35 1.6
11 58 1.6
26 11 1.4
30 39 1.2
31 52 1.2
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80

anal cancer cases

a Includes cases from Bangladesh,India and South Korea
Figure 88: Comparison of the ten most frequent HPV types in anal cancer cases in Europe and the rest
of the World
Europe (a) World (b)
16 73.4 16 71.4
6 3.6 18 4.2
18 3.6 33 3.0
11 3.0 6 2.4
33 2.4 31 2.0
35 1.8 35 1.6
74 1.8 58 1.6
31 1.2 11 1.4
30 0.6 39 1.2
52 0.6 52 1.2
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80

anal cancer cases

a Includes cases from Bosnia-Herzegovina, Czech Republic, France, Germany, Poland, Portugal, Slovenia, Spain and United Kingdom.

Figure 89: Comparison of the ten most frequent HPV types in anal cancer cases in Oceania and the rest
of the World
Oceania World (a)
1st* 16 71.4
2nd* 18 4.2
3rd* 33 3.0
4th* 6 2.4
5th* 31 2.0
No data available
6th* 35 1.6
7th* 58 1.6
8th* 11 1.4
9th* 39 1.2
10th* 52 1.2
0 10 20 30 40 50 60 70 80

anal cancer cases
a Includes cases from Europe (Bosnia-Herzegovina, Czech Republic, France, Germany, Poland, Portugal, Slovenia, Spain and United Kingdom); America (Chile, Colombia, Ecuador,
Figure 90: Comparison of the ten most frequent HPV types in AIN 2/3 cases in Africa and the rest of
the World
Africa World (a)
1st* 16 72.1
2nd* 6 9.3
3rd* 11 7.0
4th* 18 4.7
5th* 31 4.7
No data available
6th* 51 4.7
7th* 74 4.7
8th* 35 2.3
9th* 44 2.3
10th* 45 2.3
0 10 20 30 40 50 60 70 80

AIN 2/3 cases
Guatemala, Honduras, Mexico and Paraguay)

Figure 91: Comparison of the ten most frequent HPV types in AIN 2/3 cases in the Americas and the
rest of the World
16 91.7 16 72.1
11 8.3 6 9.3
6 8.3 11 7.0
4th* 18 4.7
5th* 31 4.7
6th* 51 4.7
7th* 74 4.7
8th* 35 2.3
9th* 44 2.3
10th* 45 2.3
0 10 30 50 70 90 0 10 30 50 70 90

AIN 2/3 cases
a Includes cases from Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico and Paraguay.
Figure 92: Comparison of the ten most frequent HPV types in AIN 2/3 cases in Asia and the rest of the
World
Asia World (a)
1st* 16 72.1
2nd* 6 9.3
3rd* 11 7.0
4th* 18 4.7
5th* 31 4.7
No data available
6th* 51 4.7
7th* 74 4.7
8th* 35 2.3
9th* 44 2.3
10th* 45 2.3
0 10 20 30 40 50 60 70 80

AIN 2/3 cases

Figure 93: Comparison of the ten most frequent HPV types in AIN 2/3 cases in Europe and the rest of
the World
16 65.2 16 72.1
18 8.7 6 9.3
51 8.7 11 7.0
6 8.7 18 4.7
74 8.7 31 4.7
11 4.3 51 4.7
31 4.3 74 4.7
35 4.3 35 2.3
44 4.3 44 2.3
45 4.3 45 2.3
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80

AIN 2/3 cases

a Includes cases from Bosnia-Herzegovina, Czech Republic, France, Germany, Poland, Portugal, Slovenia, Spain and United Kingdom.
Figure 94: Comparison of the ten most frequent HPV types in AIN 2/3 cases in Oceania and the rest of
the World
Oceania World (a)
1st* 16 72.1
2nd* 6 9.3
3rd* 11 7.0
4th* 18 4.7
5th* 31 4.7
No data available
6th* 51 4.7
7th* 74 4.7
8th* 35 2.3
9th* 44 2.3
10th* 45 2.3
0 10 20 30 40 50 60 70 80

AIN 2/3 cases

4.2.2 Vulvar cancer and precancerous vulvar lesions
HPV attribution for vulvar cancer is 43% worldwide (de Martel C et al. Lancet Oncol 2012;13(6):607-
15). Vulvar cancer has two distinct histological patterns with two different risk factor profiles: (1) basa-
loid/warty types (2) keratinising types. Basaloid/warty lesions are more common in young women, are
frequently found adjacent to VIN, are very often associated with HPV DNA detection (86%), and have
a similar risk factor profile as cervical cancer. Keratinising vulvar carcinomas represent the majority
of the vulvar lesions (>60%). These lesions develop from non HPV-related chronic vulvar dermatoses,
especially lichen sclerosus and/or squamous hyperplasia, their immediate cancer precursor lesion is dif-
ferentiated VIN, they occur more often in older women, and are rarely associated with HPV (6%) or with
any of the other risk factors typical of cervical cancer. HPV prevalence is frequently detected among
cases of high-grade VIN (VIN2/3) (85.3%). HPV 16 is the most common type detected followed by HPV
33 (De Vuyst H et al. Int J Cancer 2009; 124:1626-36). In this section, the HPV prevalence among
vulvar cancer cases in the World is presented.
Table 18: Studies on HPV prevalence among vulvar cancer cases

de Sanjos 2013a PCR-SPF10, EIA, (HPV 6, 11, 24 70.8 (50.8-85.1) HPV 16 (58.3%)
(Africa) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 18 (4.2%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 45 (4.2%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 52 (4.2%)
73, 74, 82, 83, 87, 89, 91)
de Sanjos 2013b PCR-SPF10, EIA, (HPV 6, 11, 188 28.7 (22.7-35.6) HPV 16 (18.1%)
(Asia) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 18 (1.6%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 44 (1.6%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 45 (1.1%)
73, 74, 82, 83, 87, 89, 91) HPV 52 (1.1%)
Allen 2002 (Aus- MY09/11 and Type-specific for 6, 18 55.6 (33.7-75.4) -
tralia) 11, 16, 18, 31, 33, 35, 39, 45, 51
and 52
Tan 2013 (Aus- PCR L1-Consensus primer, 20 90.0 (69.9-97.2) HPV 16 (80.0%)
tralia) (HPV 6, 11, 16, 18, 26, 31, 33, 35, HPV 33 (5.0%)
39, 40, 42, 44, 45, 51, 52, 53, 54, HPV 35 (5.0%)
56, 58, 59, 66, 68, 69, 70, 71, 73, HPV 52 (5.0%)
74, 82) HPV 54 (5.0%)
Pinto 1999 PCR L1-Consensus primer, 158 24.1 (18.1-31.3) HPV 16 (16.5%)
(Brazil) PCR-E6, TS (HPV 06/11, 16, 18, HPV 18 (9.5%)
40, 42, 43, 44, 45, 51, 52, 54, 56, HPV 6/11 (1.3%)
58) HPV 45 (0.6%)
Al-Ghamdi 2002 MY09/11, GP5/GP6 and 20 85.0 (64.0-94.8) -
(Canada) type-specific for HPV16 and 18
Gao 1997 (China) L1-PCR for HPV6/11 and 13 23.1 (8.2-50.3) -
HPV16/18
Guo 1996 (China) PCR HPV6/11, 16, 18 37 27.0 (15.4-43.0) -
Ngan 1999 L1-PCR for HPV16 and 18 48 47.9 (34.5-61.7) -
(China)
Skapa 2007 PCR-GP5+/GP6+, TS (HPV 3, 7, 46 41.3 (28.3-55.7) -
(Czech Rep.) 6, 10, 11, 13, 16, 18, 26-35, 39,
40, 42-45, 51, 53-59, 61, 62,
66-74, 77, 81-87, 89-91)


(Czech Rep.) Sequencing (HPV 6, 11, 16, 18, HPV 33 (8.7%)
20, 21, 22, 23, 26, 30, 31, 32, 33, HPV 6 (2.2%)
34, 35, 38, 39, 40, 42, 43, 44, 45, HPV 42 (2.2%)
51, 52, 53, 54, 56, 57, 58, 59, 60, HPV 45 (2.2%)
61, 62, 66, 67, 68, 69, 70, 71, 72,
73, 74, 80, 81, 82, 83, 84, 85, 86,
87, 89, 90, 91)
Bryndorf 2004 PCR-SPF10, (HPV 6, 11, 16, 18, 10 60.0 (31.3-83.2) HPV 16 (40.0%)
(Denmark) 31, 33, 35, 42, 44, 45, 51, 52, 56, HPV 33 (20.0%)
58) HPV 56 (10.0%)
Hrding 1991 PCR-E6/E7, TS (HPV 16) 24 58.3 (38.8-75.5) -
(Denmark)
Hrding 1993 PCR-E6, PCR-E7, TS (HPV 6, 62 30.6 (20.6-43.0) HPV 16 (21.0%)
(Denmark) 11, 16, 18, 33) HPV 18 (4.8%)
HPV 33 (4.8%)
Hrding 1994 PCR-E6, PCR-E7, TS (HPV 6, 78 30.8 (21.6-41.7) HPV 16 (28.2%)
(Denmark) 11, 16, 18, 33) HPV 33 (3.8%)
Madsen 2008 , EIA, (HPV 6, 11, 16, 18, 31, 33, 60 51.7 (39.3-63.8) HPV 16 (36.7%)
(Denmark) 35, 42, 44, 45, 51, 52, 56, 58, 61, HPV 33 (11.7%)
67, 73) HPV 73 (3.3%)
HPV 6 (1.7%)
HPV 51 (1.7%)
de Sanjos 2013 c PCR-SPF10, EIA, (HPV 6, 11, 903 19.3 (16.8-22.0) HPV 16 (13.8%)
(Europe) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (1.2%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (0.6%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 31 (0.6%)
73, 74, 82, 83, 87, 89, 91) HPV 44 (0.4%)
Iwasawa 1997 PCR-MY09/11, PCR 74 36.5 (26.4-47.9) HPV 16 (25.7%)
(Finland) L1-Consensus primer, PCR-E6, HPV 18 (12.2%)
TS (HPV 6, 11, 16, 18, 33) HPV 33 (1.4%)
Choschzick 2011 , PCR-MY09/11, Sequencing 39 46.2 (31.6-61.4) HPV 16 (43.6%)
(Germany) (HPV 6, 11, 16, 18, 33) HPV 33 (2.6%)
Hampl 2006 (Ger- , PCR-MY09/11, Sequencing 48 60.4 (46.3-73.0) HPV 16 (39.6%)
many) (HPV 16, 18, 20, 21, 22, 23, 26, HPV 33 (8.3%)
30, 31, 32, 33, 35, 42, 44, 45, 51, HPV 31 (4.2%)
52, 56, 58, 61, 67, 73, 91) HPV 18 (2.1%)
Hampl 2008 (Ger- PCR-(MY09/11, GP5+/6+), TS , 36 50.0 (34.5-65.5) -
many) Sequencing
Milde-Langosch PCR-MY09/11, TS (HPV 6, 11, 40 27.5 (16.1-42.8) HPV 16 (25.0%)
1995 (Germany) 16, 18, 31, 33, 35)
Reuschenbach PCR- MULTIPLEX (HPV 6, 11, 183 43.7 (36.7-51.0) HPV 16 (36.1%)
2013 (Germany) 16, 18, 31, 33, 35, 39, 42, 43, 44, HPV 18 (2.7%)
45, 51, 52, 56, 58, 59, 68, 70, 71, HPV 33 (1.1%)
73, 82) HPV 6 (0.5%)
HPV 11 (0.5%)
Bonvicini 2005 PCR-MY09/11 (HPV 16, 18, 31, 16 0.0 (0.0-19.4) -
(Italy) 33, 35, 45, 52, 58)
Della Torre 1992 PCR-,TS (HPV 6, 11, 16, 18) 11 54.5 (28.0-78.7) -
(Italy)
Pilotti 1995 (Italy) PCR-,TS (HPV 6, 11, 16, 18) 23 47.8 (29.2-67.0) -
Koyamatsu 2003 E7 (115-158 bp) for HPV16, HPV 31 12.9 (5.1-28.9) -
(Japan) 18, L1 (250bp) for HPV
6,11,16,18,31,33, 42,52,58


Nagano 1996 PCR-L1C1/C2, RFLP (HPV 6, 11 72.7 (43.4-90.3) HPV 16 (36.4%)
(Japan) 11, 16, 18, 30, 31, 33, 34, 35, 39, HPV 6 (9.1%)
42, 43, 44, 45, 51, 52, 53, 54, 56, HPV 18 (9.1%)
58, 59, 61, 66, 68, 70) HPV 51 (9.1%)
HPV 56 (9.1%)
Osakabe 2007 PCR-L1C1/C2, RFLP (HPV 6, 21 23.8 (10.6-45.1) HPV 16 (14.3%)
(Japan) 11, 16, 18, 31, 33, 42, 52, 58) HPV 6 (4.8%)
HPV 52 (4.8%)
de Sanjos 2013d
(Latin America
16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 18 (2.8%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 45 (2.5%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 33 (2.2%)
73, 74, 82, 83, 87, 89, 91) HPV 6 (1.2%)
Ansink 1994 PCR-GP5/GP6, TS (HPV 6, 11, 60 31.7 (21.3-44.2) -
(Netherlands) 13, 16, 18, 30-33, 45, 51)
Kagie 1997 PCR-CPI/CPIIG, Sequencing 66 19.7 (11.9-30.8) HPV 16 (16.7%)
(Netherlands) (HPV 6, 11, 16, 31, 33, 45) HPV 33 (1.5%)
HPV 45 (1.5%)
Trietsch 2013 PCR, (HPV 6, 11, 16, 18, 26, 31, 108 16.7 (10.8-24.8) HPV 16 (10.2%)
(Netherlands) 33, 35, 39, 40, 43, 44, 45, 51, 52, HPV 33 (5.6%)
53, 54, 56, 58, 59, 66, 68, 69, 70, HPV 18 (1.9%)
71, 73, 74, 82)
van de Nieuwen- PCR L1-Consensus primer, 130 34.6 (27.0-43.1) HPV 16 (15.4%)
hof 2009 (Nether- (HPV 6, 11, 16, 18, 31, 33, 35, 42, HPV 33 (5.4%)
lands) 45, 51, 52, 53, 54, 56, 58, 66, 73) HPV 18 (2.3%)
HPV 52 (1.5%)
HPV 54 (1.5%)
van der Avoort PCR L1-Consensus primer, 16 0.0 (0.0-19.4) -
2006 (Nether- PCR-SPF10, (HPV 6, 11, 16, 18,
lands) 31, 33, 35, 42, 44, 45, 51, 52, 56,
58)
de Sanjos 2013 e PCR-SPF10, EIA, (HPV 6, 11, 220 40.0 (33.8-46.6) HPV 16 (27.3%)
(Oceania) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (3.6%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (2.7%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 6 (1.4%)
73, 74, 82, 83, 87, 89, 91) HPV 39 (1.4%)
Bujko 2012 PCR, LBA (HPV 6, 11, 16, 18, 44 34.1 (21.9-48.9) HPV 16 (20.5%)
(Poland) 26, 31, 33, 34, 35, 39, 40, 42, 43, HPV 11 (11.4%)
44, 45, 51, 52, 53, 54, 56, 57, 58, HPV 44 (4.5%)
59, 61, 66, 68, 70, 71, 72, 73, 81, HPV 52 (4.5%)
82, 83, 84) HPV 58 (4.5%)
Kowalewska 2010 PCR-(PGMY,L1), RLBM,(HPV 6, 44 15.9 (7.9-29.4) -
(Poland) 11, 16, 18, 26, 31, 33-35, 39, 40,
42-45, 51-59, 61, 66, 68, 70-73,
81-84 and CP6108)
Liss 1998 (Poland) PCR-MY09/11, PCR 18 16.7 (5.8-39.2) HPV 16 (16.7%)
L1-Consensus primer, PCR-E6,
PCR-E7, RFLP (HPV 6, 11, 16,
18, 31, 33, 35, 45, 52, 58)
Alonso 2011 PCR-SPF10, (HPV 6, 11, 16, 18, 98 19.4 (12.8-28.3) HPV 16 (14.3%)
(Spain) 31, 33, 35, 42, 45, 51, 52, 53, 54, HPV 33 (2.0%)
56, 58, 66) HPV 31 (1.0%)
HPV 51 (1.0%)
HPV 52 (1.0%)


Guerrero 2011 , PCR L1-Consensus primer, 30 16.7 (7.3-33.6) HPV 59 (10.0%)
(Spain) (HPV 6, 11, 16, 18, 26, 31, 33, 34, HPV 6 (3.3%)
35, 39, 40, 42, 43, 44, 45, 51, 52, HPV 16 (3.3%)
53, 54, 56, 57, 58, 59, 61, 66, 68, HPV 18 (3.3%)
70, 71, 72, 73, 81, 82, 83, 84)
Lerma 1999 PCR L1-Consensus primer, TS 57 12.3 (6.1-23.2) HPV 16 (12.3%)
(Spain) (HPV 16, 18)
Santos 2006 PCR-GP5+/GP6+,SPF10, LIPA, 92 17.4 (11.0-26.4) -
(Spain) TS (HPV 6, 11, 16, 18, 26, 31, 33,
35, 39, 40, 43-45, 51-54, 56, 58,
59, 66, 68, 69, 70, 71, 73, 74, 82)
Larsson 2012 PCR-E6, (HPV 6, 11, 16, 18, 31, 130 30.8 (23.5-39.2) HPV 16 (23.8%)
(Sweden) 33, 39, 45, 51, 52, 56, 58, 59) HPV 33 (3.8%)
HPV 18 (1.5%)
HPV 56 (0.8%)
HPV 59 (0.8%)
Lindell 2010 , PCR-CPI/CPIIG, TS, 75 30.7 (21.4-41.8) HPV 16 (21.3%)
(Sweden) Sequencing (HPV 6, 11, 16, 18, HPV 18 (2.7%)
33, 52) HPV 33 (2.7%)
HPV 52 (1.3%)
Ngamkham 2013 , EIA (HPV 6, 11, 16, 18, 26, 31, 25 44.0 (26.7-62.9) HPV 16 (36.0%)
(Thailand) 33, 34, 35, 39, 40, 42, 43, 44, 45, HPV 33 (8.0%)
51, 52, 53, 54, 56, 57, 58, 59, 66, HPV 35 (8.0%)
68, 70, 71, 72, 73, 81, 82, 83, 84, HPV 18 (4.0%)
89) HPV 58 (4.0%)
Abdel-Hady 2001 , TS (HPV 6, 11, 16, 18, 31, 33) 11 27.3 (9.7-56.6) HPV 16 (27.3%)
(UK) HPV 33 (18.2%)
HPV 18 (9.1%)
Gasco 2002 (UK) PCR- E6/E7,TS (HPV 16) 36 36.1 (22.5-52.4) -
Ogunbiyi 1994 PCR-GP5+/6+, TS (HPV 6, 11, 33 75.8 (59.0-87.2) -
(UK) 16, 18, 31, 33)
Bloss 1991 (USA) SBH (HPV6, 11, 16, 18 and 31) 21 47.6 (28.3-67.6) -
and E6/E7 primers
Carter 2001 MY09/11 and RFLP; 38 79.0 (63.7-88.9) -
(USA) type-specific for HPV16, 18
de Sanjos 2013 PCR-SPF10, EIA, (HPV 6, 11, 50 50.0 (36.6-63.4) HPV 16 (34.0%)
(USA) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (8.0%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 6 (2.0%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 18 (2.0%)
73, 74, 82, 83, 87, 89, 91) HPV 44 (2.0%)
Gargano 2012 PCR-SPF10, LBA, (HPV 6, 11, 176 68.8 (61.6-75.1) HPV 16 (48.3%)
(USA) 16, 18, 26, 31, 33, 34, 35, 39, 40, HPV 33 (10.2%)
42, 43, 44, 45, 51, 52, 53, 54, 56, HPV 52 (2.8%)
58, 59, 61, 62, 66, 67, 68, 69, 70, HPV 18 (1.7%)
71, 72, 73, 74, 81, 82, 83, 84) HPV 31 (1.1%)
Kim 1996 (USA) PCR-MY09/11, PCR 18 38.9 (20.3-61.4) HPV 16 (27.8%)
L1-Consensus primer, TS, HPV 18 (5.6%)
Sequencing (HPV 16, 18)
Lee 1994 (USA) MY09/11, GP5/GP6, SBH and 21 57.1 (36.5-75.5) -
type-specific for HPV6, 11, 16,
18, 31
Madeleine 1997 PCR-MY09/11, PCR 55 50.9 (38.1-63.6) HPV 16 (43.6%)
(USA) L1-Consensus primer, PCR-E6,
RFLP (HPV 16)
Monk 1995 (USA) MY09/11, GP5/GP6, SBH and 55 60.0 (46.8-71.9) -
type-specific for HPV6, 16, 18


Nuovo 1991 (USA) SBH and probes for HPV6, 11, 23 30.4 (15.6-50.9) -
16, 18, 31, 33 and 35
Pinto 1999 (USA) PCR-RFLP MY09/11 16 50.0 (28.0-72.0) -
Sagerman 1996 E6 for HPV6/11 and HPV16/18 19 15.8 (5.5-37.6) -
(USA) and E1/E2 for HPV33. MY09/11.
SBH.
Sutton 2008 PCR L1-Consensus primer, LBA 116 69.8 (60.9-77.4) HPV 16 (56.0%)
(USA) (HPV 6, 11, 16, 18, 26, 31, 33, 34, HPV 33 (10.3%)
35, 39, 40, 42, 45, 51, 52, 53, 54, HPV 45 (3.4%)
56, 58, 59, 61, 62, 66, 67, 68, 70, HPV 6 (2.6%)
71, 72, 73, 81, 82, 83, 84) HPV 52 (2.6%)
Tate 1994 (USA) PCR-MY09/11, PCR 13 53.8 (29.1-76.8) HPV 16 (46.2%)
L1-Consensus primer, RFLP HPV 33 (7.7%)
(HPV 16, 33)
Riethdorf 2004 f , PCR L1-Consensus primer, TS 71 87.3 (77.6-93.2) HPV 16 (87.3%)
(World) (HPV 16)
EIA: Enzyme ImmunoAssay; LBA: Line-Blot Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; RLBM: Reverse Line Blotting Method; SBH:
Southern Blot Hybridization; SPF: Short Primer Fragment; TS: Type Specific;
a Includes cases from Mali, Mozambique, Nigeria, and Senegal
b Includes cases from Bangladesh, India, Israel, South Korea, Kuwait, Lebanon, Philippines, Taiwan and Turkey
c Includes cases from Austria, Belarus, Bosnia-Herzegovina, Czech Republic, France, Germany, Greece, Italy, Poland, Portugal, Spain and United Kingdom
d Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay, and Venezuela
e Includes cases from Australia and New Zealand
f Includes cases from Germany and United States of America
Table 19: Studies on HPV prevalence among VIN 2/3 cases

de Sanjos 2013a PCR-SPF10, EIA, (HPV 6, 11, 20 100.0 (83.9-100.0) HPV 16 (80.0%)
(Asia) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 6 (5.0%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (5.0%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 33 (5.0%)
73, 74, 82, 83, 87, 89, 91) HPV 35 (5.0%)
Tan 2013 (Aus- PCR L1-Consensus primer, 44 90.9 (78.8-96.4) HPV 16 (68.2%)
tralia) (HPV 6, 11, 16, 18, 26, 31, 33, 35, HPV 26 (4.5%)
39, 40, 42, 44, 45, 51, 52, 53, 54, HPV 33 (4.5%)
56, 58, 59, 66, 68, 69, 70, 71, 73, HPV 52 (4.5%)
74, 82) HPV 82 (4.5%)
Skapa 2007 PCR-GP5+/GP6+, TS (HPV 3, 7, 48 89.6 (77.8-95.5) -
(Czech Rep.) 6, 10, 11, 13, 16, 18, 26-35, 39,
40, 42-45, 51, 53-59, 61, 62,
66-74, 77, 81-87, 89-91)
(Czech Rep.) Sequencing (HPV 6, 11, 16, 18, HPV 33 (8.5%)
20, 21, 22, 23, 26, 30, 31, 32, 33, HPV 18 (5.3%)
34, 35, 38, 39, 40, 42, 43, 44, 45, HPV 6 (4.3%)
51, 52, 53, 54, 56, 57, 58, 59, 60, HPV 11 (2.1%)
61, 62, 66, 67, 68, 69, 70, 71, 72,
73, 74, 80, 81, 82, 83, 84, 85, 86,
87, 89, 90, 91)
Hrding 1991 PCR-E6/E7, TS (HPV 16) 19 78.9 (56.7-91.5) -
(Denmark)
Junge 1995 (Den- PCR-E6, PCR-E7, TS (HPV 6, 58 87.9 (77.1-94.0) HPV 16 (77.6%)
mark) 11, 16, 18, 31, 33) HPV 33 (10.3%)


de Sanjos 2013b PCR-SPF10, EIA, (HPV 6, 11, 312 86.9 (82.7-90.2) HPV 16 (69.6%)
(Europe) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (11.2%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (2.2%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 6 (1.6%)
73, 74, 82, 83, 87, 89, 91) HPV 52 (1.3%)
many) (HPV 6, 11, 16, 18, 20, 21, 22, 23, HPV 33 (10.7%)
26, 30, 31, 32, 33, 35, 42, 44, 45, HPV 31 (4.2%)
51, 52, 56, 58, 61, 67, 73, 74, 91) HPV 18 (3.0%)
Hillemanns 2006 HC2 (HPV 6, 11, 16, 18, 31, 33, 29 86.2 (69.4-94.5) -
(Germany) 35, 39, 42, 43, 44, 45, 51, 52, 56,
58, 59, 68), TS (HPV16, 18)
Tsimplaki 2012 (HPV 6, 11, 16, 18, 31, 33, 35, 40, 14 78.6 (52.4-92.4) HPV 16 (64.3%)
(Greece) 42, 43, 44, 45, 51, 52, 53, 56, 58, HPV 18 (7.1%)
59, 66, 73) HPV 51 (7.1%)
HPV 52 (7.1%)
HPV 53 (7.1%)
Bonvicini 2005 PCR-MY09/11 (HPV 16, 18, 31, 25 44.0 (26.7-62.9) HPV 16 (36.0%)
(Italy) 33, 35, 45, 52, 58) HPV 35 (8.0%)
HPV 33 (4.0%)
HPV 52 (4.0%)
de Sanjos 2013 c
(Latin America
16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (8.7%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 6 (4.8%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 31 (4.0%)
73, 74, 82, 83, 87, 89, 91) HPV 11 (1.6%)
van Beurden 1995 PCR-CPI/CPIIG, Sequencing 46 95.7 (85.5-98.8) HPV 16 (89.1%)
(Netherlands) (HPV 6, 11, 16, 18, 20, 21, 22, 23, HPV 33 (2.2%)
26, 30, 31, 32, 33, 45) HPV 45 (2.2%)
van der Avoort PCR L1-Consensus primer, 32 56.3 (39.3-71.8) HPV 16 (40.6%)
2006 (Nether- PCR-SPF10, (HPV 6, 11, 16, 18, HPV 6 (6.3%)
lands) 31, 33, 35, 42, 43, 44, 45, 51, 52, HPV 31 (6.3%)
56, 58, 59, 74) HPV 33 (3.1%)
van Esch 2014 , , TS (HPV 16, 18, 33, 73) 43 100.0 (91.8-100.0) HPV 16 (81.4%)
(Netherlands) HPV 33 (14.0%)
HPV 73 (2.3%)
van Seters 2008 PCR-GP5+/6+, RLBM, (HPV 6, 52 96.2 (87.0-98.9) -
(Netherlands) 11, 16, 18, 26, 31, 33-35, 39, 40,
42-45, 51-59, 61, 66, 68, 70-73,
81-84, CP6108)
de Sanjos 2013d PCR-SPF10, EIA, (HPV 6, 11, 125 94.4 (88.9-97.3) HPV 16 (71.2%)
(Oceania) 16, 18, 26, 30, 31, 33, 34, 35, 39, HPV 33 (10.4%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 18 (4.0%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 31 (3.2%)
73, 74, 82, 83, 87, 89, 91) HPV 6 (1.6%)
Lerma 1999 PCR L1-Consensus primer, TS 18 27.8 (12.5-50.9) HPV 16 (27.8%)
(Spain) (HPV 16, 18)
Abdel-Hady 2001 , TS (HPV 06/11, 16, 18, 31, 33) 32 71.9 (54.6-84.4) HPV 16 (62.5%)
(UK) HPV 6/11 (18.8%)
HPV 31 (3.1%)
HPV 33 (3.1%)
Baldwin 2003 , PCR L1-Consensus primer, 11 100.0 (74.1-100.0) HPV 16 (90.9%)
(UK) Sequencing (HPV 6, 11, 16, 18, HPV 16 (90.9%)
31, 33) HPV 33 (9.1%)
HPV 33 (9.1%)


Bryant 2011 (UK) , PCR- MULTIPLEX (HPV 6, 11, 49 81.6 (68.6-90.0) HPV 16 (67.3%)
16, 18, 31, 33, 35, 40, 42, 43, 44, HPV 33 (16.3%)
45, 51, 52, 53, 56, 58, 59, 66, 73) HPV 6 (10.2%)
HPV 18 (2.0%)
HPV 31 (2.0%)
Daayana 2010 , EIA, (HPV 6, 11, 16, 26, 31, 33, 19 78.9 (56.7-91.5) HPV 16 (73.7%)
(UK) 34, 35, 39, 40, 42, 43, 44, 45, 51, HPV 33 (5.3%)
52, 53, 54, 56, 57, 58, 59, 61, 66, HPV 42 (5.3%)
68, 70, 71, 72, 73, 81, 82, 83, 84) HPV 84 (5.3%)
Gasco 2002 (UK) PCR-(MY09/11, CPI/IIG), 28 42.9 (26.5-60.9) -
sequencing
Winters 2008 , EIA, (HPV 6, 11, 16, 18, 26, 31, 20 85.0 (64.0-94.8) HPV 16 (75.0%)
(UK) 33, 34, 35, 39, 40, 42, 43, 44, 45, HPV 18 (5.0%)
51, 52, 53, 54, 56, 57, 58, 59, 61, HPV 33 (5.0%)
66, 68, 70, 71, 72, 73, 81, 82, 83,
84)
Gargano 2012 PCR-SPF10, LBA, (HPV 16, 18, 68 97.1 (89.9-99.2) HPV 16 (80.9%)
(USA) 33, 52, 59) HPV 33 (8.8%)
HPV 59 (2.9%)
HPV 18 (1.5%)
Madeleine 1997 PCR-MY09/11, PCR 253 71.5 (65.7-76.7) HPV 16 (61.7%)
(USA) L1-Consensus primer, PCR-E6,
RFLP (HPV 16)
Srodon 2006 PCR-MY09/11, PCR-SPF10, , 34 100.0 (89.8-100.0) HPV 16 (91.2%)
(USA) Sequencing (HPV 6, 11, 16, 18, HPV 18 (5.9%)
20, 21, 22, 23, 26, 30, 31, 32, 33, HPV 35 (5.9%)
34, 35, 38, 39, 40, 42, 43, 44, 45, HPV 11 (2.9%)
51, 52, 53, 54, 56, 57, 58, 59, 60, HPV 33 (2.9%)
61, 62, 66, 67, 68, 69, 70, 71, 72,
73, 74, 80, 81, 82, 83, 84, 85, 86,
87, 89, 90, 91)
Riethdorf 2004 e , PCR L1-Consensus primer, TS 60 68.3 (55.8-78.7) HPV 16 (68.3%)
(World) (HPV 16)
95% CI: 95% Confidence Interval; VIN 2/3: Vulvar intraepithelial neoplasia of grade 2/3;
EIA: Enzyme ImmunoAssay; HC2: Hybrid Capture 2; LBA: Line-Blot Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; RLBM: Reverse Line
Blotting Method; SPF: Short Primer Fragment; TS: Type Specific;
a Includes cases from Bangladesh, India, Israel, South Korea, Kuwait, Lebanon, Philippines, Taiwan and Turkey
b Includes cases from Austria, Belarus, Bosnia-Herzegovina, Czech Republic, France, Germany, Greece, Italy, Poland, Portugal, Spain and United Kingdom
c Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay, and Venezuela
d Includes cases from Australia and New Zealand
e Includes cases from Germany and United States of America

Figure 95: Comparison of the ten most frequent HPV types in vulvar cancer cases in Africa and the rest
of the World
16 58.3 16 19.4
18 4.2 33 1.8
45 4.2 18 1.5
52 4.2 45 0.9
5th* 6 0.6
6th* 31 0.6
7th* 44 0.6
8th* 52 0.5
9th* 51 0.4
10th* 56 0.4
0 10 20 30 40 50 60 0 10 20 30 40 50 60

vulvar cancer cases
VIN 2/3: Vulvar intraepithelial neoplasia of grade 2/3;
a Includes cases from Mali, Mozambique, Nigeria, and Senegal.
b Includes cases from America (Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay, United States of America and Venezuela); Africa (Mali,
Mozambique, Nigeria, and Senegal); Oceania (Australia and New Zealand); Europe (Austria, Belarus, Bosnia-Herzegovina, Czech Republic, France, Germany, Greece, Italy, Poland, Portugal,
Spain and United Kingdom); and in Asia (Bangladesh, India, Israel, South Korea, Kuwait, Lebanon, Philippines, Taiwan and Turkey)
Figure 96: Comparison of the ten most frequent HPV types in vulvar cancer cases in the Americas and
16 26.5 16 19.4
33 2.9 33 1.8
18 2.7 18 1.5
45 2.1 45 0.9
6 1.3 6 0.6
52 0.8 31 0.6
56 0.8 44 0.6
31 0.5 52 0.5
39 0.5 51 0.4
51 0.5 56 0.4
0 10 20 30 0 10 20 30

vulvar cancer cases

a Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay, United States of America and Venezuela

Figure 97: Comparison of the ten most frequent HPV types in vulvar cancer cases in Asia and the rest
of the World
Asia (a) World (b)
16 18.1 16 19.4
18 1.6 33 1.8
44 1.6 18 1.5
45 1.1 45 0.9
52 1.1 6 0.6
58 1.1 31 0.6
11 0.5 44 0.6
26 0.5 52 0.5
30 0.5 51 0.4
31 0.5 56 0.4
0 10 20 0 10 20

vulvar cancer cases

a Includes cases from Bangladesh, India, Israel, South Korea, Kuwait, Lebanon, Philippines, Taiwan and Turkey.
Figure 98: Comparison of the ten most frequent HPV types in vulvar cancer cases in Europe and the
rest of the World
16 13.8 16 19.4
33 1.2 33 1.8
18 0.6 18 1.5
31 0.6 45 0.9
44 0.4 6 0.6
51 0.4 31 0.6
53 0.3 44 0.6
58 0.3 52 0.5
74 0.3 51 0.4
35 0.2 56 0.4
0 10 20 0 10 20

vulvar cancer cases

a Includes cases from Austria, Belarus, Bosnia-Herzegovina, Czech Republic, France, Germany, Greece, Italy, Poland, Portugal, Spain and United Kingdom.

Figure 99: Comparison of the ten most frequent HPV types in vulvar cancer cases in Oceania and the
rest of the World
Oceania (a) World (b)
16 27.3 16 19.4
33 3.6 33 1.8
18 2.7 18 1.5
39 1.4 45 0.9
6 1.4 6 0.6
31 0.9 31 0.6
44 0.9 44 0.6
45 0.9 52 0.5
52 0.9 51 0.4
56 0.9 56 0.4
0 10 20 30 0 10 20 30

vulvar cancer cases

a Includes cases from Australia and New Zealand.
Figure 100: Comparison of the ten most frequent HPV types in VIN 2/3 cases in Africa and the rest of
the World
Africa World (a)
1st* 16 67.1
2nd* 33 10.2
3rd* 6 2.4
4th* 18 2.4
5th* 31 1.9
No data available
6th* 52 1.4
7th* 51 1.2
8th* 56 0.9
9th* 74 0.9
10th* 66 0.7
0 10 20 30 40 50 60 70

VIN 2/3 cases
a Includes cases from America (Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay and Venezuela); Oceania (Australia and New Zealand);
Europe (Austria, Belarus, Bosnia-Herzegovina, Czech Republic, France, Germany, Greece, Italy, Poland, Portugal, Spain and United Kingdom); and in Asia (Bangladesh, India, Israel, South
Korea, Kuwait, Lebanon, Philippines, Taiwan and Turkey)

Figure 101: Comparison of the ten most frequent HPV types in VIN 2/3 cases in the Americas and the
rest of the World
16 56.7 16 67.1
33 8.7 33 10.2
6 4.7 6 2.4
31 3.9 18 2.4
11 1.6 31 1.9
45 1.6 52 1.4
51 1.6 51 1.2
52 1.6 56 0.9
58 1.6 74 0.9
18 0.8 66 0.7
0 10 20 30 40 50 60 70 0 10 20 30 40 50 60 70

VIN 2/3 cases

a Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay, and Venezuela.
b Includes cases from America (Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Uruguay and Venezuela); Oceania (Australia and New Zealand);
Figure 102: Comparison of the ten most frequent HPV types in VIN 2/3 cases in Asia and the rest of the
World
Asia (a) World (b)
16 80.0 16 67.1
6 5.0 33 10.2
18 5.0 6 2.4
33 5.0 18 2.4
35 5.0 31 1.9
54 5.0 52 1.4
7th* 51 1.2
8th* 56 0.9
9th* 74 0.9
10th* 66 0.7
0 10 20 30 40 50 60 70 80 90 0 10 20 30 40 50 60 70 80 90

VIN 2/3 cases
a Includes cases from Bangladesh, India, Israel, South Korea, Kuwait, Lebanon, Philippines, Taiwan and Turkey.

Figure 103: Comparison of the ten most frequent HPV types in VIN 2/3 cases in Europe and the rest of
the World
16 69.6 16 67.1
33 11.2 33 10.2
18 2.2 6 2.4
6 1.6 18 2.4
52 1.3 31 1.9
56 1.3 52 1.4
44 1.0 51 1.2
66 1.0 56 0.9
74 1.0 74 0.9
31 0.6 66 0.7
0 10 20 30 40 50 60 70 0 10 20 30 40 50 60 70

VIN 2/3 cases

a Includes cases from Austria, Belarus, Bosnia-Herzegovina, Czech Republic, France, Germany, Greece, Italy, Poland, Portugal, Spain and United Kingdom.
Figure 104: Comparison of the ten most frequent HPV types in VIN 2/3 cases in Oceania and the rest
of the World
16 71.2 16 67.1
33 10.4 33 10.2
18 4.0 6 2.4
31 3.2 18 2.4
6 1.6 31 1.9
51 1.6 52 1.4
11 0.8 51 1.2
34 0.8 56 0.9
40 0.8 74 0.9
42 0.8 66 0.7
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80

VIN 2/3 cases

a Includes cases from Australia and New Zealand.

4.2.3 Vaginal cancer and precancerous vaginal lesions
Vaginal and cervical cancers share similar risk factors and it is generally accepted that both carcinomas
share the same aetiology of HPV infection although there is limited evidence available. Women with
vaginal cancer are more likely to have a history of other anogenital cancers, particularly of the cervix,
and these two carcinomas are frequently diagnosed simultaneously. HPV DNA is detected among 70%
of invasive vaginal carcinomas and 91% of high-grade vaginal neoplasias (VaIN2/3). HPV16 is the
most common type in high-grade vaginal neoplasias and it is detected in at least 70% of HPV-positive
carcinomas (de Martel C et al. Lancet Oncol 2012;13(6):607-15; De Vuyst H et al. Int J Cancer 2009;
124: 1626-36).
Table 20: Studies on HPV prevalence among vaginal cancer cases

(Africa) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 45 (10.5%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 18 (5.3%)
68, 69, 73, 82) HPV 31 (5.3%)
HPV 33 (5.3%)
(Americas) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 31 (5.8%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 18 (4.2%)
68, 69, 73, 82) HPV 33 (4.2%)
HPV 52 (3.1%)
Alemany 2014 c PCR-SPF10, EIA, (HPV 6, 11, 46 71.7 (57.5-82.7) HPV 16 (41.3%)
(Asia-Pacific) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 33 (4.3%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 68 (4.3%)
68, 69, 73, 82) HPV 18 (2.2%)
HPV 26 (2.2%)
Madsen 2008 , EIA, (HPV 6, 11, 16, 18, 31, 33, 27 88.9 (71.9-96.1) HPV 16 (77.8%)
(Denmark) 35, 39, 40, 42, 44, 45, 51, 52, 56, HPV 33 (7.4%)
58) HPV 18 (3.7%)
HPV 39 (3.7%)
HPV 45 (3.7%)
Alemany 2014d PCR-SPF10, EIA, (HPV 6, 11, 152 71.1 (63.4-77.7) HPV 16 (47.4%)
(Europe) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 18 (3.3%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 73 (3.3%)
68, 69, 73, 82) HPV 33 (2.6%)
HPV 56 (2.6%)
Koyamatsu 2003 E7 (115-158 bp) for HPV16, HPV 16 43.8 (23.1-66.8) -
(Japan) 18, L1 (250bp) for HPV
6,11,16,18,31,33,42,52,58.
Ferreira 2008 PCR, (HPV 6, 11, 16, 18, 31, 33, 21 81.0 (60.0-92.3) HPV 16 (33.3%)
(Portugal) 35, 40, 42, 44, 45, 51, 52, 56, 58) HPV 31 (28.6%)
HPV 40 (14.3%)
HPV 6 (9.5%)
HPV 18 (9.5%)
Fuste 2010 PCR-SPF10, (HPV 6, 11, 16, 18, 32 78.1 (61.2-89.0) HPV 16 (56.3%)
(Spain) 31, 33, 35, 39, 40, 42, 45, 51, 52, HPV 52 (6.3%)
56, 58, 59, 68) HPV 35 (3.1%)
HPV 51 (3.1%)
HPV 58 (3.1%)


Larsson 2013 PCR-E6, (HPV 6, 11, 16, 18, 31, 69 53.6 (42.0-64.9) HPV 16 (37.7%)
(Sweden) 33, 35, 39, 45, 51, 52, 56, 58, 59) HPV 18 (2.9%)
HPV 31 (2.9%)
HPV 33 (2.9%)
HPV 52 (2.9%)
Carter 2001 MY09/11 and RFLP; 54 90.7 (80.1-96.0) -
(USA) type-specific for 16, 18.
Daling 2002 MY09/11 for 6/11, 16, 18/45, 31. 25 64.0 (44.5-79.8) -
(USA)
Kiyabu 1989 E6 for HPV16 and HPV18. 14 64.3 (38.8-83.7) -
(USA)
EIA: Enzyme ImmunoAssay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; SPF: Short Primer Fragment;
a Includes cases from Mozambique, Nigeria
b Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Mexico, Paraguay, Uruguay, United States of America and Venezuela
c Includes cases from Australia, Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan and Turkey
d Includes cases from Austria, Belarus, Czech Republic, France, Germany, Greece, Poland, Spain and United Kingdom
Table 21: Studies on HPV prevalence among VaIN 2/3 cases

(Americas) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 18 (6.3%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 52 (6.3%)
68, 69, 73, 82, 89) HPV 73 (6.3%)
HPV 6 (3.8%)
(Asia-Pacific) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 52 (15.4%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 59 (15.4%)
68, 69, 73, 82, 89) HPV 45 (7.7%)
HPV 73 (7.7%)
Alemany 2014 c PCR-SPF10, EIA, (HPV 6, 11, 96 97.9 (92.7-99.4) HPV 16 (65.6%)
(Europe) 16, 18, 26, 30, 31, 33, 35, 39, 42, HPV 33 (7.3%)
45, 51, 52, 53, 56, 58, 59, 66, 67, HPV 18 (5.2%)
68, 69, 73, 82) HPV 52 (3.1%)
HPV 73 (3.1%)
many) (HPV 6, 11, 16, 18, 20, 21, 22, 23,
26, 30, 31, 32, 33, 35, 40, 44, 52,
56, 58)
Hampl 2007 (Ger- PCR-MY09/11, GP5/GP6, TS 17 94.1 (73.0-99.0) -
many) (HPV 6, 11, 16, 18, 31, 33, 35, 40,
42, 44, 45, 51, 52, 53, 55, 56, 58,
61, 66-68, 73, 74, 91,
IS887/MM4, HPVIA18)
Tsimplaki 2012 (HPV 6, 11, 16, 18, 31, 33, 35, 39, 10 40.0 (16.8-68.7) HPV 16 (20.0%)
(Greece) 40, 42, 44, 45, 51, 52, 53, 56, 58, HPV 33 (20.0%)
66, 70)
Frega 2007 (Italy) PCR, TS (HPV 16, 18) 30 100.0 (88.6-100.0) HPV 16 (86.7%)
HPV 18 (13.3%)


Sugase 1997 PCR, TS, Sequencing (HPV 6, 18 100.0 (82.4-100.0) HPV 16 (16.7%)
(Japan) 11, 16, 18, 20, 21, 22, 23, 26, 30, HPV 58 (16.7%)
31, 32, 33, 34, 35, 38, 39, 40, 42, HPV 53 (11.1%)
43, 44, 45, 51, 52, 53, 54, 56, 57, HPV 67 (11.1%)
58, 59, 60, 61, 62, 66, 67, 68, 69, HPV 35 (5.6%)
70, 71, 72, 73, 74, 80, 81, 82, 83,
84, 85, 86, 87, 89, 90, 91)
(USA) L1-Consensus primer, RFLP, TS HPV 58 (1.0%)
(HPV 16, 31, 33, 35, 58, 66, 73) HPV 66 (1.0%)
HPV 73 (1.0%)
Srodon 2006 PCR-MY09/11, PCR-SPF10, , 16 93.8 (71.7-98.9) HPV 16 (50.0%)
(USA) Sequencing (HPV 6, 11, 16, 18, HPV 58 (18.8%)
20, 21, 22, 23, 26, 30, 31, 32, 33, HPV 31 (12.5%)
34, 35, 38, 39, 40, 42, 43, 44, 45, HPV 35 (6.3%)
51, 52, 53, 54, 56, 57, 58, 59, 60, HPV 51 (6.3%)
61, 62, 66, 67, 68, 69, 70, 71, 72,
73, 74, 80, 81, 82, 83, 84, 85, 86,
87, 89, 90, 91)
95% CI: 95% Confidence Interval; VAIN 2/3: Vaginal intraepithelial neoplasia of grade 2/3;
EIA: Enzyme ImmunoAssay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; SPF: Short Primer Fragment; TS: Type Specific;
a Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Mexico, Paraguay, Uruguay, United States of America and Venezuela
b Includes cases from Australia, Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan and Turkey
c Includes cases from Austria, Belarus, Czech Republic, France, Germany, Greece, Poland, Spain and United Kingdom
Figure 105: Comparison of the ten most frequent HPV types in vaginal cancer cases in Africa and the
rest of the World
16 31.6 16 43.6
45 10.5 31 3.9
18 5.3 18 3.7
31 5.3 33 3.7
33 5.3 45 2.7
39 5.3 58 2.7
7th* 52 2.2
8th* 51 1.7
9th* 73 1.7
10th* 39 1.5
0 10 20 30 40 50 0 10 20 30 40 50

vaginal cancer cases
VAIN 2/3: Vaginal intraepithelial neoplasia of grade 2/3;
a Includes cases from Mozambique, Nigeria.
b Includes cases from Europe (Austria, Belarus, Czech Republic, France, Germany, Greece, Poland, Spain and United Kingdom); America (Argentina, Brazil, Chile, Colombia, Ecuador,
Guatemala, Mexico, Paraguay, Uruguay, United states of America and Venezuela); Africa (Mozambique, Nigeria); Asia (Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan
and Turkey); and Oceania (Australia)

Figure 106: Comparison of the ten most frequent HPV types in vaginal cancer cases in the Americas
and the rest of the World
16 42.4 16 43.6
31 5.8 31 3.9
18 4.2 18 3.7
33 4.2 33 3.7
52 3.1 45 2.7
58 3.1 58 2.7
45 2.6 52 2.2
51 2.6 51 1.7
39 2.1 73 1.7
59 1.6 39 1.5
0 10 20 30 40 50 0 10 20 30 40 50


a Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Mexico, Paraguay, Uruguay, United States of America and Venezuela.
Figure 107: Comparison of the ten most frequent HPV types in vaginal cancer cases in Asia and the
rest of the World
Asia (a) World (b)
16 39.4 16 43.6
33 3.0 31 3.9
68 3.0 18 3.7
18 3.0 33 3.7
26 3.0 45 2.7
45 3.0 58 2.7
51 3.0 52 2.2
52 3.0 51 1.7
56 3.0 73 1.7
59 3.0 39 1.5
0 10 20 30 40 50 0 10 20 30 40 50


a Includes cases from Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan and Turkey

Figure 108: Comparison of the ten most frequent HPV types in vaginal cancer cases in Europe and the
rest of the World
16 47.4 16 43.6
18 3.3 31 3.9
73 3.3 18 3.7
33 2.6 33 3.7
56 2.6 45 2.7
58 2.6 58 2.7
31 2.0 52 2.2
35 1.3 51 1.7
45 1.3 73 1.7
52 1.3 39 1.5
0 10 20 30 40 50 0 10 20 30 40 50


a Includes cases from Austria, Belarus, Czech Republic, France, Germany, Greece, Poland, Spain and United Kingdom.
Figure 109: Comparison of the ten most frequent HPV types in vaginal cancer cases in Oceania and the
rest of the World
16 46.2 16 43.6
33 7.7 31 3.9
68 7.7 18 3.7
31 7.7 33 3.7
58 7.7 45 2.7
6th* 58 2.7
7th* 52 2.2
8th* 51 1.7
9th* 73 1.7
10th* 39 1.5
0 10 20 30 40 50 0 10 20 30 40 50

a Includes cases from Australia

Figure 110: Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Africa and the rest of
the World
Africa World (a)
1st* 16 56.1
2nd* 18 5.3
3rd* 52 5.3
4th* 73 4.8
5th* 33 4.2
No data available
6th* 59 3.7
7th* 56 2.6
8th* 51 2.1
9th* 6 1.6
10th* 35 1.6
0 10 20 30 40 50 60

VaIN 2/3 cases
a Includes cases from Europe (Austria, Belarus, Czech Republic, France, Germany, Greece, Poland, Spain and United Kingdom); America (Argentina, Brazil, Chile, Colombia, Ecuador,
Guatemala, Mexico, Paraguay, Uruguay, United states of America and Venezuela); Asia (Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan and Turkey); and Oceania
(Australia)
Figure 111: Comparison of the ten most frequent HPV types in VaIN 2/3 cases in the Americas and the
rest of the World
16 46.3 16 56.1
18 6.3 18 5.3
52 6.3 52 5.3
73 6.3 73 4.8
51 3.8 33 4.2
56 3.8 59 3.7
6 3.8 56 2.6
31 2.5 51 2.1
58 2.5 6 1.6
59 2.5 35 1.6
0 10 20 30 40 50 60 0 10 20 30 40 50 60

VaIN 2/3 cases

a Includes cases from Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Mexico, Paraguay, Uruguay, United States of America and Venezuela.
(Australia)

Figure 112: Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Asia and the rest of
the World
Asia (a) World (b)
16 53.8 16 56.1
52 15.4 18 5.3
59 15.4 52 5.3
45 7.7 73 4.8
73 7.7 33 4.2
6th* 59 3.7
7th* 56 2.6
8th* 51 2.1
9th* 6 1.6
10th* 35 1.6
0 10 20 30 40 50 60 0 10 20 30 40 50 60

VaIN 2/3 cases
a Includes cases from Australia, Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan and Turkey.
(Australia)
Figure 113: Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Europe and the rest
of the World
16 65.6 16 56.1
33 7.3 18 5.3
18 5.2 52 5.3
52 3.1 73 4.8
73 3.1 33 4.2
35 2.1 59 3.7
53 2.1 56 2.6
56 2.1 51 2.1
59 2.1 6 1.6
30 1.0 35 1.6
0 10 20 30 40 50 60 70 0 10 20 30 40 50 60 70

VaIN 2/3 cases

a Includes cases from Austria, Belarus, Czech Republic, France, Germany, Greece, Poland, Spain and United Kingdom.
(Australia)

Figure 114: Comparison of the ten most frequent HPV types in VaIN 2/3 cases in Oceania and the rest
of the World
16 53.8 16 56.1
52 15.4 18 5.3
59 15.4 52 5.3
45 7.7 73 4.8
73 7.7 33 4.2
6th* 59 3.7
7th* 56 2.6
8th* 51 2.1
9th* 6 1.6
10th* 35 1.6
0 10 20 30 40 50 60 0 10 20 30 40 50 60

VaIN 2/3 cases
a Includes cases from Australia, Bangladesh, India, Israel, South Korea, Kuwait, Philippines, Taiwan and Turkey.
(Australia)

4.2.4 Penile cancer and precancerous penile lesions
HPV DNA is detectable in approximately 50% of all penile cancers (de Martel C et al. Lancet Oncol
2012;13(6):607-15). Among HPV-related penile tumours, HPV16 is the most common type detected,
followed by HPV18 and HPV types 6/11 (Miralles C et al. J Clin Pathol 2009;62:870-8). Over 95% of
invasive penile cancers are SCC and the most common penile SCC histologic sub-types are keratinising
(49%), mixed warty-basaloid (17%), verrucous (8%), warty (6%), and basaloid (4%). HPV is commonly
detected in basaloid and warty tumours but is less common in keratinising and verrucous tumours. In
this section, the HPV prevalence among penile cancer cases in the World is presented.
Table 22: Studies on HPV prevalence among penile cancer cases

(Africa) 16, 18, 26, 30, 31, 32, 33, 34, 35, HPV 30 (5.3%)
39, 40, 42, 43, 44, 45, 51, 52, 53, HPV 33 (5.3%)
54, 56, 58, 59, 61, 66, 67, 68, 69, HPV 52 (5.3%)
70, 73, 74, 82, 83, 87, 89, 90, 91)
Cubilla 1998 PCR and southern Blot. Type 11 81.8 (52.3-94.9) -
(Americas) specific for
6,11,16,18,31,33,35,52
Gregoire 1995 PCR Type specific for: 6,11,16 109 23.9 (16.8-32.7) -
(Americas) and 18 + Primers for wide range
including 16,18,31,33,35,52
Rubin 2001 PCR L1-Consensus primer, 142 42.3 (34.4-50.5) HPV 16 (25.4%)
(Americas) PCR-SPF10, EIA, (HPV 6, 11, HPV 6 (3.5%)
16, 18, 35, 45, 52, 53, 68) HPV 45 (2.8%)
HPV 52 (2.8%)
HPV 35 (2.1%)
Picconi 2000 (Ar- , PCR L1-Consensus primer, TS 38 71.1 (55.2-83.0) HPV 18 (28.9%)
gentina) (HPV 6, 16, 18, 31, 33) HPV 16 (21.1%)
HPV 6 (5.3%)
(Asia) 16, 18, 26, 30, 31, 32, 33, 34, 35, HPV 33 (1.5%)
39, 40, 42, 43, 44, 45, 51, 52, 53, HPV 35 (1.5%)
54, 56, 58, 59, 61, 66, 67, 68, 69, HPV 45 (1.5%)
70, 73, 74, 82, 83, 87, 89, 90, 91)
Mannweiler 2013 PCR L1-Consensus primer, 123 58.5 (49.7-66.9) HPV 16 (45.5%)
(Austria) PCR-SPF10, (HPV 6, 11, 16, 18, HPV 33 (4.9%)
26, 31, 33, 35, 39, 40, 43, 44, 45, HPV 18 (4.1%)
51, 52, 53, 54, 56, 58, 59, 66, 68, HPV 45 (3.3%)
69, 70, 71, 72, 73, 74, 82) HPV 6 (0.8%)
DHauwers 2012 PCR-E6, PCR-E7, qPCR (HPV 6, 36 61.1 (44.9-75.2) HPV 16 (47.2%)
(Belgium) 11, 16, 18, 31, 33, 35, 39, 45, 51, HPV 59 (5.6%)
52, 53, 56, 58, 59, 66, 67, 68) HPV 6 (2.8%)
HPV 11 (2.8%)
HPV 33 (2.8%)
Afonso 2012 PCR-MY09/11, PCR 133 56.4 (47.9-64.5) HPV 16 (17.3%)
(Brazil) L1-Consensus primer, PCR-E6, HPV 45 (12.8%)
RFLP (HPV 6, 11, 16, 18, 26, 31, HPV 6 (6.8%)
33, 35, 45, 53, 62, 70, 71, 73) HPV 18 (3.8%)
HPV 31 (3.0%)
Bezerra 2001 PCR consensus primers and 82 30.5 (21.6-41.1) -
(Brazil) probing forHPV types:
6,11,16,18,31,33,34,35,39,40,42,43,44,45,51,52,54,56
and 58


Calmon 2013 , PCR L1-Consensus primer, 47 48.9 (35.3-62.8) HPV 16 (40.4%)
(Brazil) qPCR, (HPV 6, 11, 16, 18, 26, 31, HPV 11 (10.6%)
33, 35, 39, 40, 43, 44, 45, 51, 52, HPV 35 (2.1%)
53, 54, 56, 58, 59, 66, 68, 69, 70,
71, 73, 74, 82)
de Sousa 2015 , PCR-PGMY09/11, PCR- 76 63.2 (51.9-73.1) HPV 16 (13.2%)
(Brazil) MULTIPLEX, Sequencing (HPV HPV 11 (7.9%)
11, 16, 18, 45, 69) HPV 18 (5.3%)
HPV 69 (2.6%)
HPV 45 (1.3%)
Fonseca 2013 , Sequencing (HPV 6, 11, 16, 18, 82 61.0 (50.2-70.8) HPV 11 (39.0%)
(Brazil) 33, 45, 51, 52, 53, 58, 68) HPV 6 (19.5%)
HPV 16 (18.3%)
HPV 53 (11.0%)
HPV 33 (2.4%)
Levi 1998 (Brazil) PCR MY09/11 and probing for 50 56.0 (42.3-68.8) -
6,11,16,18,31
Scheiner 2008 , PCR-MY09/11, RFLP (HPV 6, 80 72.5 (61.9-81.1) HPV 16 (15.0%)
(Brazil) 16, 18, 31, 33, 45, 71) HPV 6 (5.0%)
HPV 18 (1.3%)
HPV 31 (1.3%)
HPV 33 (1.3%)
Maden 1993 PCR L1-Consensus primer, 67 49.3 (37.7-60.9) HPV 16 (34.3%)
(Canada) PCR-E6, PCR-E7, TS (HPV 16)
Chan 1994 PCR-E6, TS (HPV 16, 18) 41 14.6 (6.9-28.4) HPV 16 (9.8%)
(China) HPV 18 (9.8%)
Krustrup 2009 PCR-GP5+/6+, EIA, RLBM, 145 61.4 (53.3-68.9) -
(Denmark) (HPV 6, 11, 16, 18, 26, 31, 33-35,
39, 40, 42-45, 51-59, 61, 66, 68,
70-73, 81(CP8304), 82/MM4,
82/IS39, 83(MM7), 84(MM8),
CP6108)
(Europe) 16, 18, 26, 31, 32, 33, 34, 35, 39, HPV 52 (1.2%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 6 (1.0%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 33 (1.0%)
73, 74, 82, 83, 87, 89, 90, 91) HPV 45 (0.7%)
Humbey 2003 PCR-MY09/11, PCR 36 66.7 (50.3-79.8) HPV 16 (25.0%)
(France) L1-Consensus primer, TS (HPV
6, 11, 16, 18, 31, 33, 35, 45, 51,
52, 58, 68)
Perceau 2003 , TS (HPV 16, 18, 31, 33) 17 17.6 (6.2-41.0) HPV 16 (17.6%)
(France)
Perceau 2003 PCR-GP5+/6+, TS (HPV 16, 18, 17 35.3 (17.3-58.7) -
(Germany) 31, 33)
Poetsch 2011 PCR- MULTIPLEX, TS (HPV 52 38.5 (26.5-52.0) HPV 16 (32.7%)
(Germany) 06/11, 16, 18) HPV 6/11 (3.8%)
HPV 18 (1.9%)
Barzon 2014 qPCR, , TS (HPV 16, 18, 26, 31, 54 29.6 (19.1-42.8) HPV 16 (25.9%)
(Italy) 33, 35, 39, 43, 44, 45, 51, 52, 53, HPV 45 (1.9%)
54, 56, 58, 59, 66, 68, 69, 70, 71, HPV 68 (1.9%)
73, 74, 82)
Gentile 2006 , PCR-MY09/11, PCR 11 72.7 (43.4-90.3) HPV 16 (45.5%)
(Italy) L1-Consensus primer, HPV 18 (18.2%)
Sequencing (HPV 16, 18, 53) HPV 53 (9.1%)


Tornesello 2008 , PCR-MY09/11, PCR-L1C1/C2, 61 47.5 (35.5-59.8) HPV 16 (42.6%)
(Italy) PCR-E6, PCR-E7, Sequencing HPV 18 (3.3%)
(HPV 6, 16, 18, 33, 35) HPV 35 (1.6%)
Iwasawa 1993 PCR-E6, TS (HPV 16, 18, 33) 111 63.1 (53.8-71.5) HPV 16 (61.3%)
(Japan) HPV 18 (1.8%)
Suzuki 1994 PCR L1-Consensus primer, 13 53.8 (29.1-76.8) HPV 16 (30.8%)
(Japan) PCR-E6, RFLP (HPV 6, 11, 16, HPV 33 (15.4%)
18, 31, 33, 42, 52, 58) HPV 31 (7.7%)
Yanagawa 2008 PCR-L1C1/C2, RFLP (HPV 6, 26 11.5 (4.0-29.0) HPV 16 (11.5%)
(Japan) 11, 16, 18, 31, 33, 42, 52, 58)
Alemany 2016 PCR-SPF10, EIA, (HPV 6, 11, 480 36.5 (32.3-40.9) -
(Latin America & 16, 18, 26, 30, 31, 32, 33, 34, 35,
Caribbean) 39, 40, 42, 43, 44, 45, 51, 52, 53,
54, 56, 58, 59, 61, 66, 67, 68, 69,
70, 73, 74, 82, 83, 87, 89, 90, 91)
Lpez-Romero PCR-E6, , Sequencing (HPV 11, 76 75.0 (64.2-83.4) HPV 16 (61.8%)
2013 (Mexico) 16, 18, 31, 33, 58, 59) HPV 11 (3.9%)
HPV 31 (3.9%)
HPV 18 (1.3%)
HPV 33 (1.3%)
Salazar 2005 PCR Specific for HPV16 57 59.6 (46.7-71.4) -
(Mexico)
Heideman 2007 , PCR-E6, PCR-E7, EIA, (HPV 6, 171 29.2 (22.9-36.5) HPV 16 (22.8%)
(Netherlands) 11, 16, 18, 26, 31, 33, 34, 35, 39, HPV 18 (2.3%)
42, 43, 44, 45, 51, 52, 53, 54, 56, HPV 45 (1.8%)
57, 58, 59, 61, 66, 68, 70, 71, 72, HPV 33 (1.2%)
73, 81, 82, 83, 84) HPV 56 (0.6%)
Lont 2006 PCR-GP5+/6+, RLBM, (HPV 6, 171 29.2 (22.9-36.5) -
(Netherlands) 11, 16, 18, 26, 31, 33-35, 39, 40,
42-45, 51-59, 61, 66, 68, 70-73,
81(CP8304), 82/MM4, 82/IS39,
83(MM7), 84(MM8), CP6108)
Cubilla 2010 PCR-SPF10, (HPV 6, 11, 16, 18, 202 31.7 (25.7-38.4) HPV 16 (22.8%)
(Paraguay) 31, 33, 34, 35, 39, 40, 42, 43, 44, HPV 6 (3.0%)
45, 51, 52, 53, 54, 56, 58, 59, 66, HPV 18 (2.0%)
68, 70, 73, 74) HPV 11 (1.5%)
HPV 35 (1.5%)
Lebelo 2014 PCR L1-Consensus primer, 40 87.5 (73.9-94.5) HPV 16 (55.0%)
(South Africa) PCR-E6, PCR-E7, qPCR (HPV 6, HPV 11 (30.0%)
11, 16, 18, 31, 33, 35, 39, 45, 51, HPV 18 (10.0%)
52, 53, 56, 58, 59, 66, 67, 68) HPV 45 (5.0%)
HPV 6 (2.5%)
Ferrndiz-Pulido PCR-SPF10, EIA, (HPV 6, 11, 78 37.2 (27.3-48.3) HPV 16 (26.9%)
2013 (Spain) 16, 18, 31, 33, 34, 35, 39, 40, 42, HPV 58 (3.8%)
43, 44, 45, 51, 52, 53, 54, 56, 58, HPV 6 (2.6%)
59, 66, 68, 70, 73, 74) HPV 33 (1.3%)
HPV 45 (1.3%)
Guerrero 2008 , (HPV 6, 11, 16, 18, 26, 31, 33, 24 45.8 (27.9-64.9) HPV 16 (45.8%)
(Spain) 34, 35, 39, 40, 42, 43, 44, 45, 51, HPV 39 (4.2%)
52, 53, 54, 56, 57, 58, 59, 61, 66,
68, 70, 71, 72, 73, 81, 82, 83, 84)
Pascual 2007 , PCR-MY09/11, PCR 49 77.6 (64.1-87.0) HPV 16 (65.3%)
(Spain) L1-Consensus primer, HPV 18 (8.2%)
Sequencing (HPV 6, 11, 16, 18)
Kirrander 2011 PCR-(HPV 6,11, 151 80.8 (73.8-86.3) -
(Sweden) 16,18,31,33,35,39,45,51,52,56,58,59),
sequencing


Senba 2006 (Thai- PCR L1-Consensus primer, 65 81.5 (70.4-89.1) HPV 18 (55.4%)
land) PCR-SPF10, Sequencing (HPV HPV 6 (40.0%)
6, 11, 16, 18, 20, 21, 22, 23, 26, HPV 34 (3.1%)
30, 31, 32, 33, 34, 35, 38, 39, 40, HPV 11 (1.5%)
42, 43, 44, 45, 51, 52, 53, 54, 56, HPV 22 (1.5%)
57, 58, 59, 60, 61, 62, 66, 67, 68,
69, 70, 71, 72, 73, 74, 80, 81, 82,
83, 84, 85, 86, 87, 89, 90, 91)
Tornesello 2008 , PCR-MY09/11, PCR-L1C1/C2, 17 64.7 (41.3-82.7) HPV 16 (58.8%)
(Uganda) PCR-E6, PCR-E7, Sequencing HPV 6 (11.8%)
(HPV 6, 16, 18, 33, 35) HPV 18 (11.8%)
HPV 33 (5.9%)
Prowse 2008 (UK) PCR-SPF10, LIPA, (HPV 6, 11, 26 53.8 (35.5-71.2) -
16, 18, 26, 31, 33-35, 39, 40,
42-45, 51-54, 56, 58, 59, 66,
68-71, 73, 74)
Stankiewicz 2011 PCR L1-Consensus primer, 102 55.9 (46.2-65.1) HPV 16 (45.1%)
(UK) PCR-SPF10 (HPV 6, 11, 16, 18, HPV 11 (9.8%)
26, 31, 33, 35, 39, 40, 43, 44, 45, HPV 6 (5.9%)
51, 52, 53, 54, 56, 58, 59, 66, 68, HPV 45 (5.9%)
69, 70, 71, 73, 74, 82) HPV 31 (4.9%)
(USA) 16, 18, 26, 30, 31, 32, 33, 34, 35,
39, 40, 42, 43, 44, 45, 51, 52, 53,
54, 56, 58, 59, 61, 66, 67, 68, 69,
70, 73, 74, 82, 83, 87, 89, 90, 91)
Cupp 1995 (USA) PCR L1-Consensus primer, 42 54.8 (39.9-68.8) HPV 16 (40.5%)
PCR-E6, TS (HPV 16, 18) HPV 18 (4.8%)
(USA) L1-Consensus primer, PCR-E6, HPV 6 (4.3%)
RFLP, Sequencing (HPV 6, 16, HPV 33 (2.1%)
18, 31, 33, 45, 53) HPV 18 (1.1%)
HPV 31 (1.1%)
Hernandez 2014 PCR, LBA, (HPV 6, 11, 16, 18, 79 63.3 (52.3-73.1) HPV 16 (44.3%)
(USA) 26, 31, 33, 35, 39, 40, 42, 45, 51, HPV 18 (5.1%)
52, 53, 54, 56, 58, 59, 61, 62, 66, HPV 33 (5.1%)
67, 68, 69, 70, 71, 72, 73, 81, 82, HPV 45 (3.8%)
83, 84, 89) HPV 6 (2.5%)
Sarkar 1992 PCR type specific for 6b/11, 16 27 59.3 (40.7-75.5) -
(USA) and 18 + Southern Blot
Varma 1991 PCR Type specific for HPV 6/11 30 66.7 (48.8-80.8) -
(USA) and 16 and ISH for
6,11,16,18,31,33 and 35
Do 2013 (Viet PCR-SPF10, PCR-E6, qPCR, 120 22.5 (15.9-30.8) HPV 16 (20.0%)
Nam) (HPV 6, 11, 16, 18, 26, 31, 33, 35, HPV 11 (0.8%)
39, 40, 43, 44, 45, 51, 52, 53, 54, HPV 18 (0.8%)
56, 58, 59, 66, 68, 69, 70, 71, 73, HPV 33 (0.8%)
74, 82) HPV 58 (0.8%)
EIA: Enzyme ImmunoAssay; ISH: In Situ Hybridization; LBA: Line-Blot Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; RLBM: Reverse Line
Blotting Method; SPF: Short Primer Fragment; TS: Type Specific;

Table 23: Studies on HPV prevalence among PeIN 2/3 cases

Study Method No. Tested % (95% CI) HPV type (%)
Mannweiler 2013 PCR L1-Consensus primer, 43 76.7 (62.3-86.8) HPV 16 (62.8%)
(Austria) PCR-SPF10, (HPV 6, 11, 16, 18, HPV 18 (9.3%)
26, 31, 33, 35, 39, 40, 43, 44, 45, HPV 33 (2.3%)
51, 52, 53, 54, 56, 58, 59, 66, 68, HPV 73 (2.3%)
69, 70, 71, 72, 73, 74, 82)
DHauwers 2012 PCR-E6, PCR-E7, qPCR (HPV 6, 13 84.6 (57.8-95.7) HPV 16 (61.5%)
(Belgium) 11, 16, 18, 31, 33, 35, 39, 45, 51, HPV 18 (23.1%)
52, 53, 56, 58, 59, 66, 67, 68) HPV 11 (15.4%)
HPV 53 (15.4%)
HPV 56 (15.4%)
(Europe) 16, 18, 26, 30, 31, 32, 33, 35, 39, HPV 33 (6.3%)
40, 42, 43, 44, 45, 51, 52, 53, 54, HPV 6 (3.1%)
56, 58, 59, 61, 66, 67, 68, 69, 70, HPV 18 (3.1%)
73, 74, 82, 83, 87, 89, 90, 91) HPV 31 (3.1%)
Alemany 2016 PCR-SPF10, EIA, (HPV 6, 11, 11 63.6 (35.4-84.8) -
(Latin America & 16, 18, 26, 30, 31, 32, 33, 35, 39,
Caribbean) 40, 42, 43, 44, 45, 51, 52, 53, 54,
56, 58, 59, 61, 66, 67, 68, 69, 70,
73, 74, 82, 83, 87, 89, 90, 91)
Lpez-Romero PCR-E6, , Sequencing (HPV 16, 10 100.0 (72.2-100.0) HPV 16 (100.0%)
2013 (Mexico) 18, 31, 33, 58, 59)
Kirrander 2011 PCR-(HPV 6, 11, 16, 18, 31, 33, 62 88.7 (78.5-94.4) -
(Sweden) 35, 39, 45, 51, 52, 56, 58, 59),
sequencing
Wikstrm 2012 , PCR-MY09/11, PCR 28 85.7 (68.5-94.3) HPV 16 (39.3%)
(Sweden) L1-Consensus primer (HPV 6, HPV 6 (21.4%)
11, 16, 18, 26, 31, 33, 35, 39, 42, HPV 31 (7.1%)
43, 44, 45, 51, 52, 53, 56, 58, 59, HPV 33 (7.1%)
66, 68, 70, 73, 82) HPV 45 (7.1%)
Cupp 1995 (USA) PCR L1-Consensus primer, 25 92.0 (75.0-97.8) HPV 16 (80.0%)
PCR-E6, TS (HPV 16, 18) HPV 18 (8.0%)
95% CI: 95% Confidence Interval; PeIN 2/3: Penile intraepithelial neoplasia of grade 2/3;
EIA: Enzyme ImmunoAssay; PCR: Polymerase Chain Reaction; SPF: Short Primer Fragment; TS: Type Specific;

Figure 115: Comparison of the ten most frequent HPV types in penile cancer cases in Africa and the
rest of the World
16 26.3 16 22.8
30 5.3 6 1.6
33 5.3 33 1.2
52 5.3 35 1.0
5th* 45 1.0
6th* 52 0.9
7th* 11 0.7
8th* 18 0.7
9th* 59 0.7
10th* 74 0.6
0 10 20 30 0 10 20 30

penile cancer cases
a Includes cases from Mozambique, Nigeria, Senegal
b Includes cases from Australia, Bangladesh, India, South Korea, Lebanon, Philippines, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela and United States,
Mozambique, Nigeria, Senegal, Czech Republic, France, Greece, Poland, Portugal, Spain and United Kingdom.
Figure 116: Comparison of the ten most frequent HPV types in penile cancer cases in the Americas and
16 23.8 16 22.8
6 2.5 6 1.6
11 1.5 33 1.2
33 1.3 35 1.0
35 1.3 45 1.0
45 1.3 52 0.9
59 1.3 11 0.7
18 1.0 18 0.7
51 0.6 59 0.7
52 0.6 74 0.6
0 10 20 30 0 10 20 30

penile cancer cases

a Includes cases from Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela and United States

Figure 117: Comparison of the ten most frequent HPV types in penile cancer cases in Asia and the rest
of the World
Asia (a) World (b)
16 9.0 16 22.8
33 1.5 6 1.6
35 1.5 33 1.2
45 1.5 35 1.0
5th* 45 1.0
6th* 52 0.9
7th* 11 0.7
8th* 18 0.7
9th* 59 0.7
10th* 74 0.6
0 10 20 30 0 10 20 30

penile cancer cases
a Includes cases from Bangladesh, India, South Korea, Lebanon, Philippinesy
Figure 118: Comparison of the ten most frequent HPV types in penile cancer cases in Europe and the
rest of the World
16 23.4 16 22.8
52 1.2 6 1.6
6 1.0 33 1.2
33 1.0 35 1.0
45 0.7 45 1.0
58 0.7 52 0.9
18 0.5 11 0.7
31 0.5 18 0.7
35 0.5 59 0.7
44 0.5 74 0.6
0 10 20 30 0 10 20 30

penile cancer cases

a Includes cases from Czech Republic, France, Greece, Poland, Portugal, Spain and United Kingdom

Figure 119: Comparison of the ten most frequent HPV types in penile cancer cases in Oceania and the
rest of the World
Oceania World (a)
1st* 16 22.8
2nd* 6 1.6
3rd* 33 1.2
4th* 35 1.0
5th* 45 1.0
No data available
6th* 52 0.9
7th* 11 0.7
8th* 18 0.7
9th* 59 0.7
10th* 74 0.6
0 10 20 30

penile cancer cases
a Includes cases from Australia, Bangladesh, India, South Korea, Lebanon, Philippines, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela and United States,
Figure 120: Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Africa and the rest of
the World
Africa World (a)
1st* 16 69.4
2nd* 33 5.9
3rd* 58 4.7
4th* 31 3.5
5th* 51 3.5
No data available
6th* 52 3.5
7th* 6 2.4
8th* 18 2.4
9th* 45 2.4
10th* 53 2.4
0 10 20 30 40 50 60 70 80

PeIN 2/3 cases
a Includes cases from Australia, Bangladesh, India, South Korea, Lebanon, Philippines, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela, Mozambique,
Nigeria, Senegal, Czech Republic, France, Greece, Poland, Portugal, Spain and United Kingdom.

Figure 121: Comparison of the ten most frequent HPV types in PeIN 2/3 cases in the Americas and the
rest of the World
16 36.4 16 69.4
66 18.2 33 5.9
11 9.1 58 4.7
31 9.1 31 3.5
51 9.1 51 3.5
52 9.1 52 3.5
53 9.1 6 2.4
58 9.1 18 2.4
61 9.1 45 2.4
6 53 2.4
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80

PeIN 2/3 cases

a Includes cases from Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela.
b Includes cases from Australia, Bangladesh, India, South Korea, Lebanon, Philippines, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela, Mozambique,
Figure 122: Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Asia and the rest of
the World
Asia World (a)
1st* 16 69.4
2nd* 33 5.9
3rd* 58 4.7
4th* 31 3.5
5th* 51 3.5
No data available
6th* 52 3.5
7th* 6 2.4
8th* 18 2.4
9th* 45 2.4
10th* 53 2.4
0 10 20 30 40 50 60 70 80

PeIN 2/3 cases

Figure 123: Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Europe and the rest
of the World
16 73.4 16 69.4
33 6.3 33 5.9
6 3.1 58 4.7
18 3.1 31 3.5
31 3.1 51 3.5
45 3.1 52 3.5
51 3.1 6 2.4
52 3.1 18 2.4
58 3.1 45 2.4
43 1.6 53 2.4
0 10 20 30 40 50 60 70 80 90 0 10 20 30 40 50 60 70 80 90

PeIN 2/3 cases

a Includes cases from Czech Republic, France, Greece, Poland, Portugal, Spain and United Kingdom
b Includes cases from Australia, Bangladesh, India, South Korea, Lebanon, Philippines, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Venezuela, Mozambique,
Figure 124: Comparison of the ten most frequent HPV types in PeIN 2/3 cases in Oceania and the rest
of the World
Oceania World (a)
1st* 16 69.4
2nd* 33 5.9
3rd* 58 4.7
4th* 31 3.5
5th* 51 3.5
No data available
6th* 52 3.5
7th* 6 2.4
8th* 18 2.4
9th* 45 2.4
10th* 53 2.4
0 10 20 30 40 50 60 70 80

PeIN 2/3 cases

4.3 HPV burden in men

The information to date regarding anogenital HPV infection is primarily derived from cross-sectional
studies of selected populations such as general population, university students, military recruits, and
studies that examined husbands of control women, as well as from prospective studies. Special sub-
groups include mainly studies that examined STD (sexually transmitted diseases) clinic attendees,
MSM (men who have sex with men), HIV positive men, and partners of women with HPV lesions,
CIN (cervical intraepithelial neoplasia), cervical cancer or cervical carcinoma in situ. Globally, preva-
lence of penile and external genital HPV in men is higher than cervical HPV in women, but persistence
is less likely. As with genital HPV prevalence, high numbers of sexual partners increase the acquisition
of oncogenic HPV infections (Vaccine 2012, Vol. 30, Suppl 5). In this section, the HPV burden among
men in the World is presented.
Brief methods: Prevalence of human papillomavirus in men: based on systematic reviews

and meta-analyses
HPV burden in men was based on published systematic reviews and meta-analyses (Dunne EF, J Infect
Dis 2006; 194: 1044, Smith JS, J Adolesc Health 2011; 48: 540, and Hebnes JB, J Sex Med 2014; 11:
2630) up to September 15, 2014. The search terms for the review were human papillomavirus, men,
polymerase chain reaction (PCR), hybrid capture (HC), and viral DNA. References cited in selected ar-
ticles were also investigated. Inclusion criteria were: HPV DNA detection by means of PCR or HC, a
minimum of 20 cases for men and a detailed description of HPV DNA detection and genotyping tech-
niques used. The number of cases tested and HPV positive extracted for each study were pooled to
estimate the prevalence of HPV DNA globally and by geographical region. Binomial 95% confidence
intervals were calculated for each HPV prevalence.

Table 24: Studies on anogenital HPV prevalence among men

Anatomic sites HPV detection Age HPV prev
Country Study samples method Population (years) No % (95% CI)
Brazil Franceschi Glans, corona, PCR-GP5+/6+ Husbands of control 24-81 56 39.3 (26.5-53.2)
2002 urethra women
Giuliano Corona sulcus, PCR-PGMY09/11 General population 18-70 382 72.3 (67.5-76.7)
2008b glans, shaft and and GP5/6+
scrotum
Nyitray Anal canal PCR-PGMY09/11 HIV- MSW from 18-70 1305 12.2 (10.5-14.1)
2011 general population
and population from
a STD clinic
HIV- MSM from 18-70 176 47.2 (39.6-54.8)
general population
and population from
a STD clinic
Rosenblatt Shaft, dorsal and HC2 HR Partners of women - 60 15.0 (7.1-26.6)
2004 prebalanic area, without CIN
prepuce, urethral
meatus
Chile Guzmn Corona and shaft PCR-GP5+/6+ University students 20-51 61 83.6 (71.9-91.8)
2008
China Liu 2014 Coronal sulcus, PCR-SPF1/GP6+ Population-based 25-65 1279 41.1 (38.4-43.9)
shaft, glans, and esophageal cancer
scrotum cohort study
Colombia Franceschi Glans, corona, PCR-GP5+/6+ Husbands of control 23-82 128 18.8 (12.4-26.6)
2002 urethra women
Croatia Grce 1996 Urethra Filter hybridization Family planning - 79 26.6 (17.3-37.7)
(slot-blot, TS clinic attendees
6,11,16,18)
Denmark Kjaer 2005 Glans and corona PCR-GP5+/6+ TS Military conscripts 18-29 337 33.8 (28.8-39.2)
sulcus oligoprobes
Finland Hippelinen Glans, prepuce, PCR-MY09/11 TS Voluntary conscripts Mean 20 285 16.5 (12.4-21.3)
1993 corona sulcus, 6,11,16,18,31,33
urethral meatus
Kero 2011 Urethra PCR-MY09/11 and Sexual partners of 19-46 128 22.7 (15.7-30.9)
GP5+/6+ pregnant women
Germany Grussendorf- Coronal sulcus ISH Blood donors or 16-79 530 5.8 (4.0-8.2)
Conen 1987 and glans patients from
department of
dermatology
India Gupta 2006 Coronal sulcus, PCR-L1 and TS Partners of women Mean 46.9 30 26.7 (12.3-45.9)
distal and 16,18 with normal cytology
intrameatal
urethra and glans
Italy Lorenzon Coronal sulcus, PCR-Roche Linear Heterosexual men for 18-68 378 40.5 (35.5-45.6)
2014 shaft, prepuce, Array HPV routine HPV testing
and urethral Genotyping test
Nasca 2006 Penis PCR-MY09/11 and Hospital based 27-79 46 8.7 (2.4-20.8)
GP5+/6+ controls attending
clinic for nongenital
complaints
Japan Takahashi Glans, corona, HC2 HR, LR University students 18-35 75 1.3 (0.0-7.2)
2003 prepuce
Kenya Ngayo 2008 Glans, corona PCR-PGMY09/MY11 Men working in the 18-63 250 57.6 (51.2-63.8)
sulcus, shaft of and HMB01 fishing industry
the penis, scrotum
and the perianal
region
Smith 2010 Shaft, glans, PCR-GP5+/6+ Men screened to 17-28 2705 51.1 (49.2-53.0)
coronal sulcus, participate in an RCT
and inner and of male circumcision
external foreskin
tissue
Mexico Giuliano Corona sulcus, PCR-PGMY09/11 General population 18-70 362 61.9 (56.7-66.9)
2008b glans, shaft and and GP5/6+ and organized health
scrotum care systems


Anatomic sites HPV detection Age HPV prevalence
Lajous 2005 Corona, shaft, PCR-BGH 20 and Military conscripts 16-40 1030 44.6 (41.5-47.7)
upper third of the BPCO4
scrotum, urethral
meatus, urethra
Lazcano- Corona, urethra PCR-GP5+/6+ Sexually active 14-55 96 42.7 (32.7-53.2)
Ponce 2001 college students and
industry workers
Nyitray Anal canal PCR-PGMY09/11 HIV- MSM from 18-70 176 47.2 (39.6-54.8)
2011 organized health care
systems, factories
and military
HIV- MSW from 18-70 1305 12.2 (10.5-14.1)
organized health care
systems, factories
and military
Snchez- Glans and HC2 HR University students >=18 71 8.5 (3.2-17.5)
Alemn prepuce
2002
Vaccarella Scrotum, coronal PCR-PGMY09/11 Men who requested a Mean 34 779 8.7 (6.8-10.9)
2006 sulcus, the glans vasectomy
and the opening of
the meatus
Philippines Franceschi Glans, corona, PCR-GP5+/6+ Husbands of control 19-71 106 4.7 (1.5-10.7)
2002 urethra women
Republic of Shin 2004 Glans, corona, PCR-SPF10 Male students Median 22 381 8.7 (6.0-11.9)
Korea scrotum, prepuce,
urethra
Rwanda Veldhuijzen Shaft, scrotum, PCR-Roche Linear Men participating in Median 31 166 31.3 (24.4-39.0)
2012 glans/sulcus Array HPV a case-control study (IQR=27-
corona, and Genotyping test assessing risk factors 38)
foreskin in (LR-HPV types) for infertility
uncircumcised
men
PCR-Roche Linear Men participating in Median 31 166 26.5 (20.0-33.9)
Array HPV a case-control study (IQR=27-
Genotyping test assessing risk factors 38)
(HR-HPV types) for infertility
South Africa Auvert 2010 Urethra PCR-Roche Amplicor Men recruited from IQR=19- 1683 19.1 (17.2-21.0)
HPV test the general 22
population for an
RCT of male
circumcision
Spain Franceschi Glans, corona, PCR-GP5+/6+ Husbands of control 24-78 168 3.6 (1.3-7.6)
2002 urethra women
Sweden Forslund Urethra PCR-TS Military conscripts 20-23 138 8.7 (4.6-14.7)
1993 (6,11,16,18,31,33,35)
and unespecified
consensus primer
Kataoka Urethra PCR-TS Army conscripts with 18-23 66 12.1 (5.4-22.5)
1991 6,11,16,18,33 normal epithelium
Tanzania Olesen 2013 Glans, preputial PCR-LIPA and HC2 Men from the general Mean 34.2 1813 20.5 (18.7-22.5)
cavity population
(uncircumcised
men), coronal
sulcus
(circumcised
men), shaft,
corpus
Thailand Franceschi Glans, corona, PCR-GP5+/6+ Husbands of control 28-78 75 17.3 (9.6-27.8)
2002 urethra women
USA Giuliano Corona sulcus, PCR-PGMY09/11 General population 18-44 290 30.0 (24.8-35.6)
2008a glans, shaft and
scrotum


Giuliano Corona sulcus, PCR-PGMY09/11 General population 18-70 416 61.3 (56.4-66.0)
2008b glans, shaft and and GP5/6+ and population from
scrotum University
Hernandez Glans, corona PCR-PGMY09/11 University population Mean 29 300 35.3 (29.9-41.0)
2008 sulcus, penile
shaft, scrotum
Nielson Glans, corona PCR-PGMY09/11 General population 18-40 463 65.4 (60.9-69.8)
2007 sulcus, penile volunteers and STD
shaft and clinic attendees
scrotum, perianal
area, anus
Nyitray Anal canal PCR-PGMY09/11 HIV- MSW from 18-70 1305 12.2 (10.5-14.1)
and population from
University
HIV- MSM from 18-70 176 47.2 (39.6-54.8)
general population
and population from
University
Partridge Glans, urethral PCR-MY09/11 HMB Heterosexual 18-20 240 25.8 (20.4-31.9)
2007 meatus, penile 01 university students
shaft and scrotum
Weaver Glans, prepuce, PCR-MY09/11 HMB University students 18-25 283 35.0 (29.4-40.9)
2004 shaft, scrotum 01
Data updated on 15 Dec 2014 (data as of 15 Sep 2014).
HC2: Hybrid Capture 2; ISH: In Situ Hybridization; PCR: Polymerase Chain Reaction; SPF: Short Primer Fragment; TS: Type Specific; MSM: Men who have sex with men; MSW:Men who
have sex with women; STD: sexually transmitted diseases;
Data sources:
Based on published systematic reviews, the ICO HPV Information Centre has updated data until September 2014. Reference publications: 1) Dunne EF, J Infect Dis 2006; 194: 1044 2)
Smith JS, J Adolesc Health 2011; 48: 540 3) Olesen TB, Sex Transm Infect 2014; 90: 455 4) Hebnes JB, J Sex Med 2014; 11: 2630.
Auvert B, J Acquir Immune Defic Syndr 2010; 53: 111 | Forslund O, J Clin Microbiol 1993; 31: 1975 | Franceschi S, Br J Cancer 2002; 86: 705 | Giuliano AR, J Infect Dis 2008; 198: 827
| Giuliano AR, Cancer Epidemiol Biomarkers Prev 2008; 17: 2036 | Grce M, Anticancer Res 1996; 16: 1039 | Grussendorf-Conen EI, Arch Dermatol Res 1987; 279 Suppl: S73 | Gupta A,
J Clin Virol 2006; 37: 190 | Guzmn P, Rev Med Chil 2008; 136: 1381 | Hernandez BY, J Infect Dis 2008; 197: 787 | Hippelinen M, Sex Transm Dis 1993; 20: 321 | Kataoka A, J Med
Virol 1991; 33: 159 | Kero K, J Sex Med 2011; 8: 2522 | Kjaer SK, Cancer Epidemiol Biomarkers Prev 2005; 14: 1528 | Lajous M, Cancer Epidemiol Biomarkers Prev 2005; 14: 1710 |
Lazcano-Ponce E, Sex Transm Dis 2001; 28: 277 | Liu M, Cancer Epidemiol Biomarkers Prev 2014 | Lorenzon L, J Clin Virol 2014; 60: 264 | Nasca MR, Int J Dermatol 2006; 45: 681 |
Ngayo MO, Sex Transm Infect 2008; 84: 62 | Nielson CM, Cancer Epidemiol Biomarkers Prev 2007; 16: 1107 | Nyitray AG, J Infect Dis 2011; 203: 49 | Olesen TB, Sex Transm Dis 2013;
40: 592 | Partridge JM, J Infect Dis 2007; 196: 1128 | Rosenblatt C, Int J Gynaecol Obstet 2004; 84: 156 | Snchez-Alemn MA, Salud Publica Mex 2002; 44: 442 | Shin HR, J Infect Dis
2004; 190: 468 | Smith JS, Int J Cancer 2010; 126: 572 | Takahashi S, Sex Transm Dis 2003; 30: 629 | Vaccarella S, Int J Cancer 2006; 119: 1934 | Veldhuijzen NJ, Sex Transm Dis 2012;
39: 128 | Weaver BA, J Infect Dis 2004; 189: 677
Table 25: Studies on anogenital HPV prevalence among men from special subgroups
Anatomic sites HPV detection Age HPV prev
Australia Anderson Anal canal HC2 HR HIV+ MSM Median 45 123 86.2 (78.8-91.7)
2008 (28-59)
Goldstone Anus RT-PCR-Multiplex HIV- MSM Median 22 602 42.4 (38.4-46.4)
2011 or Biplex (16-27)
Penis RT-PCR-Multiplex HIV- MSM Median 22 602 18.4 (15.4-21.8)
or Biplex (16-27)
Vajdic 2009 Anal canal HC2 HIV- MSM IQR=36- 193 69.9 (62.9-76.3)
48
HIV+ MSM IQR=37- 123 94.3 (88.6-97.7)
49
Vardas 2011 Penis RT-PCR-Multiplex Heterosexual men Median 20 3132 21.2 (19.8-22.7)
or Biplex (15-24)
Brazil de Lima Coronal sulcus, PCR-GP5+/6+ Sexual partners of 18-60 43 51.2 (35.5-66.7)
Rocha 2012 glans, and women with cervical
prepuce HPV infection
Franceschi Glans, corona, PCR-GP5+/6+ Husbands of women 27-79 53 35.8 (23.1-50.2)
2002 urethra with invasive cervical
cancer
Freire 2014 Shaft, glans, PCR-Papillocheck Men referred to the 18-81 355 72.1 (67.1-76.7)
balanopreputial Urological Division
sulcus and
urethral


Goldstone Penis RT-PCR-Multiplex HIV- MSM Median 22 602 18.4 (15.4-21.8)
2011 or Biplex (16-27)
Anus RT-PCR-Multiplex HIV- MSM Median 22 602 42.4 (38.4-46.4)
or Biplex (16-27)
Guimares Anus PCR-DBH HIV+ >=18 445 65.6 (61.0-70.0)
2011
Nicolau Glans, urethra, HC2 HR, LR Partners of women 19-53 50 70.0 (55.4-82.1)
2005 internal and with HPV
external prepuce,
scrotum, anus
and population from
a STD clinic
Rombaldi Prepuce, preglans, PCR-L1, MY09/11 Partners of women 18-56 99 54.5 (44.2-64.6)
2006 shaft, urethral with CIN
canal
Rosenblatt Shaft, dorsal and HC2 HR Partners of women - 30 76.7 (57.7-90.1)
2004 prebalanic area, with CIN
prepuce, urethral
meatus
or Biplex (15-24)
Canada de Poko- Anal canal PCR-PGMY09/11 HIV+ MSM Median 43 241 97.9 (95.2-99.3)
mandy 2009 (21-66)
2011 or Biplex (16-27)
or Biplex (16-27)
Ogilvie 2009 Shaft, scrotum PCR-Roche Amplicor Heterosexual men 16-69 262 69.8 (63.9-75.3)
HPV test attending provincial
STD clinic
Salit 2009 Anus PCR-PGMY09/11 HIV+ MSM 38-50 224 93.3 (89.2-96.2)
participants in
TRACE study
Salit 2010 Anal canal HC2 HIV+ MSM Median 400 93.0 (90.0-95.3)
44.4
(IQR=39.4-
50.6)
or Biplex (15-24)
China Gao 2010 Anal canal PCR-TellgenplexTM HIV+ MSM >=18 (70% 50 96.0 (86.3-99.5)
HPV DNA Test <30 years)
HIV- MSM >=18 (70% 528 58.9 (54.6-63.1)
<30 years)
Tang 2006 Urethral meatus PCR-MY09/11 STD clinic attendees 18-70 305 13.8 (10.1-18.2)
Yang 2012 Anus PCR-TellgenplexTM HIV+ MSM >=18 91 70.3 (59.8-79.5)
HPV DNA Test
Zhang 2014 Anus PCR-GenoArray HIV+ MSM STD IQR=25- 28 71.4 (51.3-86.8)
clinic attendees 34.8
HIV- MSM, STD IQR=25- 380 33.7 (28.9-38.7)
clinic attendees 34.8
Colombia Franceschi Glans, corona, PCR-GP5+/6+ Husbands of women 24-79 50 32.0 (19.5-46.7)
cancer
Husbands of women 23-76 63 20.6 (11.5-32.7)
with cervical
carcinoma in situ
Croatia Goldstone Penis RT-PCR-Multiplex HIV- MSM Median 22 602 18.4 (15.4-21.8)
2011 or Biplex (16-27)
or Biplex (16-27)


or Biplex (15-24)
Denmark Svare 2002 Coronal sulcus, PCR-GP5+/6+ and STD clinic attendees >=18 198 44.9 (37.9-52.2)
glans, perianal TS 6,11,16,18,31,33
area, scrotum,
and shaft
France Aynaud Meatal urethra PCR-TS Men with penile and Mean 29 55 87.3 (75.5-94.7)
2003 6,11,42,16,18,33 urethral lesions
whose female
partners have genital
HPV lesions
Men with normal Mean 30 34 2.9 (0.1-15.3)
peniscopy whose
female partners have
genital HPV lesions
Damay Anal canal PCR-PapilloCheck HIV+ MSM Median 45 67 74.6 (62.5-84.5)
2010 (39-49.5)
Piketty Anal canal PCR-MY09/11 HIV+ MSM 27-62 45 80.0 (65.4-90.4)
2004
Germany Goldstone Penis RT-PCR-Multiplex HIV- MSM Median 22 602 18.4 (15.4-21.8)
2011 or Biplex (16-27)
or Biplex (16-27)
Schneider Glans, prepuce, Filter hybridization Sexual partners of Mean 36.5 156 39.1 (31.4-47.2)
1988 fossa navicularis, DNA/DNA women with HPV
shaft associated lesions of
the cervix
or Biplex (15-24)
Greece Hadjivassiliou Urethra HC2 HR, LR HIV- STD clinic 15-65 64 20.3 (11.3-32.2)
2007 attendees without
genital warts and
sexual partners of
women with genital
warts
India Gupta 2006 Coronal sulcus, PCR-L1 and TS Partners of women Mean 46.4 30 66.7 (47.2-82.7)
distal and 16,18 with cervical cancer
intrameatal
urethra and glans
Italy Barzon Glans, corona, PCR-General Men referred for HPV 20-72 947 41.7 (38.5-44.9)
2010 shaft, perianal primers for L1 testing. Indications
area, urethra, and (MY09/11, GP5 + for testing: STD
semen /6+) screening, HPV
suspected lesions,
HPV-positive
partners
Benevolo Coronal sulcus, PCR-L1 Male partners of 20-61 71 35.2 (24.2-47.5)
2008 urethra, prepuce, women with CIN
shaft and/or positive HPV
Chiarini Urethra PCR-Generic Men with symptoms - 247 31.2 (25.5-37.4)
1998 primers in E1 of nongonococcal
urethritis
Della Torre Urethra PCR-TS 6,11,16,18 Partners of women - 64 21.9 (12.5-34.0)
1992 with HPV
Giovannelli Coronal sulcus, PCR-LiPA, GP5+/6+ Partners of women 23-58 47 68.1 (52.9-80.9)
2007 frenulum, glans, and MY09/11 with HPV
prepuce, shaft
Latini 2014 Anus PCR-Linear Array HIV+ MSM Median 41 180 93.3 (88.6-96.5)
(IQR=33-
47)
HIV- MSM Median 32 438 72.4 (67.9-76.5)
(IQR=27-
39)


Orlando Anus HC2 HIV+ Median 34 233 87.1 (82.1-91.1)
2008 (IQR=30-
42)
Pierangeli Anal canal PCR-MY09/11 HIV+ MSM 25-65 18 94.4 (72.7-99.9)
2008
HIV- MSM 28-62 9 88.9 (51.8-99.7)
Japan Shigehara Coronal sulcus, PCR-HPV Men with urethritis Mean 35.2 142 47.9 (39.4-56.4)
2010 glans, prepuce, GenoArray (19-62)
urethra, and urine
Takahashi Coronal sulcus, HC2 HR, LR Patients with 17-49 130 18.5 (12.2-26.2)
2003 glans, prepuce urethritis
Takahashi Glans, corona, HC2 HR, LR STD clinic attendees 18-35 204 5.9 (3.1-10.0)
2005 inner surface of
prepuce
Mexico Goldstone Anus RT-PCR-Multiplex HIV- MSM Median 22 602 42.4 (38.4-46.4)
2011 or Biplex (16-27)
Penis RT-PCR-Multiplex HIV- MSM Median 22 602 18.4 (15.4-21.8)
or Biplex (16-27)
Leyva- Urethral meatus PCR-L1 Partners of women 17-64 187 2.1 (0.6-5.4)
Lpez 2003 with CIN
2011 organized health care
systems, factories
and military
Torres- Anus PCR-PGMY09/11 HIV+ MSM 18-69 446 93.0 (90.3-95.2)
Ibarra 2014
or Biplex (15-24)
Netherlands Bleeker Glans, corona, PCR-GP5+/6+ Partners of women 24-58 119 58.8 (49.4-67.8)
2002 frenulum, prepuce with CIN
Bleeker Corona, frenulum, PCR-GP5+/6+ Men visiting 22.8-73.2 83 25.3 (16.4-36.0)
2005a glans, inner department of
prepuce dermatology for
non-STI complaints
Bleeker Corona, frenulum, PCR-GP5+/6+ Partners of women 22.5-57.7 181 72.9 (65.8-79.3)
2005b glans, inner with dyskaryosis
prepuce and/or CIN
van der Coronal sulcus PCR-TS primers and HIV- MSM 19-76 241 15.8 (11.4-21.0)
Snoek 2003 LiPA
HIV+ MSM 29-59 17 23.5 (6.8-49.9)
Perianal area PCR-TS primers and HIV+ MSM 29-59 17 64.7 (38.3-85.8)
LiPA
HIV- MSM 19-76 241 32.8 (26.9-39.1)
Van Door- Corona, urethra, PCR-TS STD clinic attendees Mean 37 85 28.2 (19.0-39.0)
num 1994 anus, rectum 6/11,16,18,33
van Rijn Anal canal PCR-LIPA TS HIV+ MSM Median 306 56.9 (51.1-62.5)
2014 16,18,31,33,45,52,58 45.6
(IQR=39.4-
52.5)
Penile shaft PCR-LIPA TS HIV- MSM Median 441 11.1 (8.3-14.4)
16,18,31,33,45,52,58 37.6
(IQR=33.6-
42.2)
HIV+ MSM Median 306 23.2 (18.6-28.3)
45.6
(IQR=39.4-
52.5)
HIV- MSM Median 441 33.6 (29.2-38.2)
37.6
(IQR=33.6-
42.2)


Vriend 2013 Anus PCR-SPF10 primers MSW STD clinic 16-24 56 3.6 (0.4-12.3)
followed by attendees
immunoassay
Coronal sulcus, PCR-SPF10 primers MSM STD clinic 16-24 173 16.2 (11.0-22.5)
glans, prepuce, followed by attendees
shaft immunoassay
MSW STD clinic 16-24 922 26.0 (23.2-29.0)
attendees
MSM STD clinic 16-24 124 33.1 (24.9-42.1)
attendees
Philippines Franceschi Glans, corona, PCR-GP5+/6+ Husbands of women 22-77 149 6.0 (2.8-11.2)
cancer
Slovenia Golob 2014 Penis PCR-Linear Array Men from infertile Mean 33 299 37.1 (31.6-42.9)
couples
Milosevic Anal canal PCR-Linear Array HIV- MSM 16-80 116 75.0 (66.1-82.6)
2010
HIV+ MSM 20-57 20 95.0 (75.1-99.9)
South Africa Firnhaber Prepuce, penile PCR-Roche Linear Men with penile Mean 36.0 73 100.0 (95.1-100.0)
2011 shaft and genital Array HPV warts attending a
wart areas of the Genotyping test public sector
penis antiretroviral
treatment clinic
Mbulawa Shaft and glans, PCR-Roche Linear Heterosexual men 19-67 471 58.0 (53.4-62.5)
2010 and the foreskin Array HPV recruited for
in uncircumcised Genotyping test investigations of
men genital HPV
transmission
Mller 2010 Glans penis, PCR-Roche Linear Men with urethritis Mean 29.8 56 48.2 (34.7-62.0)
coronal sulcus and Array HPV syndrome attending a
penile shaft Genotyping test sexual health clinic
Asymptomatic men Mean 29.8 50 62.0 (47.2-75.3)
attending for HIV
voluntary counselling
and testing a sexual
health clinic
Glans penis, PCR-Roche Linear Men with anogenital Mean 29.8 108 100.0 (96.6-100.0)
coronal sulcus, Array HPV wart attending a
penile shaft and Genotyping test sexual health clinic
anogenital warts
Vogt 2013 Coronal sulcus, PCR-PGMY09/11 Heterosexual men IQR=29- 34 58.8 (40.7-75.4)
glans and shaft attending an HIV 37
testing centre
Spain lvarez- Anus PCR-General STD clinic attendees 17-87 123 49.6 (40.5-58.8)
Argelles primers in L1
2013 (MY09/11, GP5 +
/6+), PCR with TS
primers in E6/E7 for
typing
Balanopreputial PCR-General STD clinic attendees 17-87 1318 36.9 (34.3-39.5)
primers in L1
(MY09/11, GP5 +
/6+), PCR with TS
primers in E6/E7 for
typing
Franceschi Glans, corona, PCR-GP5+/6+ Husbands of women 25-74 84 11.9 (5.9-20.8)
cancer
Husbands of women 22-76 102 21.6 (14.0-30.8)
with cervical
carcinoma in situ
2011 or Biplex (16-27)


or Biplex (16-27)
Sendagorta Anus PCR-Genomic HIV+ MSM/bisexual >=18 298 93.0 (89.4-95.6)
2014 amplification men
Torres 2013 Anus PCR-Roche Linear HIV+ MSM IQR=28.2- 1439 95.8 (94.6-96.7)
Array HPV 40.1
Genotyping test
or Biplex (15-24)
Videla 2013 Coronal sulcus, PCR-TS primers in HIV+ MSM attending 36-47 457 24.9 (21.0-29.2)
glans, urethra, E6/E7 F-HPVTM an outpatient HIV
shaft typing (Molgentix clinic
SL, Spain)
Anus PCR-TS primers in HIV+ Heterosexual 40-48 195 41.5 (34.5-48.8)
E6/E7 F-HPVTM men attending an
typing (Molgentix outpatient HIV clinic
SL, Spain)
HIV+ MSM attending 36-47 538 84.2 (80.8-87.2)
an outpatient HIV
clinic
HIV+ Heterosexual 40-48 191 27.2 (21.0-34.1)
men attending an
outpatient HIV clinic
Sweden Kataoka Urethra PCR-TS Army conscripts with 18-23 39 25.6 (13.0-42.1)
1991 6,11,16,18,33 aceto-white
epithelium
Lwhagen Anus PCR-MY09/11 HIV+ MSM 27-54 17 94.1 (71.3-99.9)
1999
HIV- MSM 26-62 13 53.8 (25.1-80.8)
Strand 1993 Coronal sulcus, PCR-MY09/11 and STD clinic attendees 20-53 65 29.2 (18.6-41.8)
glans, preputium, GP5+/6+
and shaft
Voog 1997 Glans and PCR-MY09/11 and STD clinic attendees 19-67 20 25.0 (8.7-49.1)
prepuce GP5+/6+
Wikstrm Coronal sulcus, PCR-TS primers STD clinic attendees 17-58 228 53.9 (47.2-60.5)
1991 inner part of the followed by dot blot
prepuce, urethra
Wikstrm Corona, glans, PCR-GP5+/6+ STD clinic attendees 18-54 235 13.2 (9.1-18.2)
2000 and prepuce
Thailand Franceschi Glans, corona, PCR-GP5+/6+ Husbands of women 25-77 109 22.0 (14.6-31.0)
cancer
Phanuphak Anus PCR-Roche Linear HIV- MSM >=18 123 58.5 (49.3-67.3)
2013 Array HPV
Genotyping test
HIV+ MSM >=18 123 85.4 (77.9-91.1)
Uganda Tobian 2013 Coronal sulcus PCR-PGMY09/11 HIV+ heterosexual 15-49 421 90.7 (87.6-93.3)
and glans men
HIV- heterosexual 15-49 978 60.9 (57.8-64.0)
men
United Bissett 2011 Glans, prepuce, PCR-General Genitourinary clinic - 87 49.4 (38.5-60.4)
Kingdom shaft, scrotum primers (GP5 + /6+), attendees with
Bio-Plex array multiple sexual
technology for typing partners or diagnosis
of genital warts
within 6 months
Cuschieri Shaft PCR-INNO-LiPA Drop-in sexual health 16-25 117 29.1 (21.0-38.2)
2011 service attendees
Hillman Urethra PCR-GP5+/6+ Men infected with 17-55.6 100 18.0 (11.0-26.9)
1993 gonorrhea


Jalal 2007 Urethra PCR-General Genitourinary clinic 15-77 437 20.8 (17.1-24.9)
primers for L1 attendees
(MY09/11, GP5 +
/6+) and RLH
Lacey 1999 Anal canal PCR-GP5+/6+ HIV+ MSM 19-62 57 84.2 (72.1-92.5)
USA Baken 1995 Penis PCR-MY09/11 Heterosexual >17 48 62.5 (47.4-76.0)
partners of STD clinic
attendees
Baldwin Glans, corona, PCR-PGMY09/11 STD clinic attendees 18-70 393 28.2 (23.8-33.0)
2003 urethra
Berry 2009 Anal canal PCR-MY09/11 HIV- MSM 26-75 81 56.8 (45.3-67.8)
HIV+ MSM 26-75 32 90.6 (75.0-98.0)
Caussy Anus PCR-TS HIV homosexual Mean 40.6 105 39.0 (29.7-49.1)
1990 6,11,16,18,31,33,35 men
Chin-Hong Anus PCR-MY09/11 HIV- MSM in 18-89 1218 56.8 (54.0-59.6)
2004 EXPLORE cohort
Chin-Hong Anus PCR- generic probe HIV+ homosexual or 24-73 38 86.8 (71.9-95.6)
2008 set by DBH bisexual men
HIV- homosexual or 24-73 87 57.5 (46.4-68.0)
bisexual men
Coln-Lpez Anus PCR-MY09/11 STD clinic attendees >=18 192 57.8 (50.5-64.9)
2014 (29.8% MSM)
Conley 2010 Anal canal PCR-Linear Array HIV+ MSW Median 42 92 58.7 (47.9-68.9)
(IQR=38-
48)
HIV + MSM Median 42 379 95.8 (93.2-97.6)
(IQR=36-
48)
Critchlow Anus PCR-MY09/11 HIV- homosexual Mean 34 284 66.5 (60.7-72.0)
1998 men
HIV+ homosexual Mean 34 322 91.6 (88.0-94.4)
men
Fife 2003 Glans, corona, PCR-TS 6,11 STD clinic attendees 18-50 20 10.0 (1.2-31.7)
shaft, inguinal
skin, scrotum,
perineum,
perianal, urine
Friedman Anal canal PCR-MY09/11, HIV+ MSM <40 years 135 90.4 (84.1-94.8)
1998 HMB01, and HC
HIV- MSM <40 years 46 69.6 (54.2-82.3)
2011 or Biplex (16-27)
or Biplex (16-27)
Kiviat 1993 Anal canal PCR-MY09/11 HIV- MSM/bisexual 16-50 152 78.3 (70.9-84.6)
men
HIV+ MSM/bisexual 16-50 241 91.7 (87.5-94.9)
men
Moscicki Anus PCR-MY09/11 and High-risk adolescent 13-18 83 44.6 (33.7-55.9)
2003 HMB01 boys in REACH
cohort
and population from
University
Palefsky Anus PCR-MY09/11 HIV+ homosexual or 24-66 118 93.2 (87.1-97.0)
1997 bisexual men
Palefsky Anus PCR-MY09/11 HIV+ homosexual or 24-64 289 93.1 (89.5-95.7)
1998 bisexual men
HIV- homosexual or 26-73 200 61.0 (53.9-67.8)
bisexual men


HIV homosexual or 24-73 489 80.0 (76.1-83.4)
bisexual men
Palefsky Anal canal PCR-L1 consensus HIV+ MSM - 323 95.4 (92.5-97.4)
2005 primers
or Biplex (15-24)
Wiley 2013 Anus PCR-PGMY09/11 HIV- MSM Mean 55 683 70.3 (66.7-73.7)
HIV+ MSM Mean 55 579 90.7 (88.0-92.9)
Wilkin 2004 Anal canal HC2 HIV+ MSM 90% > 30 55 78.2 (65.0-88.2)
years
Data updated on 15 Dec 2014 (data as of 15 Sep 2014).

DBH: Dot Blot Hybridization; HC2: Hybrid Capture 2; LiPA: Line Probe Assay; PCR: Polymerase Chain Reaction; RLH: Reverse Line Hybridisation; RT-PCR: Real Time Polymerase Chain
Reaction; SPF: Short Primer Fragment; TS: Type Specific; MSM: Men who have sex with men; MSW:Men who have sex with women; STD: sexually transmitted diseases;
Data sources:
Based on published systematic reviews, the ICO HPV Information Centre has updated data until September 2014. Reference publications: 1) Dunne EF, J Infect Dis 2006; 194: 1044 2)
Smith JS, J Adolesc Health 2011; 48: 540 3) Olesen TB, Sex Transm Infect 2014; 90: 455 4) Hebnes JB, J Sex Med 2014; 11: 2630.
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83: 1744 | Bleeker MC, J Am Acad Dermatol 2002; 47: 351 | Bleeker MC, Int J Cancer 2005; 113: 36 | Bleeker MC, Clin Infect Dis 2005; 41: 612 | Caussy D, Int J Cancer 1990; 46: 214
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L, J Clin Microbiol 2007; 45: 248 | Goldstone S, J Infect Dis 2011; 203: 66 | Golob B, Biomed Res Int 2014; 2014: 100 | Guimares MD, J Acquir Immune Defic Syndr 2011; 57 Suppl 3:
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Wiley DJ, PLoS ONE 2013; 8: 108 | Wilkin TJ, J Infect Dis 2004; 190: 1685 | Yang Y, PLoS ONE 2012; 7: 104 | Zhang DY, PLoS ONE 2014; 9: 111

4.4 HPV burden in the head and neck

The last evaluation of the International Agency for Research in Cancer (IARC) on the carcinogenicity of
HPV in humans concluded that (a) there is enough evidence for the carcinogenicity of HPV type 16 in
the oral cavity, oropharynx (including tonsil cancer, base of tongue cancer and other oropharyngeal can-
cer sites), and (b) limited evidence for laryngeal cancer (IARC Monograph Vol 100B). There is increasing
evidence that HPV-related oropharyngeal cancers constitute an epidemiological, molecular and clinical
distinct form as compared to non HPV-related ones. Some studies indicate that the most likely expla-
nation for the origin of this distinct form of head and neck cancers associated with HPV is a sexually
acquired oral HPV infection that is not cleared, persists and evolves into a neoplastic lesion. The most
recent figures estimate that 25.6% of all oropharyngeal cancers are attributable to HPV infection with
HPV16 being the most frequent type (de Martel C. Lancet Oncol. 2012;13(6):607).
4.4.1 Burden of oral HPV infection in healthy population
Table 26: Studies on oral HPV prevalence among healthy populations

HPV detection
Method and
targeted HPV Age No. HPV prevalence
Country Study types Population (years) Tested % (95% CI)
MEN
Denmark Eike 1995 PCR-MY09/11. Patients with unrelated 20-79 31 0.0 (0.0-11.2)
Genotyping by disease (otosclerosis,
amplification with TS nasal complaints)and
primers (6, 11, 16, 18) their accompanying
and RFLP relatives
Finland Kero 2012 PCR-GP5+/GP6+ and Fathers-to-be of cohort - 131 18.3 (12.1-26.0)
MY09/MY11. Genotyping study
with Multimerix kit (6,
11, 16, 18, 31, 33, 39, 42,
43, 44, 45, 51, 52, 58, 59,
68, 70, 73, 82)
Italy Montaldo 2007 PCR-MY09/MY11 and Dental clinic visitors 4-77 69 14.5 (7.2-25.0)
GP5+N. Genotyping by
sequencing
United Kingdom Kujan 2006 PCR-Roche master mix Healthy volunteers from - 26 3.9 (0.1-19.6)
and HC2 digene (both university dental
able to detect the hospital.
following HR types: 16,
18, 31, 33, 35, 39, 45, 51,
52, 56, 58, 59 and 68). No
further genotyping
WOMEN
and RFLP relatives
Finland Leimola-Virtanen 1996 PCR-GP5/GP6. No Post-menopausal women 55 131 10.7 (6.0-17.3)
genotyping participating in annual
mass-screening program
for the detection of
cervical precancerous
lesions
Finland Kero 2011 PCR-GP5+/GP6+ and Spouses in 3rd - 128 17.2 (11.1-24.9)
MY09/MY11. Genotyping trimestres of pregnancy
with Multimerix kit (6, of the fathers-to-be of
11, 16, 18, 31, 33, 39, 42, cohort study
43, 44, 45, 51, 52, 58, 59,
68, 70, 73, 82)
sequencing
Spain Caadas 2004 PCR-MY09/MY11. Female sex workers who - 188 8.5 (4.9-13.5)
Genotyping by DBH with attended a dermatology
TS probes (6, 11, 16, 18, or STD clinic.
26, 31-33, 35, 39, 40, 45,
51-56, 58, 59, 61, 66-68,
70, 71 (AE8), 72, 73, 81
(AE7), 83 (PAP291), 84
(PAP155), 85 (AE5), AE2
(IS39), and AE6)
(Continued)

HPV detection
Method and
targeted HPV Age No. HPV prevalence
Country Study types Population (years) Tested % (95% CI)
18, 31, 33, 35, 39, 45, 51,
52, 56, 58, 59 and 68). No
further genotyping
BOTH OR UNSPECIFIED
and RFLP relatives
Finland Leimola-Virtanen 1996 PCR-GP5/GP6. No Post-menopausal women 55 131 10.7 (6.0-17.3)
genotyping participating in annual
mass-screening program
for the detection of
cervical precancerous
lesions
Finland Kero 2011 PCR-GP5+/GP6+ and Spouses in 3rd - 128 17.2 (11.1-24.9)
MY09/MY11. Genotyping trimestres of pregnancy
with Multimerix kit (6, of the fathers-to-be of
11, 16, 18, 31, 33, 39, 42, cohort study
43, 44, 45, 51, 52, 58, 59,
68, 70, 73, 82)
Finland Kero 2012 PCR-GP5+/GP6+ and Fathers-to-be of cohort - 131 18.3 (12.1-26.0)
MY09/MY11. Genotyping study
with Multimerix kit (6,
11, 16, 18, 31, 33, 39, 42,
43, 44, 45, 51, 52, 58, 59,
68, 70, 73, 82)
Greece Lambropoulos 1997 PCR-MY09/MY11. Healthy population 14-85 169 9.5 (5.5-14.9)
Genotyping by SBH with receiving routine oral
TS probes (6, 11, 16, 18, examination
33)
sequencing
Italy Migaldi 2012 PCR-GP5+/GP6+, Patients undergoing to 49-77 81 1.2 (0.0-6.7)
MY09/11, LCRS/E7AS, routine oral examination
pU-1M and pU-2R.
Genotyping by
sequencing
Spain Caadas 2004 PCR-MY09/MY11. Female sex workers who - 188 8.5 (4.9-13.5)
Genotyping by DBH with attended a dermatology
TS probes (6, 11, 16, 18, or STD clinic.
26, 31-33, 35, 39, 40, 45,
51-56, 58, 59, 61, 66-68,
70, 71 (AE8), 72, 73, 81
(AE7), 83 (PAP291), 84
(PAP155), 85 (AE5), AE2
(IS39), and AE6)
18, 31, 33, 35, 39, 45, 51,
52, 56, 58, 59 and 68). No
further genotyping
Data updated on 14 Dec 2016 (data as of 29 Feb 2012). Only for European countries.

4.4.2 HPV burden in head and neck cancers
Table 27: Studies on HPV prevalence among cases of oral cavity cancer
MEN
Oliveira 2009 GP5+/GP6+ (L1) DBH (6. 11. 16. 57 31.6 (21.0-44.5) -
(Brazil) 18. 31. 33. 34. 35. 39. 40. 42. 43.
44. 45. 51. 52. 54. 56. 58)
Herrero 2003 GP5+/GP6+ (L1) Hybridization 17 11.8 (3.3-34.3) HPV 16 (11.8%)
(Canada) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Noble-Topham TS-PCR E6/E7 for 6b/11/16/18 7 57.1 (25.0-84.2) HPV 18 (57.1%)
1993 (Canada) Amplification with TS primers HPV 16 (14.3%)
(6b/11. 16. 18)
Zhang 2004 TS-PCR E6 for 16/18 48 81.3 (68.1-89.8) -
(China) Amplification with TS primers
(16. 18)
Herrero 2003 GP5+/GP6+ (L1) Hybridization 53 0.0 (0.0-6.8) -
(Cuba) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Nemes 2006 MY09/MY11 (L1) Hybridization 67 44.8 (33.5-56.6) -
(Hungary) with TS probes (16. 18. 31. 33.
45. 51. 52. 58)
Balaram 1995 (In- MY09/MY11 (L1). GP5+/GP6+ 50 74.0 (60.4-84.1) -
dia) (L1)/GP17+/GP18+ (L1). Y1/Y2
and TS-PCR for 6/11/16/18
Sequencing
Chaudhary 2010 MY09/MY11 (L1) Amplification 146 33.6 (26.4-41.6) HPV 16 (33.6%)
(India) with TS primers (16)
DCosta 1998 (In- MY09/MY11 (L1) SBH (6. 11. 71 12.7 (6.8-22.4) HPV 16 (12.7%)
dia) 16. 18. 33)
Herrero 2003 (In- GP5+/GP6+ (L1) Hybridization 127 4.7 (2.2-9.9) HPV 16 (3.9%)
dia) with EIA oligonucleotide probes HPV 18 (0.8%)
(2. 6. 11. 16. 18. 31. 33. 35. 39. HPV 35 (0.8%)
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Saghravanian GP5+/GP6+ (L1) Amplification 8 0.0 (0.0-32.4) -
2011 (Iran) with TS primers HPV E6/7 (16.
18. 31. 33)
Herrero 2003 (Ire- GP5+/GP6+ (L1) Hybridization 22 4.5 (0.8-21.8) HPV 16 (4.5%)
land) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(Italy) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Bhawal 2008 TS-PCR E6 for 16 19 26.3 (11.8-48.8) HPV 16 (26.3%)
(Japan) Electrophoretic analysis using
SiHa DNA as positive control for
HPV-16


Chiba 1996 TS-PCR E6/E7 for 22 27.3 (13.2-48.2) HPV 16 (27.3%)
(Japan) 6/11/16/18/31/33/52b/58
Restriction enzyme digestion (6.
11. 16. 18. 31. 33. 52b. 58)
Shimizu 2004 TS-PCR L1 for 13 15.4 (4.3-42.2) HPV 58 (7.7%)
(Japan) 16/18/31/33/35/39/45/51/52/56/58/59/68/73/75/76/82 HPV 120 (7.7%)
Sequencing
Tsuhako 2000 TS-PCR E6/E7 for 16/18 and E6 51 52.9 (39.5-65.9) HPV 16 (33.3%)
(Japan) for 6/11 Amplification with TS HPV 18 (33.3%)
primers (6.11.16.18) HPV 6 (11.8%)
HPV 11 (2.0%)
Shin 2002 (Korea, TS-PCR E6 for 16/18/33 53 13.2 (6.5-24.8) HPV 18 (6.6%)
Rep.) Amplification with TS primers HPV 16 (1.3%)
(16. 18. 33) HPV 33 (1.3%)
Ibieta 2005 (Mex- MY09/MY11 (L1) and GP5/GP6 36 41.7 (27.1-57.8) -
ico) (L1) Amplification with TS
primers (16. 18)
Cruz 1996 GP5+/GP6+ (L1) and CPI/CPII 22 63.6 (43.0-80.3) HPV 16 (54.5%)
(Netherlands) (L1) Amplification with TS HPV 6 (4.5%)
primers and hybridization with
TS probes (2. 4. 6. 10. 11. 13.
16. 18. 25. 31. 33. 46. 51. 52)
(Poland) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Kozomara 2005 TS-PCR E6 for 16. L1 for 18. E4 42 61.9 (46.8-75.0) -
(Serbia) for 31 and E1 for 33
Amplification with TS primers
(16. 18. 31. 33)
Kansky 2003 PGMY09/11 (L1). GP5+/GP6+ 48 4.2 (1.2-14.0) HPV 33 (2.1%)
(Slovenia) (L1) and WD72/76/66/67/154 HPV 58 (2.1%)
(E6) RFLP
Boy 2006 (South TS-PCR E1 for 16 and E7 for 18 22 9.1 (2.5-27.8) HPV 18 (9.1%)
Africa) Hybridization with TS probes
(16. 18)
(Spain) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Llamas-Martnez WD-66/67/72/76/154 (E6) RFLP 19 47.4 (27.3-68.3) -
2008 (Spain) (6.11.16.18.31.33.39.42.45.52)
Herrero 2003 (Su- GP5+/GP6+ (L1) Hybridization 28 3.6 (0.6-17.7) HPV 16 (3.6%)
dan) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Dahlgren 2004 GP5+/GP6+ (L1) and CPI/CPII 51 3.9 (1.1-13.2) -
(Sweden) (L1) Amplification with TS
primers (16. 18. 33) and
sequencing
Chang 2003 (Tai- MY09 (L1) and GP5+/GP6+ (L1) 42 33.3 (21.0-48.4) -
wan) Sequencing


Chen 2002 (Tai- MY09/MY11 (L1) Hybridization 28 92.9 (77.4-98.0) HPV 16 (82.1%)
wan) with TS probes (6. 11. 16. 18) HPV 18 (71.4%)
HPV 6 (10.7%)
HPV 11 (3.6%)
Lohavanichbutr MY09/MY11 (L1) and 56 19.6 (11.3-31.8) -
2009 (USA) GP5+/GP6+ (L1) Hybridization
with Roche LBA (6. 11. 16. 18.
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Miller 1994 TS-PCR E6 for 16/18 14 78.6 (52.4-92.4) HPV 16 (71.4%)
(Venezuela) Hybridization with TS probes HPV 18 (42.9%)
(16. 18)
Premoli-De- TS-PCR for 6/11/16/18 0 - - -
Percoco 2001 Hybridization with TS probes (6.
(Venezuela) 11. 16. 18)
WOMEN
Oliveira 2009 GP5+/GP6+ (L1) DBH (6. 11. 16. 31 25.8 (13.7-43.2) -
(Brazil) 18. 31. 33. 34. 35. 39. 40. 42. 43.
44. 45. 51. 52. 54. 56. 58)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(6b/11. 16. 18)
Zhang 2004 TS-PCR E6 for 16/18 25 60.0 (40.7-76.6) -
(China) Amplification with TS primers
(16. 18)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Nemes 2006 MY09/MY11 (L1) Hybridization 12 25.0 (8.9-53.2) -
(Hungary) with TS probes (16. 18. 31. 33.
45. 51. 52. 58)
Balaram 1995 (In- MY09/MY11 (L1). GP5+/GP6+ 41 68.3 (53.0-80.4) -
dia) (L1)/GP17+/GP18+ (L1). Y1/Y2
and TS-PCR for 6/11/16/18
Sequencing
DCosta 1998 (In- MY09/MY11 (L1) SBH (6. 11. 5 20.0 (3.6-62.4) -
dia) 16. 18. 33)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Saghravanian GP5+/GP6+ (L1) Amplification 13 23.1 (8.2-50.3) HPV 16 (23.1%)
2011 (Iran) with TS primers HPV E6/7 (16. HPV 18 (23.1%)
18. 31. 33)


(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
HPV-16
Chiba 1996 TS-PCR E6/E7 for 1 0.0 (0.0-79.3) -
(Japan) 6/11/16/18/31/33/52b/58
11. 16. 18. 31. 33. 52b. 58)
(Japan) 16/18/31/33/35/39/45/51/52/56/58/59/68/73/75/76/82 HPV 76 (9.1%)
Sequencing
primers (6.11.16.18) HPV 6 (19.0%)
Shin 2002 (Korea, TS-PCR E6 for 16/18/33 23 17.4 (7.0-37.1) HPV 16 (3.9%)
Rep.) Amplification with TS primers HPV 18 (3.9%)
(16. 18. 33) HPV 33 (1.3%)
Ibieta 2005 (Mex- MY09/MY11 (L1) and GP5/GP6 14 42.9 (21.4-67.4) -
primers (16. 18)
(Netherlands) (L1) Amplification with TS
TS probes (2. 4. 6. 10. 11. 13.
16. 18. 25. 31. 33. 46. 51. 52)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Kozomara 2005 TS-PCR E6 for 16. L1 for 18. E4 8 75.0 (40.9-92.9) -
(Serbia) for 31 and E1 for 33
(16. 18. 31. 33)
(Slovenia) (L1) and WD72/76/66/67/154
(E6) RFLP
(16. 18)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Llamas-Martnez WD-66/67/72/76/154 (E6) RFLP 14 35.7 (16.3-61.2) -
2008 (Spain) (6.11.16.18.31.33.39.42.45.52)


Herrero 2003 (Su-GP5+/GP6+ (L1) Hybridization 15 0.0 (0.0-20.4) -
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
sequencing
Chang 2003 (Tai- MY09 (L1) and GP5+/GP6+ (L1) 61 60.7 (48.1-71.9) -
wan) Sequencing
wan) with TS probes (6. 11. 16. 18)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
(16. 18)
Premoli-De- TS-PCR for 6/11/16/18 50 60.0 (46.2-72.4) HPV 16 (50.0%)
Percoco 2001 Hybridization with TS probes (6. HPV 18 (16.0%)
(Venezuela) 11. 16. 18)
BOTH OR UNSPECIFIED
Gonzlez 2007 MY09/MY11 (L1) and 25 60.0 (40.7-76.6) HPV 16 (48.0%)
(Argentina) GP5+/GP6+ (L1) RFLP and DBH HPV 11 (28.0%)
HPV 6 (8.0%)
HPV 18 (4.0%)
Oliveira 2009 GP5+/GP6+ (L1) DBH (6. 11. 16. 88 29.5 (21.0-39.8) HPV 18 (28.4%)
(Brazil) 18. 31. 33. 34. 35. 39. 40. 42. 43. HPV 16 (5.7%)
44. 45. 51. 52. 54. 56. 58)
Rivero 2006 GP5+/GP6+ (L1) CSA-ISH 40 0.0 (0.0-8.8) -
(Brazil) (DAKO) (6. 11. 16. 18)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(6b/11. 16. 18)
Tang 2003 (China) TS-PCR E6 for 16/18/33 30 46.7 (30.2-63.9) HPV 16 (36.7%)
Sequencing HPV 18 (16.7%)
Wen 1997 (China) TS-PCR E6 for 16/18 45 31.1 (19.5-45.7) HPV 18 (24.4%)
Hybridization with TS probes HPV 16 (20.0%)
(HPV16.18 E6)
Zhang 2004 TS-PCR E6 for 16/18 73 74.0 (62.9-82.7) HPV 16 (58.9%)
(China) Amplification with TS primers HPV 18 (24.7%)
(16. 18)
(Cuba) with EIA oligonucleotide probes HPV 18 (1.3%)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)


Koskinen 2003 SPF10 (L1) LiPA 25 28 64.3 (45.8-79.3) HPV 16 (46.4%)
(Finland) HPV 33 (21.4%)
Klussmann 2001 A10/A5-A6/A8 (L1) and 22 18.2 (7.3-38.5) HPV 16 (13.6%)
(Germany) CP62/70-CP65/69a (L1) HPV 19 (4.5%)
Sequencing
Ostwald 2003 TS-PCR E6 for 6/11/16/18 118 43.2 (34.6-52.2) HPV 16 (29.7%)
(Germany) Hybridization with TS probes HPV 18 (13.6%)
(6/11. 16. 18)
Weiss 2011 (Ger- RT-PCR E6/E7 for 16 34 2.9 (0.5-14.9) HPV 16 (2.9%)
many) Hybridization with TS probes
(16)
Aggelopoulou L1 consensus primers and 81 49.4 (38.8-60.0) HPV 18 (27.2%)
1999 (Greece) TS-PCR E7 for 16/18 HPV 16 (6.2%)
(16. 18)
Romanitan 2008 GP5+/GP6+ (L1). CPI/CPIIG 75 1.3 (0.2-7.2) -
(Greece) (E1) and TS-PCR E6/E7 for 16
(16)
Nemes 2006 MY09/MY11 (L1) Hybridization 79 41.8 (31.5-52.8) HPV 16 (34.2%)
(Hungary) with TS probes (16. 18. 31. 33. HPV 18 (6.3%)
45. 51. 52. 58) HPV 31 (3.8%)
HPV 33 (2.5%)
Szarka 2009 MY09/MY11 (L1) and 65 47.7 (36.0-59.6) HPV 16 (27.7%)
(Hungary) GP5+/GP6+ (L1) RFLP HPV 11 (6.2%)
HPV 18 (6.2%)
HPV 33 (3.1%)
HPV 31 (1.5%)
Balaram 1995 (In- MY09/MY11 (L1). GP5+/GP6+ 91 73.6 (63.7-81.6) HPV 18 (47.3%)
dia) (L1)/GP17+/GP18+ (L1). Y1/Y2 HPV 16 (41.8%)
and TS-PCR for 6/11/16/18 HPV 11 (19.8%)
Bhattacharya MY09/MY11 (L1) Amplification 193 62.2 (55.2-68.7) HPV 16 (60.1%)
2009 (India) with TS primers (16. 18) HPV 18 (5.2%)
DCosta 1998 (In- MY09/MY11 (L1) SBH (6. 11. 99 15.2 (9.4-23.5) HPV 16 (15.2%)
dia) 16. 18. 33)
(2. 6. 11. 16. 18. 31. 33. 35. 39. HPV 35 (0.4%)
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Mishra 2006 (In- MY09/MY11 (L1) Amplification 66 27.3 (18.0-39.0) HPV 16 (27.3%)
dia) with TS primers (16. 18)
Saghravanian GP5+/GP6+ (L1) Amplification 21 14.3 (5.0-34.6) HPV 16 (14.3%)
2011 (Iran) with TS primers HPV E6/7 (16. HPV 18 (14.3%)
18. 31. 33)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)


Badaracco 2000 MY09/MY11 (L1) Amplification 38 26.3 (15.0-42.0) HPV 18 (13.2%)
(Italy) with TS primers (6.16) and HPV 6 (10.5%)
hybridization with TS probes HPV 16 (10.5%)
(11.16.18.31.45.56.57) HPV 11 (5.3%)
HPV 56 (5.3%)
Badaracco 2007 MY09/MY11 (L1) and 53 11.3 (5.3-22.6) HPV 16 (7.5%)
(Italy) GP5+/GP6+ (L1) Sequencing HPV 33 (1.9%)
HPV 58 (1.9%)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Ritt 2009 (Italy) MY09/MY11 (L1) and 25 36.0 (20.2-55.5) HPV 16 (36.0%)
GP5+/GP6+ (L1) Sequencing
Scapoli 2009 RT-PCR for 16/18/31/45 247 1.2 (0.4-3.5) HPV 16 (1.2%)
(Italy) Hybridization with TS probes
(16. 18. 31. 45)
HPV-16
Chiba 1996 TS-PCR E6/E7 for 32 18.8 (8.9-35.3) HPV 16 (18.8%)
(Japan) 6/11/16/18/31/33/52b/58
11. 16. 18. 31. 33. 52b. 58)
Higa 2003 (Japan) TS-PCR E6/E7 for 16/18 46 80.4 (66.8-89.3) HPV 16 (52.2%)
Amplification with TS E6/E7 HPV 18 (52.2%)
primers (6. 11. 16. 18) HPV 6 (21.7%)
HPV 11 (2.2%)
Kojima 2002 TS-PCR L1 and E6 for 38 53 66.0 (52.6-77.3) HPV 38 (66.0%)
(Japan) Sequencing
Shima 2000 TS-PCR E6/E7 for 46 73.9 (59.7-84.4) HPV 18 (54.3%)
(Japan) 6/11/16/18/31/33/52b/58 RFLP HPV 16 (19.6%)
(16. 18)
(Japan) 16/18/31/33/35/39/45/51/52/56/58/59/68/73/75/76/82 HPV 75 (4.2%)
HPV 120 (4.2%)
Sugiyama 2003 TS-PCR E6/E7 for 16/18 79 35.4 (25.8-46.4) HPV 16 (32.9%)
(Japan) Electrophoretic analysis using HPV 18 (2.5%)
SiHa DNA and Hela DNA as
positive controls for HPV-16 and
HPV-18. respectively.
Tang 2003 (Japan) TS-PCR E6 for 16/18/33 30 50.0 (33.2-66.8) HPV 18 (33.3%)
primers (6.11.16.18) HPV 6 (13.9%)
HPV 11 (1.4%)
Lim 2007 GP5+/GP6+ (L1) Amplification 20 85.0 (64.0-94.8) HPV 18 (75.0%)
(Malaysia) with TS primers (16. 18) HPV 16 (30.0%)
Anaya-Saavedra MY09/MY11 (L1) and 62 43.5 (31.9-55.9) HPV 16 (24.2%)
2008 (Mexico) GP5+GP6+ (L1) Sequencing HPV 18 (8.1%)
HPV 33 (3.2%)
HPV 2 (1.6%)
HPV 11 (1.6%)


Ibieta 2005 (Mex- MY09/MY11 (L1) and GP5/GP6 50 42.0 (29.4-55.8) HPV 16 (28.0%)
primers (16. 18)
Braakhuis 2004 GP5+/GP6+ (L1) and TS-PCR 106 9.4 (5.2-16.5) HPV 16 (9.4%)
(Netherlands) RLBH (6. 11. 16. 18. 26. 31. 33.
34. 35. 39. 40. 42. 43. 44. 45. 51.
52. 53. 54. 55. 56. 57. 58. 59. 61.
66. 68.70.72.73. 82/MM4. 83. 84.
82/IS39. 71/CP8061. 81/CP8304.
89)
(Netherlands) (L1) Amplification with TS HPV 6 (2.9%)
TS probes (2. 4. 6. 10. 11. 13.
16. 18. 25. 31. 33. 46. 51. 52)
Mork 2001a GP5+/GP6+ (L1) and CPI/CPII 91 7.7 (3.8-15.0) HPV 16 (4.4%)
(Northern Eu- (L1) Amplification with TS HPV 6 (1.1%)
rope) primers (6. 11. 16. 18. 33) HPV 11 (1.1%)
HPV 33 (1.1%)
Matzow 1998 GP5+/GP6+ (L1). CPI/CPIIG 30 0.0 (0.0-11.4) -
(Norway) (E1) and TS-PCR for
6/16/18/31/33 Amplification with
TS primers (6. 16. 18. 31. 33)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Snietura 2010 Real-time High Risk HPV test 45 4.4 (1.2-14.8) HPV 16 (4.4%)
(Poland) (Abbott Molecular) using L1
consensus primers Amplification
with TS primers (16. 18. 31. 33.
35. 39. 45. 51. 52. 56. 58. 59. 66
and 68 - the technique only
differentiates 16-18-other)
Kozomara 2005 TS-PCR E6 for 16. L1 for 18. E4 50 64.0 (50.1-75.9) HPV 31 (32.0%)
(Serbia) for 31 and E1 for 33 HPV 16 (26.0%)
Amplification with TS primers HPV 18 (26.0%)
(16. 18. 31. 33)
(Slovenia) (L1) and WD72/76/66/67/154 HPV 33 (1.8%)
(E6) RFLP HPV 58 (1.8%)
(16. 18)
Van Rensburg TS-PCR E6 for 6/11/16/18 146 1.4 (0.4-4.9) HPV 11 (0.7%)
1996 (South Hybridization with TS probes (4. HPV 16 (0.7%)
Africa) 16. 18)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Llamas-Martnez WD-66/67/72/76/154 (E6) RFLP 33 42.4 (27.2-59.2) HPV 16 (33.3%)
2008 (Spain) (6.11.16.18.31.33.39.42.45.52) HPV 6 (30.3%)
HPV 31 (9.1%)


Herrero 2003 (Su- GP5+/GP6+ (L1) Hybridization 43 2.3 (0.4-12.1) HPV 16 (2.3%)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Dahlgren 2004 GP5+/GP6+ (L1) and CPI/CPII 85 2.4 (0.6-8.2) HPV 16 (2.4%)
sequencing
Sand 2000 (Swe- MY09/MY11 (L1) Amplification 24 12.5 (4.3-31.0) HPV 16 (4.2%)
den) with TS primers (6b/11. 16. 18) HPV 18 (4.2%)
Chang 2003 (Tai- MY09 (L1) and GP5+/GP6+ (L1) 103 49.5 (40.1-59.0) HPV 16 (28.2%)
wan) Sequencing HPV 18 (26.2%)
HPV 6 (1.0%)
HPV 11 (1.0%)
HPV 32 (1.0%)
wan) with TS probes (6. 11. 16. 18) HPV 18 (75.9%)
HPV 6 (10.3%)
HPV 11 (3.4%)
Yang 2004 (Tai- MY09/MY11 (L1) Amplification 37 10.8 (4.3-24.7) HPV 16 (8.1%)
wan) with TS primers HPV 18 (5.4%)
(6.11.16.18.31.33.35.45.58)
Lopes 2011 (UK) GP5+/GP6+ (L1) and qPCR for 142 3.5 (1.5-8.0) HPV 16 (2.1%)
16/18 Hybridization with TS HPV 18 (2.1%)
probes (16. 18)
Snijders 1996 GP5+/GP6+ (L1) Amplification 25 20.0 (8.9-39.1) HPV 16 (20.0%)
(UK) with TS primers and SBH with
TS probes (6. 11. 16. 18. 31. 33)
Yeudall 1991 (UK) TS-PCR E6/E7 for 16. E6 for 18 39 46.2 (31.6-61.4) HPV 16 (25.6%)
and specific for 4 Hybridization HPV 18 (20.5%)
with TS probes (4. 16. 18)
Chuang 2008 RT-PCR E6/E7 for 16 21 0.0 (0.0-15.5) -
(USA) Hybridization with TS probes
(16)
Furniss 2007 TS-PCR L1 for 16 Amplification 150 25.3 (19.0-32.8) HPV 16 (25.3%)
(USA) with TS primers (16)
Ha 2002 (USA) RT-PCR E6/E7 for 16 34 2.9 (0.5-14.9) HPV 16 (2.9%)
(16)
Harris 2011 MY09/MY11 (L1) and 25 8.0 (2.2-25.0) HPV 16 (8.0%)
(USA) GP5+GP6+ (L1) Sequencing
Holladay 1993 L1 consensus primers 39 17.9 (9.0-32.7) HPV 16 (17.9%)
(USA) Hybridization with TS probes (6. HPV 18 (2.6%)
11. 16. 18. 33)
Liang 2008 (USA) GP5+/GP6+ (L1) Amplification 51 2.0 (0.3-10.3) HPV 16 (2.0%)
with TS primers (16)
Lohavanichbutr MY09/MY11 (L1) and 88 20.5 (13.3-30.0) HPV 16 (18.2%)
2009 (USA) GP5+/GP6+ (L1) Hybridization HPV 32 (1.1%)
with Roche LBA (6. 11. 16. 18. HPV 53 (1.1%)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Paz 1997 (USA) MY09/MY11 (L1) and IU/IWDO 53 13.2 (6.5-24.8) HPV 16 (9.4%)
(E1) Amplification with TS HPV 6 (1.9%)
primers (6. 16. 18) HPV 8 (1.9%)


Schlecht 2011 MY09/MY11 (L1) and HMB01 36 13.9 (6.1-28.7) HPV 16 (11.1%)
(USA) (L1) DBH (40 HPV types
including 16. 18. 31. 33. 35. 39.
45. 51. 52. 56. 58. 66)
Schwartz 1998 MY09/MY11 (L1) and TS-PCR 193 21.2 (16.1-27.5) HPV 16 (11.4%)
(USA) E6 for 6/11/16/18 Hybridization HPV 6 (6.2%)
with TS probes (6. 11. 16. 18. HPV 11 (3.6%)
31/33/35) HPV 18 (1.0%)
Smith 2004 (USA) MY09/MY11 (L1) and HMB01 123 10.6 (6.3-17.2) HPV 16 (8.1%)
(L1) Sequencing HPV 33 (2.4%)
Zhao 2005 (USA) RT-PCR E6/E7 for 16 38 15.8 (7.4-30.4) HPV 16 (15.8%)
Hybridization with TS probes
(16)
(16. 18)
Premoli-De- TS-PCR for 6/11/16/18 50 60.0 (46.2-72.4) HPV 16 (50.0%)
Percoco 2001 Hybridization with TS probes (6. HPV 18 (16.0%)
(Venezuela) 11. 16. 18)
Ribeiro 2011b PGMY09/11 (L1) Amplification 132 0.0 (0.0-2.8) -
(World) with TS primers (16)
Data updated on 14 Dec 2016 (data as of 29 Feb 2012).
DBH: Dot Blot Hybridization; EIA: Enzyme ImmunoAssay; ISH: In Situ Hybridization; LBA: Line-Blot Assay; LiPA: Line Probe Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction
Fragment Length Polymorphism; RLBH: Reverse Line Blot Hybridization; RT-PCR: Real Time Polymerase Chain Reaction; SBH: Southern Blot Hybridization; SPF: Short Primer Fragment;
TS: Type Specific;
a Includes cases from Norway, Sweden and Finland.
b Includes cases from Argentina, Brazil, Cuba, Russia, Slovakia, Czech Republic, Romania and Poland.
Table 28: Studies on HPV prevalence among cases of oropharyngeal cancer

MEN
Li 2007 (China) GP5+/GP6+ (L1). 21 14.3 (5.0-34.6) HPV 16 (14.3%)
CP65/70ct-CP66/69ct (L1).
FAP59/6415 (L1). A5/A10-A6/A8
(L1) and TS-PCR E6 for 16
Sequencing
Li 2007 (China) GP5+/GP6+ (L1). 21 14.3 (5.0-34.6) -
(China) CP65/70ct-CP66/69ct (L1).
FAP59/6415 (L1). A5/A10-A6/A8
Sequencing
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(Cuba) (Cuba) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)


Rotnglov 2011 GP5+/GP6+ (L1) RBLH (6. 11. 90 64.4 (54.2-73.6) -
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40.
42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40.
(Czech Rep.) 42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
Charfi 2008 GP5+/GP6+ (L1) and TS-PCR for 36 55.6 (39.6-70.5) -
(France) 6/11/16/18/33 Amplification with
TS primers (6. 11. 16. 18. 33)
(France) (France) 6/11/16/18/33 Amplification with
TS primers (6. 11. 16. 18. 33)
Hoffmann 2010 GP5+/GP6+ (L1). MY09/MY11 31 54.8 (37.8-70.8) HPV 16 (51.6%)
(Germany) (L1) and TS-PCR for 6/11/16/18 HPV 35 (6.5%)
Hybridization with TS probes -
Multiplex luminex*
Hoffmann 2010 GP5+/GP6+ (L1). MY09/MY11 31 54.8 (37.8-70.8) -
(Germany) (Ger- (L1) and TS-PCR for 6/11/16/18
many) Hybridization with TS probes -
Multiplex luminex*
Reimers 2007 A10/A5-A6/A8 (L1) and 83 25.3 (17.2-35.6) -
(Germany) CP62/70-CP65/69a (L1)
Sequencing
(Germany) (Ger- CP62/70-CP65/69a (L1)
many) Sequencing
(Italy) with EIA oligonucleotide probes HPV 33 (3.3%)
(2. 6. 11. 16. 18. 31. 33. 35. 39. HPV 35 (3.3%)
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(Italy) (Italy) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Hannisdal 2010 GP5+/GP6+ (L1) Sequencing 99 56.6 (46.7-65.9) -
(Norway)
(Norway) (Nor-
way)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(Spain) (Spain) with EIA oligonucleotide probes
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)


Attner 2010 (Swe- GP5+/GP6+ (L1). CPI/IIG (E1) 65 75.4 (63.7-84.2) -
den) and TS-PCR E6/7 for 16/33
(16. 33) and sequencing
den) (Sweden) and TS-PCR E6/7 for 16/33
sequencing
(Sweden) (Swe- (L1) Amplification with TS
den) primers (16. 18. 33) and
sequencing
Hammarstedt GP5+/GP6+ (L1). CPI/CPIIG 145 48.3 (40.3-56.3) -
2006 (Sweden) (E1) and TS-PCR E6 for 16
Sequencing
(Sweden) Sequencing
Nsman 2009 GP5+/GP6+ (L1). CPI/CPIIG 76 81.6 (71.4-88.7) -
(Sweden) (E1) and TS-PCR E6 for 16
Sequencing
(Sweden) (Swe- (E1) and TS-PCR E6 for 16
den) Sequencing
Lindel 2001 SPF10 (L1) Sequencing 75 8.0 (3.7-16.4) -
(Switzerland)
(Switzerland)
(Switzerland)
Al-Swiahb 2010 MY09/MY11 (L1) and GP5/GP6 260 13.8 (10.2-18.6) -
(Taiwan) (L1) In situ hybridization with
TS probes (6. 11. 16. 18. 31) and
Roche LBA
(Taiwan) (Taiwan) (L1) In situ hybridization with
TS probes (6. 11. 16. 18. 31) and
Roche LBA
Kuo 2008 (Tai- MY09 (L1) and GP5+/GP6+ (L1) 79 70.9 (60.1-79.7) -
wan) Hybridization with HPV gene
chip
(6.11.16.18.26.31-33.35.37.39.
42-45.51-56.58.59.61.62.66-70.
72.74.82.CP8061.CP8304.L1AE5MM4.MM7.MM8)
wan) (Taiwan) Hybridization with HPV gene
chip
(6.11.16.18.26.31-33.35.37.39.
42-45.51-56.58.59.61.62.66-70.
72.74.82.CP8061.CP8304.L1AE5MM4.MM7.MM8)
Chaturvedi 2011 SPF10 (L1) Inno-LiPA (6. 11. 16. 210 47.6 (41.0-54.4) -
(USA) 18. 26. 31. 33. 35. 40. 43. 44. 45.
51. 52. 53. 54. 56. 58. 59. 66. 68.
69-71. 70. 73. 74. 82)


(USA) (USA) 18. 26. 31. 33. 35. 40. 43. 44. 45.
51. 52. 53. 54. 56. 58. 59. 66. 68.
69-71. 70. 73. 74. 82)
Cohen 2008 (USA) GP5+/GP6+ (L1) and TS-PCR E7 27 70.4 (51.5-84.1) HPV 16 (70.4%)
for 16 Hybridization with TS
probes (16)
Cohen 2008 (USA) GP5+/GP6+ (L1) and TS-PCR E7 27 70.4 (51.5-84.1) -
(USA) for 16 Hybridization with TS
probes (16)
Ernster 2007 TS-PCR for 16/18 Amplification 51 72.5 (59.1-82.9) HPV 16 (72.5%)
(USA) with TS primers (16. 18)
Ernster 2007 TS-PCR for 16/18 Amplification 51 72.5 (59.1-82.9) -
(USA) (USA) with TS primers (16. 18)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
2009 (USA) (USA) GP5+/GP6+ (L1) Hybridization
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Posner 2011 TS-PCR E6/E7 for 16 89 50.6 (40.4-60.7) HPV 16 (50.6%)
(USA) Amplification with TS primers
(16)
Posner 2011 TS-PCR E6/E7 for 16 89 50.6 (40.4-60.7) -
(USA) (USA) Amplification with TS primers
(16)
Tezal 2009 (USA) TS-PCR E6 for 16/18 26 76.9 (57.9-89.0) HPV 16 (76.9%)
(16. 18)
Tezal 2009 (USA) TS-PCR E6 for 16/18 26 76.9 (57.9-89.0) -
(16. 18)
WOMEN
CP65/70ct-CP66/69ct (L1).
FAP59/6415 (L1). A5/A10-A6/A8
Sequencing
Li 2007 (China) GP5+/GP6+ (L1). 10 60.0 (31.3-83.2) -
FAP59/6415 (L1). A5/A10-A6/A8
Sequencing
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)


(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40.
42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40.
(Czech Rep.) 42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
(France) 6/11/16/18/33 Amplification with
TS primers (6. 11. 16. 18. 33)
TS primers (6. 11. 16. 18. 33)
(Germany) (L1) and TS-PCR for 6/11/16/18
Multiplex luminex*
Multiplex luminex*
(Germany) CP62/70-CP65/69a (L1)
Sequencing
many) Sequencing
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(Norway)
(Norway) (Nor-
way)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)


(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
den) and TS-PCR E6/7 for 16/33
sequencing
sequencing
Sequencing
(Sweden) Sequencing
(Sweden) (E1) and TS-PCR E6 for 16
Sequencing
den) Sequencing
(Switzerland)
(Switzerland)
(Switzerland)
(Taiwan) (L1) In situ hybridization with
TS probes (6. 11. 16. 18. 31) and
Roche LBA
TS probes (6. 11. 16. 18. 31) and
Roche LBA
wan) Hybridization with HPV gene
chip
(6.11.16.18.26.31-33.35.37.39.
42-45.51-56.58.59.61.62.66-70.
72.74.82.CP8061.CP8304.L1AE5MM4.MM7.MM8)


chip
(6.11.16.18.26.31-33.35.37.39.
42-45.51-56.58.59.61.62.66-70.
72.74.82.CP8061.CP8304.L1AE5MM4.MM7.MM8)
(USA) 18. 26. 31. 33. 35. 40. 43. 44. 45.
51. 52. 53. 54. 56. 58. 59. 66. 68.
69-71. 70. 73. 74. 82)
(USA) (USA) 18. 26. 31. 33. 35. 40. 43. 44. 45.
51. 52. 53. 54. 56. 58. 59. 66. 68.
69-71. 70. 73. 74. 82)
probes (16)
probes (16)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
(16)
(16)
(16. 18)
(16. 18)
BOTH OR UNSPECIFIED
Hong 2010 (Aus- E6-based MT-PCR Amplification 302 47.7 (42.1-53.3) HPV 16 (42.1%)
tralia) with MT-PCR kit (6. 11. 16. 18. HPV 18 (1.7%)
26. 31. 33. 35. 39. 45. 51. 52. 53. HPV 35 (1.7%)
56. 58. 59. 66. 68. 70. 73. 82) HPV 39 (1.0%)
HPV 33 (0.7%)


Hong 2010 (Aus- E6-based MT-PCR Amplification 302 47.7 (42.1-53.3) -
tralia) (Australia) with MT-PCR kit (6. 11. 16. 18.
26. 31. 33. 35. 39. 45. 51. 52. 53.
56. 58. 59. 66. 68. 70. 73. 82)
Cortezzi 2004 GP5+/GP6+ (L1) DBH (6. 11. 16. 21 14.3 (5.0-34.6) HPV 16 (14.3%)
(Brazil) 18. 31. 33. 34. 39. 42. 45. 51. 52.
54. 56)
Cortezzi 2004 GP5+/GP6+ (L1) DBH (6. 11. 16. 21 14.3 (5.0-34.6) -
(Brazil) (Brazil) 18. 31. 33. 34. 39. 42. 45. 51. 52.
54. 56)
CP65/70ct-CP66/69ct (L1).
FAP59/6415 (L1). A5/A10-A6/A8
Sequencing
Li 2007 (China) GP5+/GP6+ (L1). 31 29.0 (16.1-46.6) -
FAP59/6415 (L1). A5/A10-A6/A8
Sequencing
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Klozar 2008 GP5+/GP6+ (L1) RLBH (6. 11. 20 45.0 (25.8-65.8) HPV 16 (40.0%)
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40. HPV 33 (5.0%)
42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
Klozar 2008 GP5+/GP6+ (L1) RLBH (6. 11. 20 45.0 (25.8-65.8) -
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40.
(Czech Rep.) 42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
Rotnglov 2011 GP5+/GP6+ (L1) RBLH (6. 11. 109 65.1 (55.8-73.4) HPV 16 (60.6%)
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40. HPV 33 (1.8%)
42. 43. 44. 45. 51. 52. 53. 54. 55. HPV 18 (0.9%)
56. 57. 58. 59. 61. 66. 68. 70. 71. HPV 26 (0.9%)
72. 73. 81. 82. 83. 84. 89) HPV 52 (0.9%)
(Czech Rep.) 16. 18. 26. 31. 33. 34. 35. 39. 40.
(Czech Rep.) 42. 43. 44. 45. 51. 52. 53. 54. 55.
56. 57. 58. 59. 61. 66. 68. 70. 71.
72. 73. 81. 82. 83. 84. 89)
Charfi 2008 GP5+/GP6+ (L1) and TS-PCR for 52 61.5 (48.0-73.5) HPV 16 (51.9%)
(France) 6/11/16/18/33 Amplification with HPV 33 (1.9%)
TS primers (6. 11. 16. 18. 33)
TS primers (6. 11. 16. 18. 33)


Fouret 1997 TS-PCR E6 for 16/18/31/33/45 58 17.2 (9.6-28.9) HPV 16 (15.5%)
(France) Hybridization with TS probes
(16. 18. 31. 33. 45)
Fouret 1997 TS-PCR E6 for 16/18/31/33/45 58 17.2 (9.6-28.9) -
(France) (France) Hybridization with TS probes
(16. 18. 31. 33. 45)
Andl 1998 (Ger- TS-PCR for 6/11/16/18 21 52.4 (32.4-71.7) HPV 16 (38.1%)
many) Hybridization with TS probes (6. HPV 33 (4.8%)
11. 16. 18) and cycle sequencing
system of BRL
Andl 1998 (Ger- TS-PCR for 6/11/16/18 21 52.4 (32.4-71.7) -
many) (Germany) Hybridization with TS probes (6.
11. 16. 18) and cycle sequencing
system of BRL
Hoffmann 1998 MY09/MY11 (L1) and TS-PCR 23 26.1 (12.5-46.5) HPV 16 (8.7%)
(Germany) for 6/11/16/18/33 SBH (6. 11. 16. HPV 45 (8.7%)
18. 31. 33. 45) HPV 6 (4.3%)
Hoffmann 1998 MY09/MY11 (L1) and TS-PCR 23 26.1 (12.5-46.5) -
(Germany) (Ger- for 6/11/16/18/33 SBH (6. 11. 16.
many) 18. 31. 33. 45)
(Germany) (L1) and TS-PCR for 6/11/16/18 HPV 35 (5.1%)
Multiplex luminex*
Multiplex luminex*
HPV 96 (3.0%)
Klussmann 2001 A10/A5-A6/A8 (L1) and 33 45.5 (29.8-62.0) -
many) Sequencing
Reimers 2007 A10/A5-A6/A8 (L1) and 106 28.3 (20.6-37.5) HPV 16 (27.4%)
Sequencing
many) Sequencing
Weiss 2011 (Ger- RT-PCR E6/E7 for 16 86 38.4 (28.8-48.9) HPV 16 (38.4%)
many) Hybridization with TS probes
(16)
Weiss 2011 (Ger- RT-PCR E6/E7 for 16 86 38.4 (28.8-48.9) -
many) (Germany) Hybridization with TS probes
(16)
Wittekindt 2005 A10/A5-A6/A8 (L1) and (L1) 34 52.9 (36.7-68.5) HPV 16 (50.0%)
(Germany) Sequencing HPV 33 (2.9%)
Wittekindt 2005 A10/A5-A6/A8 (L1) and (L1) 34 52.9 (36.7-68.5) -
(Germany) (Ger- Sequencing
many)
Romanitan 2008 GP5+/GP6+ (L1). CPI/CPIIG 28 42.9 (26.5-60.9) HPV 16 (32.1%)
(Greece) (E1) and TS-PCR E6/E7 for 16
(16)


Romanitan 2008 GP5+/GP6+ (L1). CPI/CPIIG 28 42.9 (26.5-60.9) -
(Greece) (Greece) (E1) and TS-PCR E6/E7 for 16
(16)
Boscolo-Rizzo MY09/MY11 (L1) RFLP* and 22 18.2 (7.3-38.5) HPV 16 (18.2%)
2009 (Italy) amplification with TS primers
E6/E2 for 16
Boscolo-Rizzo MY09/MY11 (L1) RFLP* and 22 18.2 (7.3-38.5) -
2009 (Italy) (Italy) amplification with TS primers
E6/E2 for 16
(Italy) with EIA oligonucleotide probes HPV 33 (2.8%)
(2. 6. 11. 16. 18. 31. 33. 35. 39. HPV 35 (2.8%)
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Licitra 2006 RT-PCR E1 for 16/18 90 18.9 (12.1-28.2) HPV 16 (18.9%)
(Italy) Hybridization with TS probes
(16. 18)
Licitra 2006 RT-PCR E1 for 16/18 90 18.9 (12.1-28.2) -
(Italy) (Italy) Hybridization with TS probes
(16. 18)
Ritt 2009 (Italy) MY09/MY11 (L1) and 22 50.0 (30.7-69.3) HPV 16 (50.0%)
GP5+/GP6+ (L1) Sequencing
Ritt 2009 (Italy) MY09/MY11 (L1) and 22 50.0 (30.7-69.3) -
(Italy) GP5+/GP6+ (L1) Sequencing
Kim 2007 (Korea, RT-PCR E2/E6 for 16 52 73.1 (59.7-83.2) HPV 16 (65.4%)
Rep.) Hybridization with HPV HPV 18 (1.9%)
genotyping DNA chip arrayed by HPV 33 (1.9%)
multiple oligonucleotide probes HPV 35 (1.9%)
(6.11.16.18.31.33.34.35.39.40.42. HPV 58 (1.9%)
43.44.45.51.52.56.58.59.66.68.69)
Kim 2007 (Korea, RT-PCR E2/E6 for 16 52 73.1 (59.7-83.2) -
Rep.) (Korea, Hybridization with HPV
Rep.) genotyping DNA chip arrayed by
multiple oligonucleotide probes
(6.11.16.18.31.33.34.35.39.40.42.
43.44.45.51.52.56.58.59.66.68.69)
Oh 2004 (Korea, MY09/MY11 (L1) and HMB01 39 64.1 (48.4-77.3) HPV 16 (59.0%)
Rep.) (L1) Microarray hybridization (6. HPV 6 (2.6%)
11. 16. 18. 31. 33. 34. 35. 39. 40. HPV 33 (2.6%)
42. 43. 44. 45. 51. 52. 54. 56. 58. HPV 58 (2.6%)
59. 62. 66. 67. 68. 69. 70. 72)
Oh 2004 (Korea, MY09/MY11 (L1) and HMB01 39 64.1 (48.4-77.3) -
Rep.) (Korea, (L1) Microarray hybridization (6.
Rep.) 11. 16. 18. 31. 33. 34. 35. 39. 40.
42. 43. 44. 45. 51. 52. 54. 56. 58.
59. 62. 66. 67. 68. 69. 70. 72)


Braakhuis 2004 GP5+/GP6+ (L1) and TS-PCR 37 37.8 (24.1-53.9) HPV 16 (37.8%)
34. 35. 39. 40. 42. 43. 44. 45. 51.
52. 53. 54. 55. 56. 57. 58. 59. 61.
66. 68.70.72.73. 82/MM4. 83. 84.
82/IS39. 71/CP8061. 81/CP8304.
89)
Braakhuis 2004 GP5+/GP6+ (L1) and TS-PCR 37 37.8 (24.1-53.9) -
(Netherlands) 34. 35. 39. 40. 42. 43. 44. 45. 51.
52. 53. 54. 55. 56. 57. 58. 59. 61.
66. 68.70.72.73. 82/MM4. 83. 84.
82/IS39. 71/CP8061. 81/CP8304.
89)
Hannisdal 2010 GP5+/GP6+ (L1) Sequencing 137 51.8 (43.5-60.0) HPV 16 (48.9%)
(Norway) HPV 31 (2.9%)
HPV 18 (2.2%)
HPV 33 (0.7%)
HPV 67 (0.7%)
(Norway) (Nor-
way)
Snietura 2010 Real-time High Risk HPV test 14 50.0 (26.8-73.2) HPV 16 (50.0%)
35. 39. 45. 51. 52. 56. 58. 59. 66
Snietura 2010 Real-time High Risk HPV test 14 50.0 (26.8-73.2) -
(Poland) (Poland) (Abbott Molecular) using L1
35. 39. 45. 51. 52. 56. 58. 59. 66
Szkaradkiewicz MY09/MY11 (L1) Amplification 28 10.7 (3.7-27.2) -
2002 (Poland) with TS primers (16. 18)
Szkaradkiewicz MY09/MY11 (L1) Amplification 28 10.7 (3.7-27.2) -
2002 (Poland) with TS primers (16. 18)
(Poland)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
(2. 6. 11. 16. 18. 31. 33. 35. 39.
40. 42. 43. 44. 45. 51. 52. 56. 58.
59. 66. 68)
Attner 2010 (Swe- GP5+/GP6+ (L1). CPI/IIG (E1) 95 74.7 (65.2-82.4) HPV 16 (64.2%)
den) and TS-PCR E6/7 for 16/33 HPV 33 (7.4%)
Amplification with TS primers HPV 35 (2.1%)
(16. 33) and sequencing HPV 58 (1.1%)


Dahlgren 2004 GP5+/GP6+ (L1) and CPI/CPII 25 40.0 (23.4-59.3) HPV 16 (28.0%)
(Sweden) (L1) Amplification with TS HPV 33 (4.0%)
primers (16. 18. 33) and HPV 35 (4.0%)
sequencing HPV 38 (4.0%)
sequencing
Hammarstedt GP5+/GP6+ (L1). CPI/CPIIG 203 48.8 (42.0-55.6) HPV 16 (42.9%)
2006 (Sweden) (E1) and TS-PCR E6 for 16 HPV 33 (1.5%)
HPV 45 (0.5%)
(Sweden) Sequencing
Lindquist 2012 GP5+/GP6+ (L1) and CPI/CPIIG 56 64.3 (51.2-75.5) HPV 16 (64.3%)
(Sweden) (E1) Amplification with TS
primers (16) and Multiplex
Luminex (6. 11. 16. 18. 26. 31.
33. 35. 39. 42. 43. 44. 45. 51. 52.
53. 56. 58. 59. 66. 68. 70. 73. 82)
Lindquist 2012 GP5+/GP6+ (L1) and CPI/CPIIG 56 64.3 (51.2-75.5) -
(Sweden) (Swe- (E1) Amplification with TS
den) primers (16) and Multiplex
Luminex (6. 11. 16. 18. 26. 31.
33. 35. 39. 42. 43. 44. 45. 51. 52.
53. 56. 58. 59. 66. 68. 70. 73. 82)
Nsman 2009 GP5+/GP6+ (L1). CPI/CPIIG 98 84.7 (76.3-90.5) HPV 16 (78.6%)
(Sweden) (E1) and TS-PCR E6 for 16 HPV 33 (1.0%)
HPV 59 (1.0%)
den) Sequencing
Lindel 2001 SPF10 (L1) Sequencing 99 14.1 (8.6-22.3) HPV 16 (11.1%)
(Switzerland) HPV 33 (1.0%)
HPV 35 (1.0%)
HPV 45 (1.0%)
(Switzerland)
(Switzerland)
Al-Swiahb 2010 MY09/MY11 (L1) and GP5/GP6 274 16.4 (12.5-21.3) HPV 16 (14.2%)
(Taiwan) (L1) In situ hybridization with HPV 18 (2.6%)
TS probes (6. 11. 16. 18. 31) and HPV 31 (0.7%)
Roche LBA HPV 6 (0.4%)
HPV 11 (0.4%)
TS probes (6. 11. 16. 18. 31) and
Roche LBA


Kuo 2008 (Tai- MY09 (L1) and GP5+/GP6+ (L1) 92 75.0 (65.3-82.7) HPV 16 (63.0%)
wan) Hybridization with HPV gene HPV 58 (3.3%)
chip HPV 18 (2.2%)
(6.11.16.18.26.31-33.35.37.39. HPV 33 (2.2%)
42-45.51-56.58.59.61.62.66-70. HPV 69 (2.2%)
72.74.82.CP8061.CP8304.L1AE5MM4.MM7.MM8)
chip
(6.11.16.18.26.31-33.35.37.39.
42-45.51-56.58.59.61.62.66-70.
72.74.82.CP8061.CP8304.L1AE5MM4.MM7.MM8)
Anderson 2007 GP5+/GP6+ (L1) Hybridization 36 22.2 (11.7-38.1) HPV 16 (19.4%)
(UK) with Roche LBA (6. 11. 16. 18. HPV 11 (2.8%)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Anderson 2007 GP5+/GP6+ (L1) Hybridization 36 22.2 (11.7-38.1) -
(UK) (UK) with Roche LBA (6. 11. 16. 18.
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Schache 2011 TS-PCR E6 for 16 Amplification 98 40.8 (31.6-50.7) HPV 16 (40.8%)
(UK) with TS primers (16)
Schache 2011 TS-PCR E6 for 16 Amplification 98 40.8 (31.6-50.7) -
(UK) (UK) with TS primers (16)
Thavaraj 2011 GP5+/GP6+ (L1) Luminex 200 IS 142 70.4 (62.5-77.3) HPV 16 (64.1%)
(UK) (16. 18. 26. 31. 33. 35. 39. 45. HPV 33 (2.1%)
51. 52. 53. 56. 58. 59. 66. 68. 73. HPV 18 (0.7%)
82) HPV 35 (0.7%)
Thavaraj 2011 GP5+/GP6+ (L1) Luminex 200 IS 142 70.4 (62.5-77.3) -
(UK) (UK) (16. 18. 26. 31. 33. 35. 39. 45.
51. 52. 53. 56. 58. 59. 66. 68. 73.
82)
Agoston 2010 Generic L1 primers from Access 102 90.2 (82.9-94.6) HPV 16 (73.5%)
(USA) Genetics and TS-PCR E7 for 16 HPV 58 (1.0%)
RFLP
Agoston 2010 Generic L1 primers from Access 102 90.2 (82.9-94.6) -
(USA) (USA) Genetics and TS-PCR E7 for 16
RFLP
Chaturvedi 2011 SPF10 (L1) Inno-LiPA (6. 11. 16. 263 44.1 (38.2-50.1) HPV 16 (38.8%)
(USA) 18. 26. 31. 33. 35. 40. 43. 44. 45. HPV 35 (1.5%)
51. 52. 53. 54. 56. 58. 59. 66. 68. HPV 33 (1.1%)
69-71. 70. 73. 74. 82) HPV 58 (1.1%)
HPV 18 (0.8%)
(USA) (USA) 18. 26. 31. 33. 35. 40. 43. 44. 45.
51. 52. 53. 54. 56. 58. 59. 66. 68.
69-71. 70. 73. 74. 82)
probes (16)
probes (16)


DSouza 2007 MY09/MY11 (L1) Hybridization 60 63.3 (50.7-74.4) HPV 16 (58.3%)
(USA) with Roche LBA (6. 11. 16. 18. HPV 33 (6.7%)
26. 31. 33. 35. 39. 40. 42. 45. 51. HPV 35 (1.7%)
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
DSouza 2007 MY09/MY11 (L1) Hybridization 60 63.3 (50.7-74.4) -
(USA) (USA) with Roche LBA (6. 11. 16. 18.
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Furniss 2007 TS-PCR L1 for 16 Amplification 43 34.9 (22.4-49.8) -
(USA) (USA) with TS primers (16)
Kingma 2010 PGMY09/11 (L1) Inno-LiPA (6. 61 86.9 (76.2-93.2) HPV 16 (67.2%)
(USA) 11. 16. 18. 26. 31. 33. 35. 40. 43. HPV 18 (14.8%)
44. 45. 51. 52. 53. 54. 56. 58. 59. HPV 33 (4.9%)
66. 68. 69-71. 70. 73. 74. 82) HPV 45 (1.6%)
HPV 82 (1.6%)
Kingma 2010 PGMY09/11 (L1) Inno-LiPA (6. 61 86.9 (76.2-93.2) -
(USA) (USA) 11. 16. 18. 26. 31. 33. 35. 40. 43.
44. 45. 51. 52. 53. 54. 56. 58. 59.
66. 68. 69-71. 70. 73. 74. 82)
Kong 2009 (USA) GP5+/GP6+ (L1) and TS-PCR 49 67.3 (53.4-78.8) HPV 16 (65.3%)
HPV 33 (2.0%)
Kong 2009 (USA) GP5+/GP6+ (L1) and TS-PCR 49 67.3 (53.4-78.8) -
(USA) Sequencing
Lohavanichbutr MY09/MY11 (L1) and 31 74.2 (56.8-86.3) HPV 16 (67.7%)
2009 (USA) GP5+/GP6+ (L1) Hybridization HPV 35 (3.2%)
with Roche LBA (6. 11. 16. 18. HPV 45 (3.2%)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
(16)
(16)


(USA) (L1) DBH (40 HPV types HPV 35 (3.3%)
including 16. 18. 31. 33. 35. 39.
45. 51. 52. 56. 58. 66)
Schlecht 2011 MY09/MY11 (L1) and HMB01 30 50.0 (33.2-66.8) -
(USA) (USA) (L1) DBH (40 HPV types
including 16. 18. 31. 33. 35. 39.
45. 51. 52. 56. 58. 66)
Schwartz 1998 MY09/MY11 (L1) and TS-PCR 55 41.8 (29.7-55.0) HPV 16 (34.5%)
(USA) E6 for 6/11/16/18 Hybridization HPV 6 (12.7%)
with TS probes (6. 11. 16. 18. HPV 11 (3.6%)
31/33/35)
Schwartz 1998 MY09/MY11 (L1) and TS-PCR 55 41.8 (29.7-55.0) -
(USA) (USA) E6 for 6/11/16/18 Hybridization
with TS probes (6. 11. 16. 18.
31/33/35)
Smith 2004 (USA) MY09/MY11 (L1) and HMB01 62 40.3 (29.0-52.7) HPV 16 (37.1%)
(L1) Sequencing HPV 18 (1.6%)
HPV 33 (1.6%)
Smith 2004 (USA) MY09/MY11 (L1) and HMB01 62 40.3 (29.0-52.7) -
(USA) (L1) Sequencing
Strome 2002 MY09/MY11 (L1) and TS-PCR 52 46.2 (33.3-59.5) HPV 16 (40.4%)
(USA) E6 for 6/11/16/18 Sequencing HPV 12 (3.8%)
HPV 59 (1.9%)
Strome 2002 MY09/MY11 (L1) and TS-PCR 52 46.2 (33.3-59.5) -
(USA) (USA) E6 for 6/11/16/18 Sequencing
(16. 18)
(16. 18)
(16)
Zhao 2005 (USA) RT-PCR E6/E7 for 16 26 57.7 (38.9-74.5) -
(16)
Ribeiro 2011a PGMY09/11 (L1) Amplification 136 0.7 (0.1-4.0) HPV 16 (0.7%)
Ribeiro 2011 PGMY09/11 (L1) Amplification 136 0.7 (0.1-4.0) -
(World)a (World) with TS primers (16)
DBH: Dot Blot Hybridization; EIA: Enzyme ImmunoAssay; LBA: Line-Blot Assay; LiPA: Line Probe Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymor-
phism; RLBH: Reverse Line Blot Hybridization; RT-PCR: Real Time Polymerase Chain Reaction; SBH: Southern Blot Hybridization; SPF: Short Primer Fragment; TS: Type Specific;
a Includes cases from Argentina, Brazil, Cuba, Russia, Slovakia, Czech Republic, Romania and Poland.
Table 29: Studies on HPV prevalence among cases of hypopharyngeal or laryngeal cancer
MEN
Fliss 1994 TS-PCR E6/E7 for 6b/11/16/18 28 46.4 (29.5-64.2) HPV 16 (32.1%)
(Canada) Amplification with TS primers HPV 18 (32.1%)
(6b/11. 16. 18)


Fliss 1994 TS-PCR E6/E7 for 6b/11/16/18 28 46.4 (29.5-64.2) -
(Canada) Amplification with TS primers
(Canada) (6b/11. 16. 18)
Torrente 2005 MY09/MY11 (L1) RFLP 25 36.0 (20.2-55.5) -
(Chile)
(Chile) (Chile)
Liu 2010 (China) GP5+/GP6+ (L1) and TS-PCR 61 37.7 (26.6-50.3) -
E6/E7 for 16 and E6 for 18
(16. 18)
(China) E6/E7 for 16 and E6 for 18
(16. 18)
(Germany) for 6/11/16/18/33 Hybridization
with TS and consensus probes
and further confirmation by SBH
(6. 11. 16. 18. 31. 33. 45)
(Germany) (Ger- for 6/11/16/18/33 Hybridization
many) with TS and consensus probes
(6. 11. 16. 18. 31. 33. 45)
(Germany) for 6/11/16/18 Hybridization
(6. 11. 16. 18. 31. 33. 45)
(Germany) (Ger- for 6/11/16/18 Hybridization
(6. 11. 16. 18. 31. 33. 45)
Azzimonti 2004 GP5+/GP6+ (L1) Sequencing 23 56.5 (36.8-74.4) HPV 16 (43.5%)
(Italy) HPV 18 (13.0%)
Azzimonti 2004 GP5+/GP6+ (L1) Sequencing 23 56.5 (36.8-74.4) -
(Italy) (Italy)
Cattani 1998 MY09/MY11 (L1) and TS-PCR 70 30.0 (20.5-41.5) -
(Italy) for 33 Hybridization with TS
probes (6.11.16.18.31) and
amplification with TS primer
(33)
(Italy) (Italy) for 33 Hybridization with TS
probes (6.11.16.18.31) and
(33)


Gallo 2009 (Italy) MY09/MY11 (L1). LCRF1. 36 0.0 (0.0-9.6) -
LCRF2. LCRF3. LCRF4. E7R1.
E7R2. E7R3. E7R4 (E6) and
TS-PCR E1 for 6/11/16/18-31/33
Sequencing
(Italy) LCRF2. LCRF3. LCRF4. E7R1.
TS-PCR E1 for 6/11/16/18-31/33
Sequencing
Anwar 1993 TS-PCR for 16/18/33 26 38.5 (22.4-57.5) HPV 18 (34.6%)
(Japan) Hybridization with TS probes (4. HPV 16 (3.8%)
16. 18) HPV 33 (3.8%)
Anwar 1993 TS-PCR for 16/18/33 26 38.5 (22.4-57.5) -
(Japan) (Japan) Hybridization with TS probes (4.
16. 18)
Shidara 1994 L1C1/L1C2 RFLP (6. 11. 16. 18. 40 20.0 (10.5-34.8) HPV 16 (17.5%)
(Japan) 31. 33. 42. 52. 58) HPV 18 (2.5%)
Shidara 1994 L1C1/L1C2 RFLP (6. 11. 16. 18. 40 20.0 (10.5-34.8) -
(Japan) (Japan) 31. 33. 42. 52. 58)
Lie 1996 (Norway) CP (E1). MY09/MY11 (L1) and 38 7.9 (2.7-20.8) HPV 16 (2.6%)
GP5+/GP6+ (L1) Amplification
with TS primers
(6.11.16.18.31.33.35)
Lie 1996 (Norway) CP (E1). MY09/MY11 (L1) and 38 7.9 (2.7-20.8) -
(Norway) GP5+/GP6+ (L1) Amplification
with TS primers
(6.11.16.18.31.33.35)
Morshed 2008 SPF10 (L1) LiPA 25 78 34.6 (25.0-45.7) -
(Poland)
(Poland) (Poland)
Bozdayi 2009 MY09/MY11 (L1) Amplification 62 43.5 (31.9-55.9) -
(Turkey) with GP5+/6+ and TS primers
for HPV16 positive; For HPV16
negative cases. sequencing was
performed
(Turkey) (Turkey) with GP5+/6+ and TS primers
performed
Dnmez 2000 MY09/MY11 (L1) RFLP (6. 11. 55 12.7 (6.3-24.0) HPV 11 (7.3%)
(Turkey) 16. 18. 31. 33. 35. 39. 42. 51. 58) HPV 6 (5.5%)
Dnmez 2000 MY09/MY11 (L1) RFLP (6. 11. 55 12.7 (6.3-24.0) -
(Turkey) (Turkey) 16. 18. 31. 33. 35. 39. 42. 51. 58)
WOMEN
(6b/11. 16. 18)
(Canada) (6b/11. 16. 18)
(Chile)


(Chile) (Chile)
E6/E7 for 16 and E6 for 18
(16. 18)
(16. 18)
(6. 11. 16. 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
(Italy)
(Italy) (Italy)
Cattani 1998 MY09/MY11 (L1) and TS-PCR 28 21.4 (10.2-39.5) HPV 16 (21.4%)
(Italy) for 33 Hybridization with TS
probes (6.11.16.18.31) and
(33)
probes (6.11.16.18.31) and
(33)
TS-PCR E1 for 6/11/16/18-31/33
Sequencing


TS-PCR E1 for 6/11/16/18-31/33
Sequencing
(Japan) Hybridization with TS probes (4.
16. 18)
Anwar 1993 TS-PCR for 16/18/33 4 25.0 (4.6-69.9) -
16. 18)
(Japan) 31. 33. 42. 52. 58) HPV 18 (20.0%)
(Japan) (Japan) 31. 33. 42. 52. 58)
with TS primers
(6.11.16.18.31.33.35)
with TS primers
(6.11.16.18.31.33.35)
(Poland)
(Poland) (Poland)
(Turkey) with GP5+/6+ and TS primers
performed
performed
Dnmez 2000 MY09/MY11 (L1) RFLP (6. 11. 0 - - -
(Turkey) 16. 18. 31. 33. 35. 39. 42. 51. 58)
Dnmez 2000 MY09/MY11 (L1) RFLP (6. 11. 0 - - -
(Turkey) (Turkey) 16. 18. 31. 33. 35. 39. 42. 51. 58)
BOTH OR UNSPECIFIED
Duray 2011 (Bel- GP5+/GP6+ (L1) and RT-PCR 59 79.7 (67.7-88.0) HPV 16 (62.7%)
gium) E6/E7 for 6. 11. 16. 18. 31. 33. HPV 18 (16.9%)
35. 39. 45. 51. 52. 53. 56. 58. 59. HPV 51 (8.5%)
66. 67-L1. 68 TS real-time and HPV 33 (5.1%)
consensus PCR E6/E7 (6. 11. 16. HPV 66 (5.1%)
18. 31. 33. 35. 39. 45. 51. 52. 53.
56. 58. 59. 66. 67-L1. 68)
Duray 2011 (Bel- GP5+/GP6+ (L1) and RT-PCR 59 79.7 (67.7-88.0) -
gium) (Belgium) E6/E7 for 6. 11. 16. 18. 31. 33.
35. 39. 45. 51. 52. 53. 56. 58. 59.
66. 67-L1. 68 TS real-time and
consensus PCR E6/E7 (6. 11. 16.
18. 31. 33. 35. 39. 45. 51. 52. 53.
56. 58. 59. 66. 67-L1. 68)


Miranda 2009 GP5+/GP6+ (L1) Amplification 27 7.4 (2.1-23.4) HPV 16 (7.4%)
(Brazil) with TS primers (16. 18. 33) and HPV 6 (3.7%)
sequencing
Miranda 2009 GP5+/GP6+ (L1) Amplification 27 7.4 (2.1-23.4) -
(Brazil) (Brazil) with TS primers (16. 18. 33) and
sequencing
Fliss 1994 TS-PCR E6/E7 for 6b/11/16/18 29 44.8 (28.4-62.5) HPV 16 (31.0%)
(Canada) Amplification with TS primers HPV 18 (31.0%)
(6b/11. 16. 18)
(Canada) (6b/11. 16. 18)
Torrente 2005 MY09/MY11 (L1) RFLP 31 32.3 (18.6-49.9) HPV 16 (9.7%)
(Chile) HPV 58 (6.5%)
HPV 38 (3.2%)
HPV 39 (3.2%)
HPV 45 (3.2%)
(Chile) (Chile)
Liu 2010 (China) GP5+/GP6+ (L1) and TS-PCR 84 36.9 (27.4-47.6) HPV 16 (34.5%)
E6/E7 for 16 and E6 for 18 HPV 18 (7.1%)
(16. 18)
(16. 18)
Ma 1998 (China) TS-PCR E6/E7 for 102 58.8 (49.1-67.9) HPV 16 (29.4%)
6/11/16/18/31/33/52b/58 SBH (6. HPV 6 (24.5%)
11. 16. 18. 31. 33. 52b. 58) HPV 18 (21.6%)
HPV 11 (2.0%)
HPV 33 (1.0%)
Ma 1998 (China) TS-PCR E6/E7 for 102 58.8 (49.1-67.9) -
(China) 6/11/16/18/31/33/52b/58 SBH (6.
11. 16. 18. 31. 33. 52b. 58)
Garca-Milin MY09/MY11 (L1) and TS-PCR 33 48.5 (32.5-64.8) HPV 16 (45.5%)
1998 (Cuba) E6 for 6/11/16/18 SBH (6. 11. 16. HPV 6 (3.0%)
18) HPV 18 (3.0%)
Garca-Milin MY09/MY11 (L1) and TS-PCR 33 48.5 (32.5-64.8) -
1998 (Cuba) E6 for 6/11/16/18 SBH (6. 11. 16.
(Cuba) 18)
Lindeberg 1999 MY09/MY11 (L1). GP5+/GP6+ 30 3.3 (0.6-16.7) -
(Denmark) (L1) and CPII/II (L1)
(6.11.16.18.30.31.33.35)
Lindeberg 1999 MY09/MY11 (L1). GP5+/GP6+ 30 3.3 (0.6-16.7) -
(Denmark) (Den- (L1) and CPII/II (L1)
mark) Hybridization with TS probes
(6.11.16.18.30.31.33.35)
Koskinen 2003 SPF10 (L1) LiPA 25 28 50.0 (32.6-67.4) HPV 16 (46.4%)
(Finland) HPV 33 (14.3%)
HPV 6 (10.7%)
HPV 11 (3.6%)
HPV 51 (3.6%)
Koskinen 2003 SPF10 (L1) LiPA 25 28 50.0 (32.6-67.4) -
(Finland) (Fin-
land)


Fouret 1997 TS-PCR E6 for 16/18/31/33/45 103 6.8 (3.3-13.4) HPV 16 (6.8%)
(France) Hybridization with TS probes
(16. 18. 31. 33. 45)
Fouret 1997 TS-PCR E6 for 16/18/31/33/45 103 6.8 (3.3-13.4) -
(France) (France) Hybridization with TS probes
(16. 18. 31. 33. 45)
Fischer 2003 (Ger- L1-CP65F. 66F. 69F. 70F 47 34.0 (22.2-48.3) HPV 73 (4.3%)
many) Sequencing HPV 21 (2.1%)
HPV 22 (2.1%)
HPV 38 (2.1%)
HPV 41 (2.1%)
Fischer 2003 (Ger- L1-CP65F. 66F. 69F. 70F 47 34.0 (22.2-48.3) -
many) (Germany) Sequencing
(Germany) for 6/11/16/18/33 SBH (6. 11. 16. HPV 18 (2.0%)
18. 31. 33. 45) HPV 45 (2.0%)
(Germany) (Ger- for 6/11/16/18/33 SBH (6. 11. 16.
many) 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
(6. 11. 16. 18. 31. 33. 45)
Kleist 2000 (Ger- MY09/MY11 (L1) Amplification 35 20.0 (10.0-35.9) HPV 16 (8.6%)
many) with TS primers (16. 18) HPV 18 (8.6%)
Kleist 2000 (Ger- MY09/MY11 (L1) Amplification 35 20.0 (10.0-35.9) -
many) (Germany) with TS primers (16. 18)
Sequencing
Klussmann 2001 A10/A5-A6/A8 (L1) and 30 16.7 (7.3-33.6) -
many) Sequencing


Gorgoulis 1999 MY09/MY11 (L1) and GP5/GP6 91 20.9 (13.8-30.3) HPV 16 (14.3%)
(Greece) (L1) Amplification with TS HPV 6 (3.3%)
primers (6. 11. 16. 18. 31. 33. HPV 18 (3.3%)
35) and confirmation by DBH HPV 33 (3.3%)
with TS probes (6.11.16.18.
31.33.35).
Gorgoulis 1999 MY09/MY11 (L1) and GP5/GP6 91 20.9 (13.8-30.3) -
(Greece) (Greece) (L1) Amplification with TS
primers (6. 11. 16. 18. 31. 33.
35) and confirmation by DBH
with TS probes (6.11.16.18.
31.33.35).
Vlachtsis 2005 TS-PCR for 16/18 Amplification 90 40.0 (30.5-50.3) HPV 16 (34.4%)
(Greece) with TS primers (16. 18) HPV 18 (6.7%)
Vlachtsis 2005 TS-PCR for 16/18 Amplification 90 40.0 (30.5-50.3) -
(Greece) (Greece) with TS primers (16. 18)
Major 2005 (Hun- MY09/MY11 (L1) and 22 54.5 (34.7-73.1) HPV 11 (18.2%)
gary) GP5+/GP6+ (L1) RFLP (6. 11. HPV 6 (13.6%)
16. 18) HPV 16 (13.6%)
Major 2005 (Hun- MY09/MY11 (L1) and 22 54.5 (34.7-73.1) -
gary) (Hungary) GP5+/GP6+ (L1) RFLP (6. 11.
16. 18)
Jacob 2002 (India) TS-PCR E1 for 6/11/18 and L1 44 34.1 (21.9-48.9) HPV 16 (34.1%)
for 16 SBH with TS probes (6.
11. 16. 18)
Jacob 2002 (India) TS-PCR E1 for 6/11/18 and L1 44 34.1 (21.9-48.9) -
(India) for 16 SBH with TS probes (6.
11. 16. 18)
(Italy) HPV 18 (12.0%)
(Italy) (Italy)
Badaracco 2000 MY09/MY11 (L1) Amplification 22 50.0 (30.7-69.3) HPV 16 (27.3%)
(Italy) with TS primers (6.16) and HPV 6 (18.2%)
hybridization with TS probes HPV 45 (4.5%)
(11.16.18.31.45.56.57)
Badaracco 2000 MY09/MY11 (L1) Amplification 22 50.0 (30.7-69.3) -
(Italy) (Italy) with TS primers (6.16) and
hybridization with TS probes
(11.16.18.31.45.56.57)
Badaracco 2007 MY09/MY11 (L1) and 30 16.7 (7.3-33.6) HPV 16 (10.0%)
(Italy) GP5+/GP6+ (L1) Sequencing HPV 6 (6.7%)
Badaracco 2007 MY09/MY11 (L1) and 30 16.7 (7.3-33.6) -
(Italy) (Italy) GP5+/GP6+ (L1) Sequencing
Boscolo-Rizzo MY09/MY11 (L1) RFLP* and 45 4.4 (1.2-14.8) HPV 16 (4.4%)
2009 (Italy) amplification with TS primers
E6/E2 for 16
Boscolo-Rizzo MY09/MY11 (L1) RFLP* and 45 4.4 (1.2-14.8) -
2009 (Italy) (Italy) amplification with TS primers
E6/E2 for 16
Cattani 1998 MY09/MY11 (L1) and TS-PCR 75 29.3 (20.2-40.4) HPV 16 (12.0%)
(Italy) for 33 Hybridization with TS HPV 18 (10.7%)
probes (6.11.16.18.31) and HPV 33 (1.3%)
(33)


probes (6.11.16.18.31) and
(33)
TS-PCR E1 for 6/11/16/18-31/33
Sequencing
TS-PCR E1 for 6/11/16/18-31/33
Sequencing
(Japan) Hybridization with TS probes (4. HPV 16 (3.3%)
16. 18) HPV 33 (3.3%)
Anwar 1993 TS-PCR for 16/18/33 30 36.7 (21.9-54.5) -
16. 18)
Mineta 1998 TS-PCR E7 for 16/18 42 31.0 (19.1-46.0) HPV 16 (26.2%)
(Japan) Amplification with TS primers HPV 18 (4.8%)
(16. 18)
Mineta 1998 TS-PCR E7 for 16/18 42 31.0 (19.1-46.0) -
(Japan) (Japan) Amplification with TS primers
(16. 18)
Ogura 1991 TS-PCR E6 for 16/18 28 10.7 (3.7-27.2) HPV 16 (10.7%)
(Japan) Hybridization with TS probes HPV 18 (3.6%)
(16. 18)
Ogura 1991 TS-PCR E6 for 16/18 28 10.7 (3.7-27.2) -
(Japan) (Japan) Hybridization with TS probes
(16. 18)
(Japan) 31. 33. 42. 52. 58) HPV 18 (4.4%)
(Japan) (Japan) 31. 33. 42. 52. 58)
Gudleviciene 2009 Consensus primers from Master 25 32.0 (17.2-51.6) HPV 16 (12.0%)
(Lithuania) Mix Amplification with TS
primers (16. 18)
Gudleviciene Consensus primers from Master 25 32.0 (17.2-51.6) -
2009 (Lithuania) Mix Amplification with TS
(Lithuania) primers (16. 18)
Koskinen 2007a MY09/MY11 (L1). GP5+/GP6+ 69 4.3 (1.5-12.0) HPV 16 (1.4%)
(Northern Eu- (L1) and SPF10 (L1) LiPA 25
rope)
Koskinen 2007 MY09/MY11 (L1). GP5+/GP6+ 69 4.3 (1.5-12.0) -
(Northern (L1) and SPF10 (L1) LiPA 25
Europe)a (North-
ern Europe)
Mork 2001a GP5+/GP6+ (L1) and CPI/CPII 40 2.5 (0.4-12.9) HPV 16 (2.5%)
(Northern Eu- (L1) Amplification with TS
rope) primers (6. 11. 16. 18. 33)


Mork 2001 GP5+/GP6+ (L1) and CPI/CPII 40 2.5 (0.4-12.9) -
(Northern (L1) Amplification with TS
Europe)a (North- primers (6. 11. 16. 18. 33)
ern Europe)
Lie 1996 (Norway) CP (E1). MY09/MY11 (L1) and 39 7.7 (2.7-20.3) HPV 16 (2.6%)
with TS primers
(6.11.16.18.31.33.35)
with TS primers
(6.11.16.18.31.33.35)
Morshed 2008 SPF10 (L1) LiPA 25 93 35.5 (26.5-45.6) HPV 16 (30.1%)
(Poland) HPV 18 (6.5%)
HPV 33 (5.4%)
(Poland) (Poland)
consensus primers RT-PCR (16.
18. 31. 33. 35. 39. 45. 51. 52. 56.
58. 59. 66. 68)
(Poland) (Poland) (Abbott Molecular) using L1
consensus primers RT-PCR (16.
18. 31. 33. 35. 39. 45. 51. 52. 56.
58. 59. 66. 68)
Poljak 1997 PGMY09/11 (L1). GP5+/GP6+ 30 3.3 (0.6-16.7) HPV 16 (3.3%)
(Slovenia) (L1) and WD72/76/66/67/154
(E6) Amplification with TS
primers (6.11.16.18.31.33.51)
Poljak 1997 PGMY09/11 (L1). GP5+/GP6+ 30 3.3 (0.6-16.7) -
(Slovenia) (Slove- (L1) and WD72/76/66/67/154
nia) (E6) Amplification with TS
primers (6.11.16.18.31.33.51)
Alvarez Alvarez TS-PCR E6 and L1 for 6b/16/18 35 25.7 (14.2-42.1) HPV 6 (22.9%)
1997 (Spain) Amplification with TS primers HPV 16 (5.7%)
(6b. 16. 18)
Alvarez Alvarez TS-PCR E6 and L1 for 6b/16/18 35 25.7 (14.2-42.1) -
1997 (Spain) Amplification with TS primers
(Spain) (6b. 16. 18)
Prez-Ayala 1990 TS-PCR E6 for 6/11 51 56.9 (43.3-69.5) HPV 16 (56.9%)
(Spain) Hybridization with TS probes
(11.16)
Prez-Ayala 1990 TS-PCR E6 for 6/11 51 56.9 (43.3-69.5) -
(Spain) (Spain) Hybridization with TS probes
(11.16)
Adams 1999 MY09/MY11 (L1) RFLP 36 16.7 (7.9-31.9) HPV 16 (16.7%)
(Switzerland) (6.11.16.18.31.33.35.51.53.56)
Adams 1999 MY09/MY11 (L1) RFLP 36 16.7 (7.9-31.9) -
(Switzerland) (6.11.16.18.31.33.35.51.53.56)
(Switzerland)
Bozdayi 2009 MY09/MY11 (L1) Amplification 65 41.5 (30.4-53.7) HPV 16 (40.0%)
(Turkey) with GP5+/6+ and TS primers HPV 6 (1.5%)
performed


performed
Dnmez 2000 MY09/MY11 (L1) RFLP (6. 11. 55 12.7 (6.3-24.0) HPV 11 (7.3%)
(Turkey) 16. 18. 31. 33. 35. 39. 42. 51. 58) HPV 6 (5.5%)
Dnmez 2000 MY09/MY11 (L1) RFLP (6. 11. 55 12.7 (6.3-24.0) -
(Turkey) (Turkey) 16. 18. 31. 33. 35. 39. 42. 51. 58)
Gungor 2007 SP10296 (L1) Amplification with 95 7.4 (3.6-14.4) HPV 11 (7.4%)
(Turkey) mPCR kit (6. 11. 16. 18. 31. 33. HPV 6 (2.1%)
52. 58) HPV 16 (1.1%)
Gungor 2007 SP10296 (L1) Amplification with 95 7.4 (3.6-14.4) -
(Turkey) (Turkey) mPCR kit (6. 11. 16. 18. 31. 33.
52. 58)
(UK) with Roche LBA (6. 11. 16. 18.
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
(UK) (UK) with Roche LBA (6. 11. 16. 18.
26. 31. 33. 35. 39. 40. 42. 45. 51.
52. 53. 54. 55. 56. 58. 59. 61. 62.
64. 66. 67. 68. 69. 70. 71. 72. 73.
81. 82. 83. 84. 89)
Salam 1995 (UK) MY09/MY11 (L1) RFLP (6. 11. 36 22.2 (11.7-38.1) HPV 6 (8.3%)
16. 18. 33) HPV 16 (5.6%)
HPV 11 (2.8%)
Salam 1995 (UK) MY09/MY11 (L1) RFLP (6. 11. 36 22.2 (11.7-38.1) -
(UK) 16. 18. 33)
Snijders 1996 GP5+/GP6+ (L1) Amplification 31 19.4 (9.2-36.3) HPV 16 (19.4%)
(UK) with TS primers and SBH with
TS probes (6. 11. 16. 18. 31. 33)
Snijders 1996 GP5+/GP6+ (L1) Amplification 31 19.4 (9.2-36.3) -
(UK) (UK) with TS primers and SBH with
TS probes (6. 11. 16. 18. 31. 33)
Brandwein 1993 Perkin Census L1 consensus 40 7.5 (2.6-19.9) HPV 16 (2.5%)
(USA) primers Hybridization with TS
probes (6. 11. 16. 18. 31. 35. 51)
Brandwein 1993 Perkin Census L1 consensus 40 7.5 (2.6-19.9) -
(USA) (USA) primers Hybridization with TS
probes (6. 11. 16. 18. 31. 35. 51)
Furniss 2007 TS-PCR L1 for 16 Amplification 63 31.7 (21.6-44.0) -
(USA) (USA) with TS primers (16)
Paz 1997 (USA) MY09/MY11 (L1) and IU/IWDO 43 4.7 (1.3-15.5) HPV 16 (2.3%)
(E1) Amplification with TS
primers (6. 16. 18)
Paz 1997 (USA) MY09/MY11 (L1) and IU/IWDO 43 4.7 (1.3-15.5) -
(USA) (E1) Amplification with TS
primers (6. 16. 18)


(USA) (L1) DBH (40 HPV types
including 16. 18. 31. 33. 35. 39.
45. 51. 52. 56. 58. 66)
Schlecht 2011 MY09/MY11 (L1) and HMB01 40 27.5 (16.1-42.8) -
(USA) (USA) (L1) DBH (40 HPV types
including 16. 18. 31. 33. 35. 39.
45. 51. 52. 56. 58. 66)
Shen 1996 (USA) MY09/MY11 (L1) and TS-PCR 32 9.4 (3.2-24.2) HPV 6 (3.1%)
E7 for 16/18 RFLP* HPV 11 (3.1%)
HPV 18 (3.1%)
Shen 1996 (USA) MY09/MY11 (L1) and TS-PCR 32 9.4 (3.2-24.2) -
(USA) E7 for 16/18 RFLP*
(16)
Zhao 2005 (USA) RT-PCR E6/E7 for 16 22 18.2 (7.3-38.5) -
(16)
Ribeiro 2011b PGMY09/11 (L1) Amplification 239 0.8 (0.2-3.0) HPV 16 (0.8%)
Ribeiro 2011 PGMY09/11 (L1) Amplification 239 0.8 (0.2-3.0) -
(World)b (World) with TS primers (16)
DBH: Dot Blot Hybridization; LBA: Line-Blot Assay; LiPA: Line Probe Assay; PCR: Polymerase Chain Reaction; RFLP: Restriction Fragment Length Polymorphism; RT-PCR: Real Time
Polymerase Chain Reaction; SBH: Southern Blot Hybridization; SPF: Short Primer Fragment; TS: Type Specific;
a Includes cases from Norway, Sweden and Finland.
b Includes cases from Argentina, Brazil, Cuba, Russia, Slovakia, Czech Republic, Romania and Poland.

5 FACTORS CONTRIBUTING TO CERVICAL CANCER - 239 -
5 Factors contributing to cervical cancer

HPV is a necessary cause of cervical cancer, but it is not a sufficient cause. Other cofactors are necessary
for progression from cervical HPV infection to cancer. Tobacco smoking, high parity, long-term hormonal
contraceptive use, and co-infection with HIV have been identified as established cofactors. Co-infection
with Chlamydia trachomatis and herpes simplex virus type-2, immunosuppression, and certain dietary
deficiencies are other probable cofactors. Genetic and immunological host factors and viral factors other
than type, such as variants of type, viral load and viral integration, are likely to be important but have
not been clearly identified. (Muoz N, Vaccine 2006; 24(S3): 1-10). In this section, the prevalence of
smoking, parity (fertility), oral contraceptive use, and HIV in the World are presented.
Figure 125: Female smoking prevalence
Data accessed on 21 Jul 2015.

Adjusted and age-standardized prevalence estimates of tobacco use by country, for the year 2013. These rates are constructed solely for the purpose of comparing tobacco use prevalence
estimates across countries, and should not be used to estimate the number of smokers in the population. "Current" means smoking at the time of the survey, including daily and non-daily
smoking. "Tobacco smoking" means smoking any form of tobacco, including cigarettes, cigars, pipes, hookah, shisha, water-pipe, etc. and excluding smokeless tobacco.
2008;
For United Kingdom, Ireland, Japan, Republic of Korea, USA: Data refer to cigarette smoking only.
For New Zealand, USA: Data not approved by the national authorities.
Data sources: WHO report on the global tobacco epidemic, 2015: The MPOWER package. Geneva, World Health Organization, 2015. Available at http://www.who.int/tobacco/global_
report/2015/en/index.html

Figure 126: Total fertility rates

Fertility rate estimates by country are presented as a proxy measure of parity. Parity is the number of times a woman has given birth, while fertility rate is the average number of live births
per woman, assuming the age-specific fertility rate observed in a given year or period. Age-specific fertility rates read as the annual number of births per 1000 women in the corresponding
age group.
Please refer to original sources (available at: http://www.un.org/esa/population/publications/worldfertility2009/worldfertility2009.htm and http://epp.eurostat.ec.
europa.eu/tgm/table.do?tab=table&init=1&language=en&pcode=tsdde220&plugin=1 )
For Afghanistan: Excluding areas in the South zone.
For Anguilla, American Samoa, Bahrain, Bahamas, Belize, Barbados, Brunei, Costa Rica, Cayman Islands, Dominica, Fiji, FS Micronesia, Gibraltar, Greenland, Guatemala, French Guiana,
Guam, Jamaica, Kyrgyzstan, Republic of Korea, Kuwait, Sri Lanka, Maldives, Mexico, Marshall Islands, N Mariana Islands, Martinique, Malaysia, Niue, Panama, Qatar, Reunion, St Pierre
and Miquelon, Seychelles, Thailand, Trinidad & Tobago, Tunisia, St Vincent & The Grenadines, Wallis & Futuna Islands: The number of women by age is estimated by the United Nations
Population Division and published in the World Population Prospects Revision 2010.
For Bangladesh, Cameroon, Congo, Guinea, Mozambique: Preliminary data.
For Brazil: The estimates are based on vital registration data for federal states with more than 90 per cent of births registered and on estimates from censuses and surveys for the federal
states with incomplete birth registration.
For Central African Republic, Kiribati: Adjusted estimate.
For Canada: Postcensal estimates.
For French Guiana, Martinique, Reunion, St Pierre and Miquelon: Excluding live-born infants who died before their birth was registered.
For Hong Kong SAR, Singapore: Data pertain to resident population only.
For Ireland: Provisional
For Iran: Estimates based on the own-children method.
For Israel: Including data for East Jerusalem and Israeli residents in certain other territories under occupation by Israeli military forces since June 1967.
For Japan: Data refer to Japanese nationals in Japan only.
For Kazakhstan: Excluding infants born alive of less than 28 weeks gestation, of less than 1 000 grams in weight and 35 centimeters in length, who die within seven days of birth.
For Oman: Data refer to total population.
For Saudi Arabia: Data pertain to nationals only.
For Sudan: Data pertain to pre-secession Northern Sudan.
For St Pierre and Miquelon: Age classification based on year of birth of mother rather than the exact age of mother at birth of child.
For South Sudan: Data pertain to pre-secession Southern Sudan.
For Syria: Data pertain to nationals of the country.
For Turkmenistan: Data shown for women aged 35-39 pertain to women aged 35-49.
For British Virgin Islands: Data shown for women aged 40 to 44 pertain to women aged 40 or over.
Data sources:
For Aruba, Afghanistan, Angola, Anguilla, Albania, United Arab Emirates, Argentina, Armenia, American Samoa, Antigua & Barbuda, Australia, Burundi, Benin, Burkina Faso,
Bangladesh, Bahrain, Bahamas, Bosnia & Herzegovina, Belize, Bermuda, Bolivia, Brazil, Barbados, Brunei, Bhutan, Botswana, Central African Republic, Canada, Chile, China, Cte
dIvoire, Cameroon, DR Congo, Congo, Cook Islands, Colombia, Comoros, Cape Verde, Costa Rica, Cuba, Cayman Islands, Djibouti, Dominica, Dominican Republic, Algeria, Ecuador, Egypt,
Eritrea, Ethiopia, Fiji, FS Micronesia, Gabon, Georgia, Ghana, Gibraltar, Guinea, Guadeloupe, Gambia, Guinea-Bissau, Equatorial Guinea, Grenada, Greenland, Guatemala, French
Guiana, Guam, Guyana, Hong Kong SAR, Honduras, Haiti, Indonesia, India, Iran, Iraq, Israel, Jamaica, Jordan, Japan, Kazakhstan, Kenya, Kyrgyzstan, Cambodia, Kiribati, St Kitts
& Nevis, Republic of Korea, Kuwait, Laos, Lebanon, Liberia, Libya, St Lucia, Sri Lanka, Lesotho, Macao SAR, Morocco, Madagascar, Maldives, Mexico, Marshall Islands, Mali, Myan-
mar, Mongolia, N Mariana Islands, Mozambique, Mauritania, Montserrat, Martinique, Mauritius, Malawi, Malaysia, Mayotte, Namibia, New Caledonia, Niger, Nigeria, Nicaragua, Niue,
Nepal, Nauru, New Zealand, Oman, Pakistan, Panama, Peru, Philippines, Palau, Papua New Guinea, Puerto Rico, DPR Korea, Paraguay, Palestine, French Polynesia, Qatar, Reunion,
Rwanda, Saudi Arabia, Sudan, Senegal, Singapore, Solomon Islands, Sierra Leone, El Salvador, Somalia, St Pierre and Miquelon, South Sudan, Sao Tome & Principe, Suriname, Swazi-
land, Seychelles, Syria, Turks & Caicos Islands, Chad, Togo, Thailand, Tajikistan, Tokelau, Turkmenistan, Timor-Leste, Tonga, Trinidad & Tobago, Tunisia, Tuvalu, Tanzania, Uganda,
Uruguay, USA, Uzbekistan, St Vincent & The Grenadines, Venezuela, British Virgin Islands, US Virgin Islands, Viet Nam, Vanuatu, Wallis & Futuna Islands, Samoa, Yemen, South
Africa, Zambia, Zimbabwe: United Nations, Department of Economic and Social Affairs, Population Division (2013). World Fertility Data 2012 (POP/DB/Fert/Rev2012). Available at:
http://www.un.org/esa/population/publications/WFD2012/MainFrame.html
Andorra, Austria, Azerbaijan, Belgium, Bulgaria, Belarus, Switzerland, Cyprus, Czech Republic, Germany, Denmark, Spain, Estonia, Finland, France, United Kingdom, Greece, Croatia,
Hungary, Ireland, Iceland, Italy, Liechtenstein, Lithuania, Luxembourg, Latvia, Republic of Moldova, Macedonia, Malta, Montenegro, Netherlands, Norway, Poland, Portugal, Romania, Rus-
sian Federation, San Marino, Serbia, Slovakia, Slovenia, Sweden, Turkey, Ukraine: Eurostat - Statistical office of the European Comission [web site]. Luxembourg: European Commission;
2015. Available at: http://epp.eurostat.ec.europa.eu/portal/page/portal/eurostat/home/ [Accessed on July 2015]

Figure 127: World prevalence of hormonal contraceptive use

Proportion (%) of women using hormonal contraception (pill, injectable or implant), among those of reproductive age who are married or in union.
For Anguilla, Belize, Botswana, Cook Islands, Guadeloupe, Croatia, N Mariana Islands, Martinique, Palau, Reunion: Data pertain to all women of reproductive age, irrespective of marital
status.
For Sweden, Uruguay: Data pertain to methods used at last sex.
For Anguilla, Croatia: Data pertain to methods used during the last two months.
For Uruguay: Data pertain to men and women of reproductive age who are married or in a union.
For United Arab Emirates, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia: Data pertain to nationals of the country.
For USA: Data pertain to women currently married and currently cohabiting.
For Argentina, Guam, Portugal: Data pertain to sexually active, non-pregnant women.
For Australia, Slovakia, US Virgin Islands: Data pertain to women exposed to the risk of pregnancy.
For Austria, Belgium, Bulgaria, Germany, Estonia, France, Lithuania, Romania: Data pertain to women with co-resident male partner.
For Austria, Bulgaria, Germany, Estonia, France, United Kingdom, Lithuania, Nicaragua, Peru, Romania: Including emergency contraception.
For Belgium: Data pertain to methods used during the last 12 months.
For Belarus, Comoros, Gambia, Guatemala, Liberia, Mali, Nicaragua, Sierra Leone: Preliminary data.
For Canada, Sweden: Data pertain to women who have ever had sex.
For Chile: Data pertain to men and women of reproductive age.
For Cook Islands, Greece, Grenada, Guam, Hungary, Italy, Latvia, Mauritania, Mauritius, Malaysia, New Zealand, Poland, Puerto Rico, Reunion, Singapore, Slovenia: Adjusted.
For Czech Republic: Data pertain to women with a partner.
For Denmark: Data pertain to women in a steady sexual relationship.
For United Kingdom: Excluding Northern Ireland.
For Greece, Puerto Rico: Data pertain to sexually active women of reproductive age.
For Israel: Data pertain to the Jewish population.
For Republic of Korea, Sudan, Uruguay: Estimate.
For Kuwait: Data pertain to non-pregnant women.
For Sri Lanka: Excluding the Northern Province.
For Malta: Data pertain to married women who visited a practitioner belonging to the Malta College of Family Doctors.
For Myanmar: Data pertain to ever-married women of reproductive age.
For Malaysia: Data pertain to Peninsular Malaysia.
For Norway: Data pertain to women who were sexually active during the three months prior to the interview.
For Poland: Data pertain to women who were sexually active during the month prior to the interview.
Data sources: United Nations, Department of Economic and Social Affairs, Population Division (2014). World Contraceptive Use 2014 (POP/DB/CP/Rev2014). Available at http://www.un.
org/en/development/desa/population/publications/dataset/contraception/wcu2014.shtml
For Afghanistan, Angola, Bosnia & Herzegovina, Belarus, Belize, Bhutan, Central African Republic, DR Congo, Costa Rica, Cuba, Algeria, Guinea-Bissau, Iraq, Kazakhstan, Macedonia,
Myanmar, Montenegro, Mongolia, Mauritania, Palestine, Somalia, Serbia, South Sudan, Suriname, Swaziland, Chad, Togo, Turkmenistan, Trinidad & Tobago, Tunisia, Ukraine, Uzbekistan,
Vanuatu, Yemen: Multiple Indicator Cluster Survey (MICS).
Anguilla: National survey: Anguilla 2003 Reproductive Health Survey
Albania, Armenia, Azerbaijan, Burundi, Benin, Burkina Faso, Bangladesh, Bolivia, Cte dIvoire, Cameroon, Congo, Colombia, Cape Verde, Dominican Republic, Egypt, Eritrea, Ethiopia,
Gabon, Guinea, Gambia, Equatorial Guinea, Guyana, Honduras, Indonesia, Jordan, Kenya, Kyrgyzstan, Cambodia, Liberia, Sri Lanka, Lesotho, Republic of Moldova, Madagascar, Maldives,
Mali, Mozambique, Malawi, Namibia, Niger, Nigeria, Nicaragua, Nepal, Pakistan, Peru, Rwanda, Senegal, Sierra Leone, Sao Tome & Principe, Tajikistan, Timor-Leste, Tanzania, Uganda,
Samoa, South Africa, Zambia, Zimbabwe: Demographic and Health Survey (DHS).
United Arab Emirates, Bahrain, Qatar, Saudi Arabia: Gulf Family Health Survey (GFHS).
Argentina: National survey: Argentina 2004-2005 National Nutrition and Health Survey
Antigua & Barbuda: Contraceptive Prevalence Survey (CPS).
Australia: National survey: Household, Income and Labour Dynamics in Australia (HILDA) survey, 2005
Austria, Bulgaria, Czech Republic, Germany, Estonia, France, Lithuania, Romania: Generations and Gender Survey (GGS).
Belgium: National survey: Belgium 2004 Enqute de Sant
Bahamas, Barbados, Dominica, St Kitts & Nevis, St Lucia, Montserrat, St Vincent & The Grenadines: Caribbean Contraceptive Prevalence Survey (CCPS).
Brazil: National survey: Brazil 2006 Pesquisa Nacional por Amostra de Domicmlios
Botswana: National survey: Botswana 2007 Family Health Survey - Multiple Indicator Cluster Survey
Canada: National survey: Canada 2002 Contraceptive Studies
Switzerland, Finland, Hungary, Italy, Latvia, New Zealand, Poland, Slovenia: Fertility and Family Survey (FFS).
Chile: National survey: Chile 2006 Encuesta Nacional de Calidad de Vida y Salud
China: National survey: China 2006 National Family Planning and Reproductive Health Survey
Cook Islands: National survey: Cook Islands 1999 Reproductive Health Knowledge and Services
Comoros, Haiti, Laos: Demographic and Health Survey/Multiple Indicator Cluster Survey (DHS/MICS).
Djibouti, Libya, Morocco, Syria: Pan-Arab Project for Family Health Survey (PAPFAM).
Denmark: National survey: Denmark 1991-1993 Infertility Survey
Ecuador, Georgia, Guatemala, Jamaica, Oman, DPR Korea, Paraguay, El Salvador: Reproductive Health Survey (RHS).
Spain: National survey: Spain 2006 Fertility and Values Survey
Fiji: World Fertility Survey (WFS).
United Kingdom: National survey: United Kingdom 2008-2009 National Statistics Opinions Survey
Ghana: National survey: Ghana 2013 PMA family planning survey
Guadeloupe: National survey: Guadeloupe 1976 Fertility Survey
Greece: National survey: Greece 2001 Family planning survey
Grenada: National survey: Grenada 1990 IPPF/WHR Caribbean Contraceptive Prevalence Survey
Guam: National survey: Guam 2002 Behavioral Risk Factor Surveillance System


Hong Kong SAR: National survey: China, Hong Kong (SAR) 2007 Family Planning Knowledge, Attitude and Practice
Croatia: National survey: Croatia 1970 Yugoslavia Fertility Survey
India: National survey: India 2007-2008 District Level Household Survey
Ireland: National survey: Ireland 2004-2005 SSHR
Iran: National survey: Iran (Islamic Republic of) 2010 Multiple-Indicator Demographic and Health Survey
Israel: National survey: Israel 1987-1988 Study of Fertility and Family Formation Survey
Japan: National survey: Japan 2005 13th National Fertility Survey
Kiribati: National survey: Kiribati 2009 Demographic and Health Survey
Republic of Korea: National survey: Republic of Korea 2009 National Fertility and Family Health Survey
Kuwait: National survey: Kuwait 1999 Desired Fertility and Contraceptive Use
Lebanon: Pan-Arab Project for Child Development Survey (PAPCHILD).
Mexico: National survey: Mexico 2006 Encuesta Nacional de la Dinmica Demogrfica
Marshall Islands: National survey: Marshall Islands 2007 Demographic Health Survey (national)
Malta: National survey: Malta 1993 Survey of Family Planning
N Mariana Islands: National survey: Northern Mariana Islands 1970 KAP Survey Trust Territory
Martinique: National survey: Martinique 1976 Fertility Survey
Mauritius: National survey: Mauritius 2002 Contraceptive Prevalence Survey of Mauritius and Rodrigues Islands
Malaysia: National survey: Malaysia 2004 Population and Family Survey
Netherlands: National survey: Netherlands 2008 Birth Control Survey
Norway: National survey: Norway 2005 Survey on Contraceptive Use
Nauru: National survey: Nauru 2007 Demographic Health Survey (national)
Panama: National survey: Panama 2009 Sexual and Reproductive Health-Survey
Philippines: National survey: Philippines 2011 Family Health Survey
Palau: National survey: Palau 2003 Population, Environment and Labor Force Survey
Papua New Guinea: National survey: Papua New Guinea 2006 Demographic and Health Survey (national)
Puerto Rico: National survey: Puerto Rico 2002 Behavioral Risk Factor Surveillance System
Portugal: National survey: Portugal 2005-2006 Inquirito Nacional de Sazde
Reunion: National survey: Reunion 1997 Enqujte DEMO97, volet Famille
Russian Federation: National survey: Russian Federation 2011 Reproductive Health Survey
Sudan: National survey: Sudan 2006 Household Health Survey
Singapore: National survey: Singapore 1997 National Family Planning and Population Survey
Solomon Islands: National survey: Solomon Islands 2006-2007 Demographic and Health Survey
Slovakia: National survey: Slovakia 1997 Reproductive Practices of Slovak Women
Sweden: National survey: Sweden 1996 National Survey on Sexual Behavior
Thailand: National survey: Thailand 2009 Reproductive Health Survey
Turkey: National survey: Turkey 2008 Demographic and Health Survey
Tuvalu: National survey: Tuvalu 2007 Demographic Health Survey (national)
Uruguay: National survey: Uruguay 2004 Encuesta Nacional sobre Reproduccisn Biologica y Social de la Poblacion
USA: National survey: United States of America 2006-2010 National Survey of Family Growth
Venezuela: National survey: Venezuela (Bolivarian Republic of) 1998 Encuesta Nacional de Poblacion y Familia
US Virgin Islands: National survey: United States Virgin Islands 2002 Behavioral Risk Factor Surveillance System
Viet Nam: National survey: Viet Nam 2011 Annual Population Change Survey

Figure 128: World HIV prevalence
Data accessed on 08 Sep 2015.

Estimates include all people with HIV infection, regardless of whether they have developed symptoms of AIDS.
Data sources:
For Afghanistan, Angola, Argentina, Armenia, Azerbaijan, Burundi, Benin, Burkina Faso, Bangladesh, Belarus, Belize, Bolivia, Brazil, Botswana, Central African Republic, Chile, Cte
dIvoire, Cameroon, DR Congo, Congo, Colombia, Cape Verde, Costa Rica, Cuba, Djibouti, Denmark, Dominican Republic, Algeria, Ecuador, Egypt, Eritrea, Ethiopia, Fiji, Gabon, Georgia,
Ghana, Guinea, Gambia, Guinea-Bissau, Equatorial Guinea, Guatemala, Guyana, Honduras, Haiti, Indonesia, Ireland, Iran, Jamaica, Kazakhstan, Kenya, Kyrgyzstan, Cambodia, Laos,
Lebanon, Liberia, Sri Lanka, Lesotho, Morocco, Republic of Moldova, Madagascar, Mexico, Mali, Myanmar, Mozambique, Namibia, Mauritania, Mauritius, Malawi, Malaysia, Niger, Nigeria,
Nicaragua, Norway, Nepal, Oman, Pakistan, Panama, Peru, Philippines, Papua New Guinea, Poland, Paraguay, Rwanda, Sudan, Senegal, Sierra Leone, El Salvador, Somalia, South Sudan,
Sao Tome & Principe, Suriname, Slovakia, Slovenia, Sweden, Swaziland, Syria, Chad, Togo, Thailand, Tajikistan, Tunisia, Tanzania, Uganda, Ukraine, Uruguay, Uzbekistan, Venezuela,
Viet Nam, Yemen, South Africa, Zambia, Zimbabwe: 2015 UNAIDS database [internet]. Available at: http://aidsinfo.unaids.org/ [Accessed on September 2015]
Albania, Australia, Bahamas, Barbados, Bhutan, Switzerland, Czech Republic, Germany, Spain, Estonia, United Kingdom, India, Italy, Maldives, Macedonia, Mongolia, Romania, Serbia,
Trinidad & Tobago: 2014 UNAIDS The GAP report. Available at: http://www.unaids.org/en/resources/documents/2014/20140716_UNAIDS_gap_report [Accessed on September
2015]

6 SEXUAL BEHAVIOUR AND REPRODUCTIVE HEALTH INDICATORS - 244 -
6 Sexual behaviour and reproductive health indicators

Sexual intercourse is the primary route of transmission of genital HPV infection. Information about
sexual and reproductive health behaviours is essential to the design of effective preventive strategies
against anogenital cancers. In this section, we describe sexual and reproductive health indicators that
may be used as proxy measures of risk for HPV infection and anogenital cancers. Several studies
have reported that earlier sexual debut is a risk factor for HPV infection, although the reason for this
relationship is still unclear. In this section, information on sexual and reproductive health behaviour in
the World is presented.
Figure 129: Percentage of 15-year-old girls who report sexual intercourse

For Bulgaria, Switzerland, Finland, France, Greece, Croatia, Iceland, Israel, Lithuania, Macedonia, Portugal, Romania, Russian Federation, Slovenia, Sweden, Ukraine: Indicates a
significant gender difference (at p<0.05).
Data sources: Currie C, Nic Gabhainn S, Godeau E, Roberts C, Smith R, Currie D, Pickett W, Richter M, Morgan A and Barnekow V (eds.) (2008) Inequalities in young peoples health:
HBSC international report from the 2005/06 Survey. Health Policy for Children and Adolescents, No. 5, WHO Regional Office for Europe, Copenhagen, Denmark.

7 HPV PREVENTIVE STRATEGIES - 245 -
7 HPV preventive strategies

It is established that well-organised cervical screening programmes or widespread good quality cytology
can reduce cervical cancer incidence and mortality. The introduction of HPV vaccination could also
effectively reduce the burden of cervical cancer in the coming decades. This section presents indicators
on basic characteristics and performance of cervical cancer screening, status of HPV vaccine licensure
and introduction in the World.
7.1 Cervical cancer screening practices

Screening strategies differ between countries. Some countries have population-based programmes,
where in each round of screening women in the target population are individually identified and in-
vited to attend screening. This type of programme can be implemented nationwide or only in specific
regions of the country. In opportunistic screening, invitations depend on the individuals decision or
on encounters with health-care providers. The most frequent method for cervical cancer screening is
cytology, and there are alternative methods such as HPV DNA tests and visual inspection with acetic
acid (VIA). VIA is an alternative to cytology-based screening in low-resource settings (the see and treat
approach). HPV DNA testing is being introduced into some countries as an adjunct to cytology screen-
ing (co-testing) or as the primary screening test to be followed by a secondary, more specific test, such
as cytology.
Figure 130: Worldwide status of cervical cancer screening programmes
Data accessed on 15 Oct 2015.

Availability of a cervical cancer screening program: Public national cervical cancer screening program in place (Cytology/VIA/HPV testing). Countries may have clinical guidelines or
protocols, and cervical cancer screening services in a private sector but without a public national program. Publicly mandated programs have a law, official regulation, decision, directive or
recommendation that provides the public mandate to implement the program with an authorised screening test, examination interval, target group and funding and co-payment determined.
Self-reported quality assurance: Organised programs provide for a national or regional team responsible for implementation and require providers to follow guidelines, rules, or standard
operating procedures. They also define a quality assurance structure and mandate supervision and monitoring of the screening process. To evaluate impact, organised programs also require
ascertainment of the population disease burden. Quality assurance consists of the management and coordination of the program throughout all levels of the screening process (invitation,
testing, diagnosis and follow-up of screen-positives) to assure that the program performs adequately and provides services that are effective and in-line with program standards. The quality
assurance structure is self-reported as part of the national cancer programs or plans. For some countries when less than 50% of its regions havent had a quality assurance plan, the country
is categorised as not having quality assurance.
Note: For more detail information, please read the country report.

Table 30: Cervical cancer screening policies
Country Availability Quality Active Main Demonstration Screening Screening

of cervical assurance invitation screening projects ages interval or
cancer structure to test used (years) frequency
screening and screening for of
programme mandate primary screenings
to screening
supervise
and to
monitor
the
screening
process
Africa - - - - - - -
Algeria Yes Yes No Cytology 25/30-60/65 3 Years
Angola No - - - VIA - -
Benin Yes No No Cytology VIA - -
Botswana Yes No No VIA 30-49 5 years
Burkina Faso Yes No No Cytology VIA - -
Burundi No - - - - -
Cameroon Yes No No Cytology/VIA - -
Cape Verde Yes No No Cytology/VIA 20-49 -
CAR No - - - - -
Chad No - - - - -
Comoros No - - - - -
Congo No - - - VIA - -
Cte dIvoire Yes No No Cytology/VIA 30-50 (VIA), -
unknown
(cytology)
Djibouti No - - - - -
DR Congo No - - - - -
Egypt Yes No No Cytology 20-50 -
Eq. Guinea No - - - - -
Eritrea No - - - - -
Ethiopia No - - - VIA - -
Gabon Yes Yes No VIA Above 25 3 years
Gambia Yes No No - VIA - -
Ghana Yes No No VIA/Cytology 25 to 45 3-5 years
(VIA)/Above
45
(cytology)
Guinea No - - - VIA pilot - -
program in
Khorira and
Conakry (2003)
and Faranah
Kankan and
Siguiri (2005)
Guinea-Bissau No - - - - -
Kenya Yes No No VIA/Cytology 25-49 5 years
Lesotho Yes - - VIA - -
Liberia No - - - - -
Libya No - - - - -
Madagascar Yes No No VIA 30-50 3-5 years
Malawi Yes No No VIA 30-50 3-5 years
Mali No - - - VIA pilot - -
program for
women ages
30-59 (interval
3-5 years)
Mauritania No - - - VIA - -
Mauritius Yes No No VIA 35-55/60 5 years


to screening
supervise
and to
monitor
the
screening
process
Morocco Yes Yes No VIA 30-50 3 years
Mozambique Yes - - VIA 30-55 -
Namibia Yes No No Cytology VIA 21-64 1 year
(cytology)
Niger Yes - - VIA - -
Nigeria No - - - VIA pilot - -
program for
women between
30-50 years
(interval 3-5
years)
Rwanda Yes - - HPV - 35-45 7 years
test/VIA (if
positive
HPV test)
S.Tome & Prin. No - - - - -
Senegal Yes No No Cytology VIA 25-65 2 year
(cytology)
Seychelles Yes - - Cytology Sexually 2 years
active (not
specified
age)
Sierra Leone No - - - VIA - -
Somalia No - - - - -
South Africa Yes No No Cytology VIA Above 30 10 years
South Sudan No - - - - -
Sudan No - - - VIA pilot - -
program in
Khartoum
(2009-2010)
Swaziland Yes - No VIA/Cytology 25-45 2 years
Tanzania Yes No No VIA 30-50 3 years
Togo Yes No No Cytology VIA 35-65 -
(cytology)
Tunisia Yes Yes No Cytology 35-65 5 Years
Uganda Yes No No VIA/Cytology HPV test 25-65 3 years
(cytology),
25-49 (VIA)
Zambia Yes No No VIA 25-49 3-5 years
Zimbabwe Yes No No VIA 25-59 3 years
Americas - - - - - - -
Antigua & Bar. - - - - - -
Argentina Yes Yes Yes Cytology/HPV 35-64 Cytology
test (cytology), every 3
above 30 years after
(HPV test) 2
consecutive
annual
negative
tests. HPV
test every 3
years
Bahamas Yes No No Cytology Above 21 1 year


to screening
supervise
and to
monitor
the
screening
process
Barbados Yes No No Cytology 21-65 3 years
(ages
21-49), 5
years (ages
50-65)
Belize Yes No No Cytology 21-55 3 years
after 3
consecutive
annual
negative
tests
Bolivia Yes Yes No Cytology/VIA 25-64 3 years
after 2
consecutive
annual
negative
tests
Brazil Yes Yes No Cytology 25-64 3 years
after 2
consecutive
annual
negative
tests
Canada Yes Yes. Varies No. Varies Cytology HPV test 21-65/69/70 Varies by
by region by region varies by regions:
region Manitoba,
Ontario,
Qubec,
Nova
Scotia:
every 3
years (ages
21- 65/69).
Prince
Edward
island:
every 2
years (ages
21-65 ).
Other
regions
every 2-3
years (ages
21-70) after
3
consecutive
annual
negative
tests
Chile Yes Yes No Cytology 25-64 3 years


to screening
supervise
and to
monitor
the
screening
process
Colombia Yes No No Cytology/VIA/HPV 25-69 Cytology
30-50 (VIA), years after
30-69 (HPV 2
test) consecutive
annual
negative
tests. VIA
every 3
years. HPV
test every 5
years
Costa Rica Yes No No Cytology Above 20 1 year
Cuba Yes No No Cytology 25-64 3 years
Dominica Yes No No Cytology 15-59 -
Dominican Rep. Yes No No Cytology/HPV 35-64 Cytology
test every 1 year
Ecuador Yes No No Cytology 35-64 5 years
El Salvador Yes No No Cytology/VIA HPV test 30-59 2 years
Grenada Yes - - Cytology VIA - -
Guatemala Yes No No Cytology/VIA 25-54 3 years
Guyana Yes No No Cytology/VIA 25-49 -
Haiti Yes No No Cytology VIA - -
Honduras Yes Yes No Cytology VIA 30-59 3 years
(cytology) after 2
consecutive
annual
negative
tests
Jamaica Yes No No Cytology 25-54 3 years
after 2
consecutive
annual
negative
tests
Mexico Yes Yes No Cytology/HPV 25-64 Cytology
test every 3
years after
2
consecutive
annual
negative
tests
Nicaragua Yes Yes No Cytology/VIA HPV test 25-64 Cytology/VIA
(cytology), every 3
30-50 (VIA) years after
3
consecutive
annual
negative
tests


to screening
supervise
and to
monitor
the
screening
process
Panama Yes No No Cytology/VIA 25-59 3 years
after 3
consecutive
annual
negative
tests
Paraguay Yes Yes No Cytology/VIA HPV test 25-49 Cytology/VIA
every 3
years after
3
consecutive
annual
negative
tests
Peru Yes Yes Yes Cytology/VIA HPV test PAP/VIA: Cytology/VIA
30-49 every 3
years
St Kitts & Nev. Yes No No Cytology Sexually 3 years
active (not after 2
specified consecutive
age) annual
negative
tests
St Lucia Yes - - Cytology VIA - -
St Vincent Yes No No Cytology 20-65 3 years
after 2
consecutive
annual
negative
tests
Suriname Yes No No Cytology/VIA 23-55 2 years
Trinidad & Tob. Yes No No Cytology Sexually 1 year
active (not
specified
age)
Uruguay Yes Yes No Cytology 21-69 3 years
after 2
consecutive
annual
negative
tests
USA Yes Yes only in No Cytology/HPV 21-65 3 years
NBCCED test (cytology), (cytology), 5
Program over 30 years (HPV
(HPV test) test)
Venezuela Yes No No Cytology 25-64 3 years
Asia - - - - - - -
Afghanistan Yes No No Cytology VIA 15-49 5 years
Armenia Yes No No Cytology 30-60 3 years
Azerbaijan No - - - - -
Bahrain Yes No No Cytology 30-65 3 years
after 2-3
consecu-
tives annual
negative
tests


to screening
supervise
and to
monitor
the
screening
process
Bangladesh Yes No No VIA Above 30 -
Bhutan No - - - VIA - -
Brunei Yes No Yes Cytology 22-65 3 years
Cambodia Yes No No VIA 30-49 5 years
China Yes No No Cytology HPV test 30-59 Cytology
/VIA every 3
years (ages
35-59). VIA
in rural
women
(ages 30-54)
DPR Korea Yes No No Cytology 30-60 1 year
Georgia Yes No No Cytology HPV test 25-60 3 years
India Yes No No Cytology VIA/HPV test 35-64 3 years
(cytology)
Indonesia Yes Yes No VIA 30-50 5 years
Iran Yes No No Cytology Married 3 years
after 3
consecutive
annual
negative
tests
Iraq Yes - - - Above 20 -
Israel Yes No No Cytology 35-54 3 years
Japan Yes Yes Yes Cytology Above 20 2 years
Jordan Yes No No Cytology 25-35 -
Kazakhstan Yes No No Cytology 30-60 5 years
Kuwait Yes No No Cytology Married 5 years
Kyrgyzstan Yes No No Cytology - 5 year
Laos No - - - - -
Lebanon Yes No No Cytology 3 years 2-3 years
after
becoming
sexually
active
Malaysia Yes No No Cytology 20-65 3 years
Maldives Yes - - VIA 30-50 5 years
Mongolia Yes No No VIA 30-60 3 years
Myanmar No - - - VIA - -
Nepal Yes No No VIA 30-60 5 years
Oman Yes No No Cytology 20-69 3 Years
Pakistan Yes No No VIA 30-60 5 years
Philippines Yes No No VIA 25-55 5-7 years
Qatar Yes No No Cytology 21-65 1 year
Rep. Korea Yes No No Cytology Above 30 2 years
Saudi Arabia Yes No No Cytology 21-65 3 Years
(married
women)
Singapore Yes No No Cytology 25-69 3 years
Sri Lanka Yes No No Cytology 30-65 5 years


to screening
supervise
and to
monitor
the
screening
process
Syria Yes No No Cytology 15-55 -
Tajikistan Yes No No Cytology Above 20 -
Thailand Yes Yes No Cytology/VIA 30-65 5 years
Timor-Leste No - - - - -
Turkey Yes Yes Yes Cytology VIA 30-65 5 Years
(cytology)
Turkmenistan Yes No No Cytology Above 20 1 year
UAE Yes No No Cytology 30-64 3 years
Uzbekistan Yes No No Cytology 25-49 -
Viet Nam Yes - No Cytology/VIA - -
Yemen No - - - - -
Europe - - - - - - -
Albania Yes No No Cytology Above 20 2-3 Years
Andorra Yes No No Cytology - -
Austria Yes No No Cytology Above 18 1 year
Belarus Yes No No Cytology Above 18 1 year
Belgium Yes No. Varies No Cytology 25-64 3 years
by region
Bosnia & H. Yes Yes No Cytology 21-70 1 year
Bulgaria Yes No No Cytology 30-59 3 years
Croatia Yes Yes No Cytology 25-64 3 years
Cyprus Yes No No Cytology 24-65 -
Czech Rep. Yes Yes No Cytology 25-60 1 year
Denmark Yes Yes Yes Cytology 23-65 3 years
(ages
23-49), 5
years (ages
50-65)
Estonia Yes Yes Yes Cytology 30-59 5 years
Finland Yes Yes Yes Cytology 30-60 5 years
France Yes Yes Yes Cytology 25-65 3 years
Germany Yes No No Cytology HPV test Above 20 1 year
Greece Yes No No Cytology Above 20 1 year
Hungary Yes Yes Yes Cytology 25-65 3 years
Iceland Yes Yes Yes Cytology 20-69 2 years
(ages
20-39), 4
years (ages
40-69)
Ireland Yes Yes Yes Cytology 25-60 3 years
(ages
25-44), 5
years (ages
45-60)
Italy Yes Yes Yes Cytology/HPV 25-64 3 years
test (Cytology),
5 years
(HPV test)
Latvia Yes Yes Yes Cytology 25-70 3 years


to screening
supervise
and to
monitor
the
screening
process
Lithuania Yes Yes Yes Cytology 25-60 3 years
Luxembourg Yes No No Cytology Above 15 1 year
Macedonia Yes No No Cytology 30-55 3 years
Malta Yes Yes Yes Cytology/HPV Above 25 Cytology
Above 30 years (ages
(HPV test) 25-50), VIA
every 5
years (above
50 years
old). HPV
test every 5
years
Moldova Yes No No Cytology Above 20 2 years
Monaco Yes - No Cytology 21-65 3 years
after 2
consecutive
annual
negative
tests
Montenegro Yes Yes No Cytology 25-64 3 years
Netherlands Yes Yes Yes Cytology/HPV 30-60 5 years
test
Norway Yes Yes Yes Cytology 25-69 3 years
Poland Yes Yes Yes Cytology 25-59 3 years
Portugal Yes Yes Yes Cytology 25-64 3 years
Romania Yes Yes Yes Cytology 25-64 5 years
Russia Yes No No Cytology Above 18 1 year
San Marino Yes - Yes Cytology/HPV 25-30 3 years
test (cytology), (cytology), 5
30-65 (HPV years (HPV
test) test)
Serbia Yes Yes Yes Cytology 25-65 3 years
Slovakia Yes No No Cytology 23-64 3 years
Slovenia Yes Yes Yes Cytology 20-64 3 years
Spain Yes No. Varies No. Varies Cytology/HPV 25-65 3 years
by region by region test (cytology), (cytology), 5
test) test)
Sweden Yes Yes Yes Cytology 23-60 3 years
(ages
23-50), 5
years (ages
50-60)
Switzerland Yes No No Cytology Above 20 3 years
UK Yes Yes Yes Cytology/HPV 25-64 3 years
test (ages
25-49), 5
years (ages
50-64)
Ukraine Yes No No Cytology 18-65 1 year
Oceania - - - - - - -


to screening
supervise
and to
monitor
the
screening
process
Australia Yes Yes Yes Cytology HPV test 18-69 2 years
(cytology), (cytology), 5
test) test)
Fiji Yes No No Cytology VIA 25-60 3 Years
(cytology),
30-49 (VIA)
FS Micronesia Yes No No Cytology/VIA 25-49 5 years
Kiribati Yes - - Cytology/VIA - -
Marshall Is. Yes - - VIA/Cytology 21-50 (VIA), 2 years
50-60 (VIA)
(cytology)
Nauru Yes No No Cytology - -
New Zealand Yes Yes Yes Cytology/HPV 20-70 3 years
test) test)
Palau Yes No No Cytology/HPV 21-65 3 years
over 30 years (HPV
(HPV test) test)
Papua N. Guinea Yes No No - - -
Samoa No - - - - -
Solomon Is. No - - - - -
Tonga No - - - - -
Tuvalu No - - - - -
Vanuatu No - - - VIA - -
Data accessed on 15 Oct 2015.
a CDCs National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screenings and diagnostic services to low-income, uninsured, and
underinsured women across the United States, since 1990. USA-Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below
250% of federal poverty level; ages 21 to 64 for cervical cancer screening.
Public national cervical cancer screening program in place (Cytology/VIA/HPV testing). Countries may have clinical guidelines or protocols, and cervical cancer screening services in a
private sector but without a public national program. Publicly mandated programmes have a law, official regulation, decision, directive or recommendation that provides the public mandate
to implement the programme with an authorised screening test, examination interval, target group and funding and co-payment determined.
Self-reported quality assurance: Organised programmes provide for a national or regional team responsible for implementation and require providers to follow guidelines, rules, or standard
operating procedures. They also define a quality assurance structure and mandate supervision and monitoring of the screening process. To evaluate impact, organised programmes also
require ascertainment of the population disease burden. Quality assurance consists of the management and coordination of the programme throughout all levels of the screening process
(invitation, testing, diagnosis and follow-up of screen-positives) to assure that the programme performs adequately and provides services that are effective and in-line with programme
standards. The quality assurance structure is self-reported as part of the national cancer programs or plans.
Self-reported active invitation or recruitment, as organised population-based programmes, identify and personally invite each eligible person in the target population to attend a given
round of screening.
Data sources are detailed at the country-specific report.

7.2 HPV vaccination

7.2.1 HPV vaccine licensure and introduction
Figure 131: Worldwide status of HPV vaccination programmes

Data sources: Cervical Cancer Action: a global Coalition to stop Cervical Cancer (CCa). Progress In Cervical Cancer Prevention: The CCA Report card. Update August 2015, available
at http://www.cervicalcanceraction.org/pubs/pubs.php. Annual WHO/UNICEF Joint Reporting Form (Update of 2015/July/15). Geneva, Immunization, Vaccines and Biologicals
(IVB), World Health Organization. Available at: http://www.who.int/immunization/monitoring_surveillance/en/ Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS,
Brotherton JM. Human papillomavirus vaccine introductionthe first five years. Vaccine. 2012 Nov 20;30 Suppl 5:F139-48.

Table 31: HPV vaccination policies for the female population

Routine Immunization
Country HPV vaccination Date of start Target age Full course HPV%(period)
programme
Afghanistan No Program - - -
Albania No Program - - -
Algeria No Program - - -
Andorra National program - 12 -
Angola Pilot program - - -
Antigua & Barbuda No Program - - -
Argentina National program 2011 11 50% (2013)
Armenia No Program - - -
Australia National program 2007 12-13 73.1 (2014)
Austria National program 2006 9 -
Azerbaijan No Program - - -
Bahamas National program - - -
Bahrain No Program - - -
Bangladesh Pilot program - - -
Barbados National program - 11 -
Belarus No Program - - -
Belgium National program 2007 12-13 Varies by region: 29-82% (2012)
Belize National program 2014 - -
Benin Pilot program - - -
Bhutan National program 2010 12 92% (2010)
Bolivia Pilot program - - -
Bosnia & Herzegovina No Program - - -
Botswana National program - - -
Brazil National program 2014 9 -
Brunei National program 2012-2015 12-13 -
Bulgaria National program 2012 12 -
Burkina Faso Pilot program - - -
Burundi Pilot program - - -
Cambodia Pilot program - - -
Cameroon Pilot program - - -
Canada National program 2007-2009 9-14 Ranges from 60 to 85% by region (2013)1
Cape Verde No Program - - -
Central African Republic No Program 2016 - -
Chad No Program - - -
Chile National program 2014 9 -
China No Program - - -
Colombia National program 2011 9-17 87% (2013)
Comoros No Program - - -
Congo No Program - - -
Costa Rica No Program - - -
Cte dIvoire Pilot program - - -
Croatia No Program - 15-26 -
Cuba No Program - - -
Cyprus No Program - - -
Czech Republic National program 2012 13 -
Denmark National program 2009 12 82% (2015)
Djibouti No Program - - -
Dominica No Program - - -
Dominican Republic National program 2014 - -
DPR Korea No Program - - -
DR Congo No Program - - -
Ecuador National program - 9 -
Egypt No Program - - -


programme
El Salvador No Program - - -
Equatorial Guinea No Program - - -
Eritrea No Program - - -
Estonia No Program - - -
Ethiopia Pilot program - - -
Fiji National program 2008 13 -
Finland National program 2013 11-12 68% (2015)
France National program 2007 11-14 25.0-29.3 (2012)2
FS Micronesia National program 2009 9 -
Gabon No Program - - -
Gambia Pilot program - - -
Georgia Pilot program - 10-13 -
Germany National program 2007 9-14 40% (2012)
Ghana Pilot program - - -
Greece National program 2008 11-18 Varies by source: 5-27% (2011)
Grenada No Program - - -
Guatemala No Program - - -
Guinea No Program - - -
Guinea-Bissau No Program - - -
Guyana National program 2011 11 -
Haiti Pilot program - - -
Honduras Pilot program - - -
Hungary National program - 12 -
Iceland National program 2011 12 88% (2014)
India Pilot program - - -
Indonesia Pilot program - - -
Iran No Program - - -
Iraq No Program - - -
Ireland National program 2010 12-13 84.9% (2014)
Israel National program 2013 13 -
Italy National program 2007-2008 12 71% (2014)
Jamaica No Program - - -
Japan National program 2011 13 0.6% (2014 in Sapporo
Jordan No Program - - -
Kazakhstan No Program - - -
Kenya Pilot program - - -
Kiribati National program 2011 9-13 -
Kuwait No Program - - -
Kyrgyzstan No Program - - -
Laos Pilot program - - -
Latvia National program 2010 12 60.6 (2011)3
Lebanon No Program - - -
Lesotho National program 2012 9-13 -
Liberia Pilot program - - -
Libya National program 2013 15 -
Liechtenstein - - - -
Lithuania No Program - - -
Luxembourg National program 2008 12-18 17% (2009)
Macedonia National program 2010 12 65% (2012)
Madagascar Pilot program - - -
Malawi Pilot program 2013 9-13 -
Malaysia National program 2010 13 87%(2011)


programme
Maldives No Program - - -
Mali Pilot program - - -
Malta National program 2012 12 -
Marshall Islands National program 2008 11-12 -
Mauritania No Program - - -
Mauritius No Program - - -
Mexico National program 2008 10 67% (2010)
Monaco National program 2011 14 -
Mongolia Pilot program - - -
Montenegro No Program - - -
Morocco No Program - - -
Mozambique Pilot program 2014 - -
Myanmar No Program - - -
Namibia No Program - - -
Nauru No Program - - -
Nepal Pilot program - - -
Netherlands National program 2010 12 61% (2014)
New Zealand National program 2008 12 56% (2014)
Nicaragua No Program - - -
Niger Pilot program - - -
Nigeria No Program - - -
Norway National program 2009 12 79% (2014)
Oman No Program - - -
Pakistan No Program - - -
Palau National program 2009 9-26 -
Palestine - - - -
Panama National program 2008 10 67% (2010)
Papua New Guinea Pilot program - - -
Paraguay National program 2013 10 -
Peru National program 2011 10 -
Philippines National program - - -
Poland No Program - - -
Portugal National program 2009 13 87% (2015)
Qatar No Program - - -
Republic of Korea No Program - - -
Republic of Moldova Pilot program - 9-15 -
Romania National program 2010 12 <5%3
Russian Federation No Program - 11-14 -
Rwanda National program 2011 11-12 99% (2013)
Samoa No Program - - -
San Marino National program 2009 11 -
Sao Tome & Principe Pilot program - - -
Saudi Arabia No Program - - -
Senegal Pilot program - - -
Serbia No Program - - -
Seychelles National program 2014 10-12 -
Sierra Leone Pilot program - - -
Singapore National program 2010 9-26 -
Slovakia No Program - - -
Slovenia National program 2009 12 49% (2012)
Solomon Islands Pilot program - - -
Somalia No Program - - -


programme
South Africa National program 2014 9 87% (First dose
South Sudan No Program - - -
Spain National program 2008 11-14 73% (2014)
Sri Lanka No Program - - -
St Kitts & Nevis No Program - - -
St Lucia No Program - - -
St Vincent & The No Program - - -
Grenadines
Sudan No Program - - -
Suriname National program 2013 9 -
Swaziland No Program - - -
Sweden National program 2012 10-12 80% (2014)
Switzerland National program 2008 11-14 51% (2013)
Syria No Program - - -
Taiwan - - - -
Tajikistan No Program - - -
Tanzania Pilot program - - -
Thailand Pilot program - - -
Timor-Leste No Program - - -
Togo Pilot program 2014 - -
Tonga No Program - - -
Trinidad & Tobago National program 2013 11-12 -
Tunisia No Program - - -
Turkey No Program - - -
Turkmenistan No Program - - -
Tuvalu No Program - - -
Uganda National program 2012 10 -
Ukraine No Program - - -
United Arab Emirates National program 2008 15-17 59% (2011)
United Kingdom National program 2008 12-13 86% (2014)
Uruguay National program 2013 12 -
USA National program 2006 11-12 39.7% (2014)
Uzbekistan National program 2015 - -
Vanuatu National program - - -
Venezuela No Program - - -
Viet Nam Pilot program - - -
Western Sahara - - - -
Yemen No Program - - -
Zambia Pilot program - - -
Zimbabwe Pilot program 2014 - -
Data sources:
Cervical Cancer Action: a global Coalition to stop Cervical Cancer (CCa). Progress In Cervical Cancer Prevention: The CCA Report card. Update August 2015, available at http:
//www.cervicalcanceraction.org/pubs/pubs.php.
Annual WHO/UNICEF Joint Reporting Form (Update of 2015/July/15). Geneva, Immunization, Vaccines and Biologicals (IVB), World Health Organization. Available at: http://www.who.
int/immunization/monitoring_surveillance/en/
Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS, Brotherton JM. Human papillomavirus vaccine introductionthe first five years. Vaccine. 2012 Nov 20;30 Suppl 5:F139-
48. 1 Saraiya M, Steben M, Watson M, Markowitz L.Evolution of cervical cancer screening and prevention in United States and Canada: Implications for public health practitioners and
clinicians. Prev Med. 2013;57(5):426-33.
2 Lchantillon gnraliste des bnficiaires (EGB): La couverture vaccinale chez le vaccin contre le VPH pour les filles et de trois doses. Update 31/12/12.
3 Poljak M, Seme K, Maver PJ, Kocjana BJ, Cuschierib KS, Rogovskayac S, et al. Human Papillomavirus Prevalence and Type-Distribution, Cervical Cancer Screening Practices and Current
Status of Vaccination Implementation in Central and Eastern Europe. Vaccine (2013), http://dx.doi.org/10.1016/j.vaccine.2013.03.029

8 PROTECTIVE FACTORS FOR CERVICAL CANCER - 260 -
8 Protective factors for cervical cancer

Male circumcision and the use of condoms have shown a significant protective effect against HPV transmission.
Figure 132: Worldwide prevalence of male circumcision

Data from Demographic and Health Surveys (DHS) and other publications to categorise the country-wide prevalence of male circumcision as <20%, 20-80%, or >80%.
Please refer to country-specific reference(s) for full methodologies.
Data sources: Based on systematic reviews and meta-analysis performed by ICO. The ICO HPV Information Centre has updated data until August 2015. Reference publication: Albero G,
Sex Transm Dis. 2012 Feb;39(2):104-13.
For Afghanistan, Bulgaria, Bosnia & Herzegovina, Belize, Bolivia, Bhutan, Cape Verde, Algeria, Ecuador, Egypt, Fiji, FS Micronesia, Georgia, Guatemala, Honduras, Indonesia, Iran,
Jordan, Kazakhstan, Laos, Lebanon, Libya, Sri Lanka, Morocco, Maldives, Macedonia, Myanmar, Montenegro, Mongolia, Mauritius, Nicaragua, Nepal, Oman, Pakistan, Panama, Peru,
Papua New Guinea, DPR Korea, Paraguay, Romania, Russian Federation, Saudi Arabia, Solomon Islands, El Salvador, Serbia, Suriname, Syria, Tajikistan, Turkmenistan, Tunisia, Turkey,
Uzbekistan, Venezuela, Viet Nam, Samoa, Yemen: Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
acceptability
Angola, Botswana, Central African Republic, Djibouti, Eritrea, Gambia, Guinea-Bissau, Equatorial Guinea, Mauritania, Sudan, Somalia: Drain PK, BMC Infect Dis 2006; 6: 172 | WHO
2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Albania, Madagascar: 2008 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of
prevalence, safety and acceptability
United Arab Emirates, Argentina, Armenia, Austria, Bahrain, Belarus, Brunei, Switzerland, Chile, Costa Rica, Cuba, Cyprus, Czech Republic, Estonia, Finland, France, Greece, Hungary,
Iceland, Israel, Italy, Kuwait, Lithuania, Latvia, Netherlands, Norway, Poland, Portugal, Qatar, Slovakia, Sweden, Trinidad & Tobago, Taiwan, Uruguay: WHO 2007: Male circumcision:
Global trends and determinants of prevalence, safety and acceptability
Australia: Donovan B, Genitourin Med 1994; 70: 317 | Ferris JA, Aust N Z J Public Health 2010; 34: 160 | Parker SW, Med J Aust 1983; 2: 288 | WHO 2007: Male circumcision: Global
trends and determinants of prevalence, safety and acceptability
Azerbaijan, Haiti, India: 2006 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of
prevalence, safety and acceptability
Burundi, Burkina Faso, Malawi, Rwanda, Tanzania, Zimbabwe: 2010 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision:
Global trends and determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Belgium: Bronselaer GA, BJU Int 2013; 111: 820 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Benin: 2012 Demographic and Health Surveys (DHS) | Auvert B, AIDS 2001; 15 Suppl 4: S31 | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and
determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Bangladesh: Ashraf H, BMC Infect Dis 2010; 10: 208 | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
acceptability
Brazil: Castellsagu X, Am J Epidemiol 2005; 162: 907 | Drain PK, BMC Infect Dis 2006; 6: 172 | Giuliano AR, Cancer Epidemiol Biomarkers Prev 2008; 17: 2036 | WHO 2007: Male
circumcision: Global trends and determinants of prevalence, safety and acceptability
Canada: Ogilvie GS, Sex Transm Infect 2009; 85: 221 | Quayle SS, J Urol 2003; 170: 1533 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
acceptability
China: Drain PK, BMC Infect Dis 2006; 6: 172 | Wan S, Pediatrics 2014; 133: e624 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
| Zeng Y, Biomed Res Int 2014; 2014: 498987
Cte dIvoire, Gabon, Mali: 2012 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of
prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Cameroon: 2011 Demographic and Health Surveys (DHS) | Auvert B, AIDS 2001; 15 Suppl 4: S31 | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends
and determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
DR Congo: 2007 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability | Williams BG, PLoS Med 2006; 3: e262
Congo, Ethiopia, Mozambique: 2011 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of
prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Colombia, Philippines, Thailand: Castellsagu X, Am J Epidemiol 2005; 162: 907 | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants
of prevalence, safety and acceptability
Comoros: 2012 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability
Germany: Hoschke B, Urologe A 2013; 52: 562 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Denmark: Frisch M, BMJ 1995; 311: 1471 | Frisch M, J R Soc Med 2015; 108: 297 | Svare EI, Sex Transm Infect 2002; 78: 215 | WHO 2007: Male circumcision: Global trends and
determinants of prevalence, safety and acceptability
Dominican Republic: 2013 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence,
safety and acceptability
Spain: Canadas MP, Clin Microbiol Infect 2013; 19: 611 | Castellsagu X, Am J Epidemiol 2005; 162: 907 | WHO 2007: Male circumcision: Global trends and determinants of prevalence,
safety and acceptability
United Kingdom: Cathcart P, Br J Surg 2006; 93: 885 | Dave SS, Sex Transm Infect 2003; 79: 499 | Doerner R, Arch Sex Behav 2013; 42: 1319 | Oriel JD, Br J Vener Dis 1971; 47: 1 |
Rickwood AM, BMJ 2000; 321: 792 | Thornton AC, Sex Transm Dis 2011; 38: 928 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Ghana: 2008 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
acceptability | Williams BG, PLoS Med 2006; 3: e262
Guinea, Senegal: 2005 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence,
safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Guyana: 2009 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability
Ireland: Groves H, Ulster Med J 2010; 79: 80 | Ryan C, J Am Acad Dermatol 2015; 72: 978 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
acceptability
Iraq: Drain PK, BMC Infect Dis 2006; 6: 172 | Naji H, Front Med 2013; 7: 122 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Jamaica: Drain PK, BMC Infect Dis 2006; 6: 172 | Figueroa JP, West Indian Med J 2010; 59: 351 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability


Japan: WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability | Yamagishi T, Sex Transm Infect 2012; 88: 534
Kenya: 2008 Demographic and Health Surveys (DHS) | Auvert B, AIDS 2001; 15 Suppl 4: S31 | Drain PK, BMC Infect Dis 2006; 6: 172 | Lavreys L, J Infect Dis 1999; 180: 330 | Ngayo
MO, Sex Transm Infect 2008; 84: 62 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Kyrgyzstan: 2012 Demographic and Health Surveys (DHS) | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Cambodia, Republic of Moldova: 2005 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants
of prevalence, safety and acceptability
Republic of Korea: Ku JH, Sex Transm Infect 2003; 79: 65 | Shin HR, J Infect Dis 2004; 190: 468 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability
Liberia, Namibia, Nigeria, Sierra Leone, Togo: 2013 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and
determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Lesotho: 2009 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability | Williams BG, PLoS Med 2006; 3: e262
Mexico: Giuliano AR, Cancer Epidemiol Biomarkers Prev 2008; 17: 2036 | Lajous M, Cancer Epidemiol Biomarkers Prev 2005; 14: 1710 | Vaccarella S, Cancer Epidemiol Biomarkers Prev
2006; 15: 326 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Malaysia: Drain PK, BMC Infect Dis 2006; 6: 172 | Tang WS, J Sex Med 2011; 8: 2071 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
acceptability
Niger, Swaziland: 2006 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence,
safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
New Zealand: Dickson N, Sex Transm Dis 2005; 32: 517 | Fergusson DM, Pediatrics 2006; 118: 1971 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability
Slovenia: Klavs I, Sex Transm Infect 2008; 84: 49 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Chad: 2004 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
Timor-Leste: 2009 Demographic and Health Surveys (DHS) | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and acceptability
Uganda: 2011 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | Tobian AA, N Engl J Med 2009; 360: 1298 | WHO 2007: Male circumcision: Global
trends and determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262
Ukraine: 2007 Demographic and Health Surveys (DHS) | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety
and acceptability
USA: Baldwin SB, Sex Transm Dis 2004; 31: 601 | Cook LS, Am J Public Health 1994; 84: 197 | Giuliano AR, Cancer Epidemiol Biomarkers Prev 2008; 17: 2036 | Hernandez BY, J Infect
Dis 2008; 197: 787 | Lu B, J Infect Dis 2009; 199: 362 | McKinney CM, Sex Transm Dis 2008; 35: 814 | Nelson CP, J Urol 2005; 173: 978 | Nielson CM, Cancer Epidemiol Biomarkers Prev
2007; 16: 1107 | Partridge JM, J Infect Dis 2007; 196: 1128 | Ryan C, J Am Acad Dermatol 2015; 72: 978 | Weaver BA, J Infect Dis 2004; 189: 677 | WHO 2007: Male circumcision: Global
trends and determinants of prevalence, safety and acceptability
South Africa: Auvert B, J Infect Dis 2009; 199: 14 | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends and determinants of prevalence, safety and
Zambia: 2013 Demographic and Health Surveys (DHS) | Auvert B, AIDS 2001; 15 Suppl 4: S31 | Drain PK, BMC Infect Dis 2006; 6: 172 | WHO 2007: Male circumcision: Global trends
and determinants of prevalence, safety and acceptability | Williams BG, PLoS Med 2006; 3: e262

Figure 133: Worldwide prevalence of condom use

Condom use: Proportion of male partners who are using condoms with their female partners of reproductive age (15-49 years) to whom they are married or in union by country.
For Anguilla, Croatia: Data pertain to methods used during the last two months.
For United Arab Emirates, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia: Data pertain to nationals of the country.
For Chile: Data pertain to men and women of reproductive age.
For Cook Islands, Greece, Grenada, Guam, Hungary, Italy, Latvia, Mauritania, Mauritius, Malaysia, New Zealand, Poland, Puerto Rico, Reunion, Singapore, Slovenia: Adjusted.
For Comoros, Gambia, Guatemala, Liberia, Mali, Nicaragua, Sierra Leone: Preliminary data.
For United Kingdom: Excluding Northern Ireland.
For Israel: Data pertain to the Jewish population.
For Republic of Korea, Sudan, Uruguay: Estimate.
For Sri Lanka: Excluding the Northern Province.
For Malaysia: Data pertain to Peninsular Malaysia.
For Sweden, Uruguay: Data pertain to methods used at last sex.
For Uruguay: Data pertain to men and women of reproductive age who are married or in a union.
Data sources: United Nations, Department of Economic and Social Affairs, Population Division (2014). World Contraceptive Use 2014 (POP/DB/CP/Rev2014). Available at http://www.un.
org/en/development/desa/population/publications/dataset/contraception/wcu2014.shtml
For Afghanistan, Bosnia & Herzegovina, Belarus, Belize, Bhutan, Central African Republic, DR Congo, Costa Rica, Cuba, Djibouti, Algeria, Guinea-Bissau, Iraq, Kazakhstan, Macedonia,
Myanmar, Montenegro, Mongolia, Mauritania, Palestine, Somalia, Serbia, South Sudan, Suriname, Swaziland, Chad, Togo, Turkmenistan, Trinidad & Tobago, Tunisia, Ukraine, Uzbekistan,
Vanuatu, Yemen: Multiple Indicator Cluster Survey (MICS).
Angola: National survey: Angola 2008-2009 Inquerito Integrado Sobre o Bem-estar da Populacio (IBEP).
Anguilla: National survey: Anguilla 2003 Reproductive Health Survey.
Albania, Armenia, Azerbaijan, Burundi, Benin, Burkina Faso, Bangladesh, Bolivia, Cte dIvoire, Cameroon, Congo, Colombia, Cape Verde, Dominican Republic, Egypt, Eritrea, Ethiopia,
Gabon, Guinea, Gambia, Equatorial Guinea, Guyana, Honduras, Indonesia, Jordan, Kenya, Kyrgyzstan, Cambodia, Liberia, Sri Lanka, Lesotho, Morocco, Republic of Moldova, Madagascar,
Maldives, Mali, Mozambique, Malawi, Namibia, Niger, Nigeria, Nicaragua, Nepal, Pakistan, Peru, Rwanda, Senegal, Sierra Leone, Sao Tome & Principe, Tajikistan, Timor-Leste, Tanzania,
Uganda, Samoa, South Africa, Zambia, Zimbabwe: Demographic and Health Survey (DHS).
United Arab Emirates, Bahrain, Qatar, Saudi Arabia: Gulf Family Health Survey (GFHS).
Argentina: National survey: Argentina 2004-2005 National Nutrition and Health Survey.
Antigua & Barbuda: Contraceptive Prevalence Survey (CPS).
Australia: National survey: Household, Income and Labour Dynamics in Australia (HILDA) survey, 2005.
Austria, Belgium, Bulgaria, Czech Republic, Germany, Estonia, France, Lithuania, Romania: Generations and Gender Survey (GGS).
Bahamas, Barbados, Dominica, St Kitts & Nevis, St Lucia, Montserrat, St Vincent & The Grenadines: Caribbean Contraceptive Prevalence Survey (CCPS).
Brazil: National survey: Brazil 2006 Pesquisa Nacional por Amostra de Domicmlios.
Botswana: National survey: Botswana 2007 Family Health Survey - Multiple Indicator Cluster Survey.
Canada: National survey: Canada 2002 Contraceptive Studies.
Switzerland, Finland, Hungary, Italy, Latvia, New Zealand, Poland, Slovenia: Fertility and Family Survey (FFS).
Chile: National survey: Chile 2006 Encuesta Nacional de Calidad de Vida y Salud.
China: National survey: China 2006 National Family Planning and Reproductive Health Survey.
Cook Islands: National survey: Cook Islands 1999 Reproductive Health Knowledge and Services.
Comoros, Haiti, Laos: Demographic and Health Survey/Multiple Indicator Cluster Survey (DHS/MICS).
Denmark: National survey: Denmark 1991-1993 Infertility Survey.
Ecuador, Georgia, Guatemala, Jamaica, Oman, DPR Korea, Paraguay, El Salvador: Reproductive Health Survey (RHS).
Spain: National survey: Spain 2006 Fertility and Values Survey.
Fiji: World Fertility Survey (WFS).
United Kingdom: National survey: United Kingdom 2008-2009 National Statistics Opinions Survey.
Ghana: National survey: Ghana 2013 PMA family planning survey.
Guadeloupe: National survey: Guadeloupe 1976 Fertility Survey.
Greece: National survey: Greece 2001 Family planning survey.
Grenada: National survey: Grenada 1990 IPPF/WHR Caribbean Contraceptive Prevalence Survey.
Guam: National survey: Guam 2002 Behavioral Risk Factor Surveillance System.
Hong Kong SAR: National survey: China, Hong Kong (SAR) 2007 Family Planning Knowledge, Attitude and Practice.
Croatia: National survey: Croatia 1970 Yugoslavia Fertility Survey.
India: National survey: India 2007-2008 District Level Household Survey.
Ireland: National survey: Ireland 2004-2005 SSHR.
Iran: National survey: Iran (Islamic Republic of) 2010 Multiple-Indicator Demographic and Health Survey.
Israel: National survey: Israel 1987-1988 Study of Fertility and Family Formation Survey.
Japan: National survey: Japan 2005 13th National Fertility Survey.
Kiribati: National survey: Kiribati 2009 Demographic and Health Survey.
Republic of Korea: National survey: Republic of Korea 2009 National Fertility and Family Health Survey.
Kuwait: National survey: Kuwait 1999 Desired Fertility and Contraceptive Use.
Lebanon: Pan-Arab Project for Child Development Survey (PAPCHILD).
Libya, Syria: Pan-Arab Project for Family Health Survey (PAPFAM).
Mexico: National survey: Mexico 2006 Encuesta Nacional de la Dinamica Demografica.
Marshall Islands: National survey: Marshall Islands 2007 Demographic Health Survey (national).
Malta: National survey: Malta 1993 Survey of Family Planning.
Martinique: National survey: Martinique 1976 Fertility Survey.
Mauritius: National survey: Mauritius 2002 Contraceptive Prevalence Survey of Mauritius and Rodrigues Islands.
Malaysia: National survey: Malaysia 2004 Population and Family Survey.


Netherlands: National survey: Netherlands 2008 Birth Control Survey.
Norway: National survey: Norway 2005 Survey on Contraceptive Use.
Nauru: National survey: Nauru 2007 Demographic Health Survey (national).
Panama: National survey: Panama 2009 Sexual and Reproductive Health-Survey.
Philippines: National survey: Philippines 2011 Family Health Survey.
Palau: National survey: Palau 2003 Population, Environment and Labor Force Survey.
Papua New Guinea: National survey: Papua New Guinea 2006 Demographic and Health Survey (national).
Puerto Rico: National survey: Puerto Rico 2002 Behavioral Risk Factor Surveillance System.
Portugal: National survey: Portugal 2005-2006 Inquirito Nacional de Sazde.
Reunion: National survey: Reunion 1997 Enqujte DEMO97, volet Famille.
Russian Federation: National survey: Russian Federation 2011 Reproductive Health Survey.
Sudan: National survey: Sudan 2006 Household Health Survey.
Singapore: National survey: Singapore 1997 National Family Planning and Population Survey.
Solomon Islands: National survey: Solomon Islands 2006-2007 Demographic and Health Survey.
Slovakia: National survey: Slovakia 1997 Reproductive Practices of Slovak Women.
Sweden: National survey: Sweden 1996 National Survey on Sexual Behavior.
Thailand: National survey: Thailand 2009 Reproductive Health Survey.
Turkey: National survey: Turkey 2008 Demographic and Health Survey.
Tuvalu: National survey: Tuvalu 2007 Demographic Health Survey (national).
Uruguay: National survey: Uruguay 2004 Encuesta Nacional sobre Reproduccisn Biologica y Social de la Poblacion.
USA: National survey: United States of America 2006-2010 National Survey of Family Growth.
Venezuela: National survey: Venezuela (Bolivarian Republic of) 1998 Encuesta Nacional de Poblacion y Familia.
US Virgin Islands: National survey: United States Virgin Islands 2002 Behavioral Risk Factor Surveillance System.
Viet Nam: National survey: Viet Nam 2011 Annual Population Change Survey.

9 REFERENCES - 264 -
9 References
HPV-related statistics were gathered from specific databases created at the Institut Catal dOncologia and the International Agency for
Research on Cancer.
Systematic collection of published literature from peer-reviewed journals is stored in these databases. Data correspond to results from
the following reference papers as well as updated results from continuous monitoring of the literature by the HPV Information Centre:
Table 32: References of studies included

Country Study
HPV prevalence and HPV type distribution for cytologically normal women
General sources Based on systematic reviews and meta-analysis performed by ICO. The ICO
HPV Information Centre has updated data until June 2015. Reference
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DR Congo Hovland S, Br J Cancer 2010; 102: 957 | Sangwa-Lugoma G, Sex Transm Dis
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Algeria Hammouda D, Int J Cancer 2005; 113: 483 | Hammouda D, Int J Cancer 2011;
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Egypt Abdel Aziz MT, Med Sci Monit 2006; 12: MT43
Ethiopia Leyh-Bannurah SR, Infect Agents Cancer 2014; 9: 33 | Ruland R, Eur J
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Gabon Si-Mohamed A, J Med Virol 2005; 77: 430
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Kenya De Vuyst H, Cancer Causes Control 2010; 21: 2309 | De Vuyst H, Sex Transm
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JO, Br J Cancer 2004; 90: 638
Rwanda Singh DK, J Infect Dis 2009; 199: 1851 | Veldhuijzen NJ, Sex Transm Dis 2012;
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Senegal Astori G, Intervirology 1999; 42: 221 | Hanisch RA, J Clin Virol 2013; 58: 696 |
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| Xi LF, Int J Cancer 2003; 103: 803
Tunisia Hassen E, Infection 2003; 31: 143
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Uganda Asiimwe S, Int J STD AIDS 2008; 19: 605 | Banura C, J Infect Dis 2008; 197:
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Cancer 2011; 6: 8 | Safaeian M, Sex Transm Dis 2007; 34: 429 | Taube JM,
Diagn Cytopathol 2010; 38: 555
(Continued)

Table 32 Continued
Country Study
South Africa Allan B, J Clin Microbiol 2008; 46: 740 | Denny L, JAMA 2005; 294: 2173 |
Jones HE, J Clin Microbiol 2007; 45: 1679 | Mbulawa ZZ, J Gen Virol 2010; 91:
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Zimbabwe Baay MF, J Med Virol 2004; 73: 481 | Fukuchi E, Sex Transm Dis 2009; 36: 305
| Nowak RG, J Infect Dis 2011; 203: 1182 | Womack SD, Int J Cancer 2000; 85:
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Americas
Argentina Abba MC, Rev Argent Microbiol 2003; 35: 74 | Badano I, Rev Argent Microbiol
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Belize Cathro HP, Hum Pathol 2009; 40: 942
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| Carestiato FN, Braz J Infect Dis 2006; 10: 331 | Cassel AP, Genet Mol Biol
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Fernandes JV, Int J Gynaecol Obstet 2009; 105: 21 | Figueiredo Alves RR, BMC
Public Health 2013; 13: 1041 | Franco EL, J Infect Dis 1995; 172: 756 |
Girianelli VR, Rev Bras Ginecol Obstet 2010; 32: 39 | Lippman SA, Int J STD
AIDS 2010; 21: 105 | Lorenzato F, Int J Gynecol Cancer 2000; 10: 143 | Lorenzi
AT, Gynecol Oncol 2013; 131: 131 | Magalhes PA, Arch Gynecol Obstet 2015;
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| Oliveira FA, Mem Inst Oswaldo Cruz 2007; 102: 751 | Oliveira LH, Rev Soc
Bras Med Trop 2010; 43: 4 | Pinto Dda S, Cad Saude Publica 2011; 27: 769 |
Rocha DA, Infect Dis Obstet Gynecol 2013; 2013: 514859 | Roteli-Martins CM,
Int J Gynecol Pathol 2011; 30: 173 | Silva KC, Mem Inst Oswaldo Cruz 2009;
104: 885 | Tamego-Lopes BP, Infect Agents Cancer 2014; 9: 25 | Tomita LY, Int
J Cancer 2010; 126: 703 | Trottier H, Cancer Epidemiol Biomarkers Prev 2006;
15: 1274 | Vieira RC, Infect Agent Cancer 2015; 10:
Canada Demers AA, Chronic Dis Inj Can 2012; 32: 177 | Jiang Y, Infect Agents Cancer
2013; 8: 25 | Kapala J, J Virol Methods 2007; 142: 223 | Louvanto K, Am J
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Moore RA, Cancer Causes Control 2009; 20: 1387 | Ogilvie GS, Vaccine 2013; 31:
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Roteli-Martins CM, Int J Gynecol Pathol 2011; 30: 173 | Sellors JW, CMAJ
2000; 163: 503 | Young TK, Sex Transm Dis 1997; 24: 293
Chile Ferreccio C, BMC Public Health 2008; 8: 78 | Ferreccio C, Cancer Epidemiol
Biomarkers Prev 2004; 13: 2271 | Ferreccio C, Int J Cancer 2013; 132: 916 |
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Colombia Camargo M, BMC Cancer 2014; 14: 451 | Leon S, Sex Transm Dis 2009; 36: 290
| Molano M, Br J Cancer 2002; 87: 324 | Muoz N, Sex Transm Dis 1996; 23:
504 | Soto-De Leon S, PLoS ONE 2011; 6: e14705
Costa Rica Herrero R, J Infect Dis 2005; 191: 1796 | Safaeian M, J Clin Microbiol 2007; 45:
1447
Cuba Soto Y, J Low Genit Tract Dis 2014; 18: 210
Ecuador Brown CR, Braz J Med Biol Res 2009; 42: 629
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Guyana Kightlinger RS, Am J Obstet Gynecol 2010; 202: 626.e1
Honduras Ferrera A, Int J Cancer 1999; 82: 799 | Ferrera A, Int J Gynaecol Obstet 2011;
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Causes Control 2009; 20: 1663
(Continued)

Table 32 Continued
Country Study
Haiti Mandigo M, Int J Gynaecol Obstet 2015; 128: 206 | Walmer DK, PLoS ONE
2013; 8: e76110
Jamaica Lewis-Bell K, Rev Panam Salud Publica 2013; 33: 159 | Watt A, Infect Agents
Cancer 2009; 4 Suppl 1: S11
Mexico Aguilar-Lemarroy A, J Med Virol 2015; 87: 871 | Carrillo-Garca A, Gynecol
Oncol 2014; 134: 534 | Giuliano AR, Cancer Epidemiol Biomarkers Prev 2001;
10: 1129 | Giuliano AR, Int J STD AIDS 2005; 16: 247 | Hernndez-Avila M,
Arch Med Res 1997; 28: 265 | Hernndez-Girn C, Sex Transm Dis 2005; 32:
613 | Illades-Aguiar B, Cancer Detect Prev 2009; 32: 300 | Illades-Aguiar B,
Gynecol Oncol 2010; 117: 291 | Lazcano-Ponce E, Cancer Causes Control 2010;
21: 1693 | Lazcano-Ponce E, Int J Cancer 2001; 91: 412 | Lpez Rivera MG,
Infect Dis Obstet Gynecol 2012; 2012: 384758 | Monroy OL, J Clin Virol 2010;
47: 43 | Orozco-Coln A, Int J Infect Dis 2010; 14: e1082 | Parada R, BMC Infect
Dis 2010; 10: 223 | Rojo Contreras W, Ginecol Obstet Mex 2008; 76: 9 | Salcedo
M, Asian Pac J Cancer Prev 2014; 15: 10061 | Salmern J, Cancer Causes
Control 2003; 14: 505 | Snchez-Anguiano LF, BMC Infect Dis 2006; 6: 27
Nicaragua Jeronimo J, Int J Gynecol Cancer 2014; 24: 576
Peru Almonte M, Int J Cancer 2007; 121: 796 | Garca PJ, Bull World Health Organ
2004; 82: 483 | Iwasaki R, Braz J Infect Dis 2014; 18: 469 | Martorell M, Genet
Mol Res 2012; 11: 2099 | Santos C, Br J Cancer 2001; 85: 966 | Silva-Caso W,
Asian Pac J Trop Med 2014; 7S1: S121
Paraguay Mendoza LP, J Med Virol 2011; 83: 1351 | Roln PA, Int J Cancer 2000; 85: 486
| Torres LM, Braz J Infect Dis 2009; 13: 203
Suriname Geraets DT, Sex Transm Infect 2014
Trinidad & Tobago Andall-Brereton GM, Rev Panam Salud Publica 2011; 29: 220 | Ragin CC,
Biomarkers 2007; 12: 510
Uruguay Berois N, J Med Virol 2014; 86: 647 | Ramas V, J Med Virol 2013; 85: 845
USA Castle PE, J Clin Oncol 2012; 30: 3044 | Castle PE, Lancet Oncol 2011; 12: 880
| Castle PE, Obstet Gynecol 2009; 113: 595 | Chaturvedi AK, J Med Virol 2005;
75: 105 | Cibas ES, Gynecol Oncol 2007; 104: 702 | Datta SD, Ann Intern Med
2008; 148: 493 | Dunne EF, Cancer Causes Control 2013; 24: 403 | Dunne EF,
JAMA 2007; 297: 813 | Evans MF, Cancer 2006; 106: 1054 | Giuliano AR,
Cancer Epidemiol Biomarkers Prev 1999; 8: 615 | Giuliano AR, Cancer
Epidemiol Biomarkers Prev 2001; 10: 1129 | Goodman MT, Cancer Res 2008; 68:
8813 | Hernandez BY, Nutr Cancer 2004; 49: 109 | Insinga RP, Cancer
Epidemiol Biomarkers Prev 2007; 16: 709 | Kahn JA, Obstet Gynecol 2008; 111:
1103 | Khanna N, Int J Gynecol Cancer 2007; 17: 615 | Kotloff KL, Sex Transm
Dis 1998; 25: 243 | Moscicki AB, JAMA 2001; 285: 2995 | Schiffman M, Cancer
Epidemiol Biomarkers Prev 2011; 20: 1398 | Sherman ME, J Natl Cancer Inst
2003; 95: 46 | Smith EM, Cancer Detect Prev 2003; 27: 472 | Smith EM, Int J
Gynaecol Obstet 2004; 87: 131 | Swan DC, J Clin Microbiol 1999; 37: 1030 |
Tarkowski TA, J Infect Dis 2004; 189: 46 | Wheeler CM, Int J Cancer 2013; 132:
198 | Winer RL, Am J Epidemiol 2003; 157: 218 | Zhao C, Cancer 2007; 111: 292
Venezuela Michelli E, Invest Clin 2011; 52: 344 | Tellez L, Ecancermedicalscience 2015; 9:
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Bangladesh Nahar Q, PLoS ONE 2014; 9: e107675
Bahrain Hajjaj AA, Saudi Med J 2006; 27: 487
Bhutan Tshomo U, BMC Infect Dis 2014; 14: 408
(Continued)

Table 32 Continued
Country Study
China Belinson J, Gynecol Oncol 2001; 83: 439 | Belinson JL, Am J Clin Pathol 2011;
135: 790 | Belinson JL, Int J Gynecol Cancer 2003; 13: 819 | Bian ML, Exp
Ther Med 2013; 6: 1332 | Chan PK, J Infect Dis 2002; 185: 28 | Chan PK, J
Med Virol 2009; 81: 1635 | Chen Q, PLoS ONE 2012; 7: e32149 | Chen Z, Exp
Ther Med 2013; 6: 85 | Chui SH, Public Health 2012; 126: 600 | Dai M, Br J
Cancer 2006; 95: 96 | Ding X, J Med Virol 2014; 86: 1937 | DU H, Zhonghua Liu
Xing Bing Xue Za Zhi 2012; 33: 799 | He X, Eur J Epidemiol 2008; 23: 403 | Hu
SY, Chin J Cancer Res 2011; 23: 25 | Jin Q, Chin Med J 2010; 123: 2004 | Li C,
Cancer Epidemiol Biomarkers Prev 2010; 19: 2655 | Li H, Eur J Obstet Gynecol
Reprod Biol 2013; 170: 202 | Li LK, Br J Cancer 2006; 95: 1593 | Lin M, Aust N
Z J Obstet Gynaecol 2008; 48: 189 | Lu S, J Med Virol 2015; 87: 504 | Mai RQ,
Asian Pac J Cancer Prev 2014; 15: 4945 | Moy LM, Int J Cancer 2010; 127: 646
| Qiao YL, Lancet Oncol 2008; 9: 929 | Sui S, Asian Pac J Cancer Prev 2013; 14:
5861 | Sun LL, Virol J 2012; 9: 153 | Sun ZR, Int J Gynaecol Obstet 2010; 109:
105 | Wang S, BMC Cancer 2012; 12: 160 | Wang X, Int J Gynaecol Obstet 2013;
120: 37 | Wang XC, Asian Pac J Cancer Prev 2014; 15: 7333 | Wang YY, Asian
Pac J Cancer Prev 2013; 14: 7483 | Wei H, Int J Gynaecol Obstet 2014; 126: 28 |
Wu D, Eur J Obstet Gynecol Reprod Biol 2010; 151: 86 | Wu EQ, Cancer Causes
Control 2013; 24: 795 | Wu R, Int J Gynecol Cancer 2010; 20: 1411 | Wu RF, Int
J Cancer 2007; 121: 1306 | Ye J, Int J Gynecol Cancer 2010; 20: 1374 | Ye J,
Virol J 2010; 7: 66 | Yeoh GP, Acta Cytol 2006; 50: 627 | Yip YC, J Med Virol
2010; 82: 1724 | Yu XW, J Low Genit Tract Dis 2013; 17: 17 | Yuan X, Arch
Gynecol Obstet 2011; 283: 1385 | Zhang L, Arch Gynecol Obstet 2012; 286: 695
| Zhang R, J Clin Virol 2013; 58: 144 | Zhang WY, Chin Med J 2008; 121: 1578
| Zhao FH, Cancer Prev Res (Phila) 2013; 6: 938 | Zhao FH, Int J Cancer 2014;
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Georgia Alibegashvili T, Cancer Epidemiol 2011; 35: 465
Indonesia de Boer MA, Int J Gynecol Cancer 2006; 16: 1809 | Rachmadi L, Acta Cytol
2012; 56: 171 | Vet JN, Br J Cancer 2008; 99: 214
India Aggarwal R, Indian J Cancer 2006; 43: 110 | Arora R, Eur J Obstet Gynecol
Reprod Biol 2005; 121: 104 | Basu P, Int J Cancer 2013; 132: 1693 | Bhatla N,
Int J Gynecol Pathol 2008; 27: 426 | Datta P, Cancer Epidemiol 2010; 34: 157 |
Dutta S, Int J Gynecol Pathol 2012; 31: 178 | Franceschi S, Br J Cancer 2005;
92: 601 | Gravitt PE, PLoS ONE 2010; 5: e13711 | Gupta S, Cytopathology
2009; 20: 249 | Jeronimo J, Int J Gynecol Cancer 2014; 24: 576 | Kashyap V, J
Cytol 2013; 30: 190 | Kerkar SC, Sex Reprod Healthc 2011; 2: 7 | Laikangbam
P, Int J Gynecol Cancer 2007; 17: 107 | Mittal S, Int J Gynaecol Obstet 2014;
126: 227 | Pandey S, Asian Pac J Cancer Prev 2012; 13: 2643 |
Sankaranarayanan R, Int J Cancer 2004; 112: 341 | Sankaranarayanan R, Int J
Cancer 2005; 116: 617 | Sarkar K, BMC Infect Dis 2011; 11: 72 | Singh A, Int J
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K, Int J Gynaecol Obstet 2012; 119: 253
Iran Eghbali SS, Virol J 2012; 9: 194 | Khodakarami N, Int J Cancer 2012; 131: E156
| Moradi A, Iran J Cancer Prev 2011; 3: 135 | Safaei A, Indian J Pathol
Microbiol 2010; 53: 681 | Shahramian I, Iran J Public Health 2011; 40: 113 |
Zandi K, Virol J 2010; 7: 65 | Zavarei 2008: reported in Vaccarella S, Vaccine
2013; 31 Suppl 6: G32
Japan Asato T, J Infect Dis 2004; 189: 1829 | Chen L, J Med Virol 2013; 85: 1229 |
Inoue M, Int J Gynecol Cancer 2006; 16: 1007 | Ishi K, J Obstet Gynaecol Res
2004; 30: 380 | Konno R, Cancer Sci 2011; 102: 877 | Maehama T, Infect Dis
Obstet Gynecol 2005; 13: 77 | Masumoto N, Gynecol Oncol 2004; 94: 509 |
Nishiwaki M, J Clin Microbiol 2008; 46: 1161 | Onuki M, Cancer Sci 2009; 100:
1312 | Saito J, Int J Gynaecol Obstet 1995; 51: 43 | Sasagawa T, Cancer
Epidemiol Biomarkers Prev 2001; 10: 45 | Sasagawa T, Jpn J Cancer Res 1997;
88: 376 | Sasagawa T, Sex Transm Infect 2005; 81: 280 | Satoh T, J Virol
Methods 2013; 188: 83 | Takehara K, Patholog Res Int 2011; 2011: 246936 |
Yoshikawa H, Br J Cancer 1999; 80: 621
(Continued)

Table 32 Continued
Country Study
Kazakhstan Buleshov 2011: reported in De Vuyst H, Vaccine 2013; 31 Suppl 5: F32
Republic of Korea An HJ, Cancer 2003; 97: 1672 | Bae J, Gynecol Oncol 2009; 115: 75 | Bae JH, J
Microbiol Biotechnol 2009; 19: 1051 | Bae JM, Arch Virol 2014; 159: 1909 | Cho
EJ, J Med Microbiol 2011; 60: 162 | Cho NH, Am J Obstet Gynecol 2003; 188: 56
| Hwang HS, Cancer Epidemiol Biomarkers Prev 2004; 13: 2153 | Hwang Y,
Ann Lab Med 2012; 32: 201 | Kim J, Int J Gynecol Cancer 2012; 22: 1570 | Kim
JH, Oncol Rep 2013; 29: 1645 | Kim JK, J Microbiol Biotechnol 2014; 24: 1143 |
Kim K, Asian Pac J Cancer Prev 2012; 13: 269 | Kim MA, J Korean Med Sci
2012; 27: 922 | Kim MA, Obstet Gynecol 2010; 116: 932 | Kim MJ, Obstet
Gynecol Sci 2013; 56: 110 | Kim TE, Korean J Pathol 2014; 48: 24 | Kim Y, J
Infect Chemother 2014; 20: 74 | Kim YJ, J Microbiol 2013; 51: 665 | Lee EH, J
Korean Med Sci 2012; 27: 1091 | Lee H, Epidemiol Infect 2014; 142: 1579 | Lee
HP, J Med Virol 2011; 83: 471 | Lee SA, Cancer Lett 2003; 198: 187 | Lee SJ,
Int J Med Sci 2012; 9: 103 | Oh JK, Eur J Cancer Prev 2009; 18: 56 | Oh YL,
Cytopathology 2001; 12: 75 | Park EK, J Korean Med Sci 2014; 29: 32 | Shim
HS, BMC Infect Dis 2010; 10: 284 | Shin HR, Int J Cancer 2003; 103: 413 | Shin
HR, J Infect Dis 2004; 190: 468 | Um TH, Ann Clin Lab Sci 2011; 41: 48
Kuwait Al-Awadhi R, J Med Virol 2011; 83: 453
Laos Phongsavan K, Int J Gynecol Cancer 2012; 22: 1398
Lebanon Karam WG, Lebanese Medical Journal 2005; 53: 132 | Mroueh AM, Eur J
Gynaecol Oncol 2002; 23: 429
Mongolia Chimeddorj B, Asian Pac J Cancer Prev 2008; 9: 563 | Dondog B, Cancer
Epidemiol Biomarkers Prev 2008; 17: 1731
Malaysia Chong PP, Asian Pac J Cancer Prev 2010; 11: 1645 | Othman N, Asian Pac J
Cancer Prev 2014; 15: 2245 | Tay SK, Aust N Z J Obstet Gynaecol 2009; 49: 323
Nepal Johnson DC, PLoS ONE 2014; 9: e101255 | Sherpa AT, Cancer Causes Control
2010; 21: 323
Pakistan Raza SA, Br J Cancer 2010; 102: 1657
Philippines Ngelangel C, J Natl Cancer Inst 1998; 90: 43
Saudi Arabia Al-Ahdal MN, J Infect Dev Ctries 2014; 8: 320
Thailand Chaiwongkot A, Asian Pac J Cancer Prev 2007; 8: 279 | Chandeying V, Sex
Health 2006; 3: 11 | Chansaenroj J, Asian Pac J Cancer Prev 2010; 11: 117 |
Chichareon S, J Natl Cancer Inst 1998; 90: 50 | Chopjitt P, Int J Infect Dis 2009;
13: 212 | Ekalaksananan T, J Obstet Gynaecol Res 2010; 36: 1037 |
Laowahutanont P, Asian Pac J Cancer Prev 2014; 15: 5879 | Marks M, Int J
Cancer 2011; 128: 2962 | Natphopsuk S, Asian Pac J Cancer Prev 2013; 14: 6961
| Paengchit K, Asian Pac J Cancer Prev 2014; 15: 6151 | Settheetham-Ishida W,
Microbiol Immunol 2005; 49: 417 | Siriaunkgul S, Asian Pac J Cancer Prev
2014; 15: 6837 | Siritantikorn S, Southeast Asian J Trop Med Public Health
1997; 28: 707 | Sriamporn S, Int J Gynecol Cancer 2006; 16: 266 | Sukvirach S,
J Infect Dis 2003; 187: 1246 | Suwannarurk K, Cancer Epidemiol 2009; 33: 56 |
Swangvaree SS, Asian Pac J Cancer Prev 2010; 11: 1465 | Thomas DB, Am J
Epidemiol 2001; 153: 723 | Wongworapat K, Sex Transm Dis 2008; 35: 172
Turkey Akcali S, Asian Pac J Cancer Prev 2013; 14: 503 | Altun 2011: reported in
Vaccarella S, Vaccine 2013; 31 Suppl 6: G32 | Bayram A, J Med Virol 2011; 83:
1997 | Demir ET, J Med Virol 2012; 84: 1242 | Dursun P, BMC Infect Dis 2009;
9: 191 | Eren F, Int J Gynaecol Obstet 2010; 109: 235 | Inal MM, Int J Gynecol
Cancer 2007; 17: 1266 | Kasap B, Eur J Obstet Gynecol Reprod Biol 2011; 159:
168 | Ozalp SS, J Turk Ger Gynecol Assoc 2012; 13: 8 | Oztrk S, Mikrobiyol
Bul 2004; 38: 223 | Sahiner F, Diagn Microbiol Infect Dis 2014; 80: 43 | Sahiner
F, J Microbiol Methods 2014; 97: 44 | Tezcan S, Asian Pac J Cancer Prev 2014;
15: 3997 | Yuce K, Arch Gynecol Obstet 2012; 286: 203 | zcan ES, J Obstet
Gynaecol 2011; 31: 656
(Continued)

Table 32 Continued
Country Study
Taiwan Chen HC, Int J Cancer 2011; 128: 1192 | Huang YK, Br J Cancer 2008; 98: 863
| Jeng CJ, Clin Invest Med 2005; 28: 261 | Lai CH, Epidemiol Infect 2012; 140:
466 | Liaw KL, Int J Cancer 1995; 62: 565 | Lin H, Gynecol Oncol 2005; 96: 84 |
Lin H, Gynecol Oncol 2006; 101: 40 | Tsai HT, Cancer Epidemiol Biomarkers
Prev 2005; 14: 2544 | Wang CH, J Med Virol 2010; 82: 1416
Uzbekistan Inamova 2009: reported in De Vuyst H, Vaccine 2013; 31 Suppl 5: F32
Viet Nam Pham TH, Int J Cancer 2003; 104: 213 | Vu LT, Asian Pac J Cancer Prev 2011;
12: 561 | Vu LT, Asian Pac J Cancer Prev 2012; 13: 37 | Vu LT, Western Pac
Surveill Response J 2012; 3: 57
Europe
Belgium Arbyn M, Cancer Epidemiol Biomarkers Prev 2009; 18: 321 | Baay MF, Eur J
Cancer 2005; 41: 2704 | Baay MF, Eur J Gynaecol Oncol 2001; 22: 204 |
Depuydt CE, Br J Cancer 2003; 88: 560 | Depuydt CE, Gynecol Obstet Invest
2010; 70: 273 | Depuydt CE, J Clin Microbiol 2012; 50: 4073 | Merckx M, Eur J
Cancer Prev 2014; 23: 288 | Schmitt M, Int J Cancer 2013; 132: 2395 | Weyn C,
Cancer Epidemiol 2013; 37: 457
Bulgaria Kovachev S, J Med Virol 2013; 85: 1577
Belarus Rogovskaya SI, Vaccine 2013; 31 Suppl 7: H46
Switzerland Bigras G, Br J Cancer 2005; 93: 575
Czech Republic Tachezy R, PLoS ONE 2013; 8: e79156
Germany de Jonge M, Acta Cytol 2013; 57: 591 | Iftner T, J Med Virol 2010; 82: 1928 |
Luyten A, Int J Cancer 2014; 135: 1408 | Petry KU, BMC Infect Dis 2013; 13:
135 | Petry KU, Br J Cancer 2003; 88: 1570 | Schneider A, Int J Cancer 2000;
89: 529
Denmark Bonde J, BMC Infect Dis 2014; 14: 413 | Kjr SK, Cancer Causes Control 2014;
25: 179 | Nielsen A, Sex Transm Dis 2008; 35: 276 | Svare EI, Eur J Cancer
1998; 34: 1230
Spain Bernal M, Infect Agents Cancer 2008; 3: 8 | Castellsagu X, J Med Virol 2012;
84: 947 | de Sanjose S, Sex Transm Dis 2003; 30: 788 | Dillner J, BMJ 2008;
337: a1754 | Gonzlez C, Sex Transm Infect 2006; 82: 260 | Lloveras B, PLoS
ONE 2013; 8: e58153 | Martorell M, Scand J Infect Dis 2010; 42: 549 | Muoz
N, Sex Transm Dis 1996; 23: 504 | Ortiz M, J Clin Microbiol 2006; 44: 1428
Estonia Uuskla A, BMC Infect Dis 2010; 10: 63
Finland Auvinen E, Scand J Infect Dis 2005; 37: 873 | Malila N, Int J Cancer 2013; 132:
2141
France Baudu A, J Epidemiol Glob Health 2014; 4: 35 | Beby-Defaux A, J Med Virol
2004; 73: 262 | Boulanger JC, Gynecol Obstet Fertil 2004; 32: 218 | Casalegno
JS, Int J Gynaecol Obstet 2011; 114: 116 | Clavel C, Br J Cancer 2001; 84: 1616
| Dalstein V, Int J Cancer 2003; 106: 396 | Haguenoer K, Gynecol Oncol 2014;
134: 302 | Heard I, PLoS ONE 2013; 8: e79372 | Monsonego J, Gynecol Oncol
2005; 99: 160 | Monsonego J, Int J Cancer 2011; 129: 691 | Pannier-Stockman
C, J Clin Virol 2008; 42: 353 | Riethmuller D, Diagn Mol Pathol 1999; 8: 157 |
Vaucel E, Arch Gynecol Obstet 2011; 284: 989
United Kingdom Cuschieri KS, J Clin Pathol 2004; 57: 68 | Cuzick J, Br J Cancer 1999; 81: 554 |
Cuzick J, Lancet 1995; 345: 1533 | Cuzick J, Lancet 2003; 362: 1871 | Geraets
DT, J Clin Microbiol 2014; 52: 3996 | Grainge MJ, Emerging Infect Dis 2005; 11:
1680 | Herbert A, J Fam Plann Reprod Health Care 2007; 33: 171 | Hibbitts S,
Br J Cancer 2008; 99: 1929 | Hibbitts S, J Clin Virol 2014; 59: 109 |
Howell-Jones R, Br J Cancer 2010; 103: 209 | Kavanagh K, Br J Cancer 2014;
110: 2804 | Kitchener HC, Br J Cancer 2006; 95: 56 | Peto J, Br J Cancer 2004;
91: 942
Greece Agorastos T, Eur J Cancer Prev 2004; 13: 145 | Agorastos T, Eur J Cancer Prev
2014; 23: 425 | Agorastos T, PLoS ONE 2015; 10: e0119755 | Argyri E, BMC
Infect Dis 2013; 13: 53 | Panotopoulou E, J Med Virol 2007; 79: 1898 |
Paraskevaidis E, Gynecol Oncol 2001; 82: 355 | Tsiodras S, BMC Cancer 2010;
10: 53 | Tsiodras S, Clin Microbiol Infect 2011; 17: 1185
(Continued)

Table 32 Continued
Country Study
Croatia Grahovac M, Coll Antropol 2007; 31 Suppl 2: 73 | Kaliterna V, Cent Eur J Public
Health 2013; 21: 26 | Kaliterna V, Coll Antropol 2007; 31 Suppl 2: 79
Hungary Nyri T, Eur J Obstet Gynecol Reprod Biol 2006; 126: 246
Ireland Anderson L, J Med Virol 2013; 85: 295 | Keegan H, Br J Biomed Sci 2007; 64: 18
Italy Agarossi A, J Med Virol 2009; 81: 529 | Ammatuna P, Cancer Epidemiol
Biomarkers Prev 2008; 17: 2002 | Astori G, Virus Res 1997; 50: 57 | Barzon L, J
Med Virol 2010; 82: 1424 | Bellaminutti S, J Med Virol 2014; 86: 1920 | Carozzi
F, Br J Cancer 2000; 83: 1462 | Carozzi F, J Clin Virol 2014; 60: 257 |
Centurioni MG, BMC Infect Dis 2005; 5: 77 | Del Mistro A, J Med Screen 2014;
21: 30 | Del Prete R, J Clin Virol 2008; 42: 211 | Giambi C, BMC Infect Dis
2013; 13: 74 | Giorgi Rossi P, Infect Agents Cancer 2011; 6: 2 | Masia G, Vaccine
2009; 27 Suppl 1: A11 | Panatto D, BMC Infect Dis 2013; 13: 575 | Piana A,
BMC Public Health 2011; 11: 785 | Ronco G, Eur J Cancer 2005; 41: 297 | Salfa
MC, Ig Sanita Pubbl 2011; 67: 425 | Sammarco ML, Eur J Obstet Gynecol
Reprod Biol 2013; 168: 222 | Tenti P, J Infect Dis 1997; 176: 277 | Tornesello
ML, J Gen Virol 2008; 89: 1380 | Tornesello ML, J Med Virol 2006; 78: 1663 |
Verteramo R, BMC Infect Dis 2009; 9: 16 | Zappacosta B, New Microbiol 2009;
32: 351
Lithuania Bumbuliene Z, Acta Obstet Gynecol Scand 2012; 91: 511 | Gudleviciene Z,
Medicina (Kaunas) 2005; 41: 910 | Kliucinskas M, Gynecol Obstet Invest 2006;
62: 173 | Simanaviciene V, J Med Virol 2014
Latvia Silins I, Gynecol Oncol 2004; 93: 484
Montenegro Vujosevic D, Acta Medica (Hradec Kralove) 2012; 55: 130
Netherlands Boers A, PLoS ONE 2014; 9: e101930 | Bulkmans NW, Int J Cancer 2004; 110:
94 | Hesselink AT, J Clin Microbiol 2013; 51: 2409 | Jacobs MV, Int J Cancer
2000; 87: 221 | Lenselink CH, PLoS ONE 2008; 3: e3743 | Rijkaart DC, Br J
Cancer 2012; 106: 975 | Rijkaart DC, Lancet Oncol 2012; 13: 78 | Rozendaal L,
J Clin Pathol 2000; 53: 606 | Zielinski GD, Br J Cancer 2001; 85: 398
Norway Gjoen K, APMIS 1996; 104: 68 | Molden T, Cancer Epidemiol Biomarkers Prev
2005; 14: 367 | Molden T, Gynecol Oncol 2006; 100: 95 | Skjeldestad FE, Acta
Obstet Gynecol Scand 2008; 87: 81
Poland Bardin A, Eur J Cancer 2008; 44: 557
Portugal Dutra I, Infect Agents Cancer 2008; 3: 6 | Pista A, Clin Microbiol Infect 2011;
17: 941 | Pista A, Int J Gynecol Cancer 2011; 21: 1150 | Vieira L, Eur J
Microbiol Immunol (Bp) 2013; 3: 61
Romania Moga MA, Asian Pac J Cancer Prev 2014; 15: 6887 | Ursu RG, Virol J 2011; 8:
558
Russian Federation Alexandrova YN, Cancer Lett 1999; 145: 43 | Bdaizieva 2010: reported in De
Vuyst H, Vaccine 2013; 31 Suppl 5: F32 | Goncharevskaya 2011: reported in De
Vuyst H, Vaccine 2013; 31 Suppl 5: F32 | Komarova 2010: reported in De Vuyst
H, Vaccine 2013; 31 Suppl 5: F32 | Kubanov 2005: reported in De Vuyst H,
Vaccine 2013; 31 Suppl 5: F32 | Rogovskaya SI, Vaccine 2013; 31 Suppl 7: H46 |
Shargorodskaya 2011: reported in De Vuyst H, Vaccine 2013; 31 Suppl 5: F32 |
Shipitsyna E, Cancer Epidemiol 2011; 35: 160 | Shipulina 2011: reported in De
Vuyst H, Vaccine 2013; 31 Suppl 5: F32
Slovenia Ucakar V, J Med Virol 2014; 86: 1772 | Ucakar V, Vaccine 2012; 30: 116
Sweden Elfstrm KM, BMJ 2014; 348: g130 | Gyllensten U, Gynecol Oncol 2012; 125:
343 | Kjellberg L, Am J Obstet Gynecol 1998; 179: 1497 | Naucler P, N Engl J
Med 2007; 357: 1589 | Stenvall H, Acta Derm Venereol 2007; 87: 243 | Ylitalo
N, Cancer Res 2000; 60: 6027
Oceania
Australia Bowden FJ, Sex Health 2005; 2: 229 | Tabrizi SN, J Clin Virol 2014; 60: 250 |
Tabrizi SN, Lancet Infect Dis 2014; 14: 958
Fiji Foliaki S, Infect Agents Cancer 2014; 9: 14
(Continued)

Table 32 Continued
Country Study
Vanuatu Aruhuri B, Cancer Prev Res (Phila) 2012; 5: 746 | McAdam M, PLoS ONE 2010;
5: e13266
HPV type distribution for invasive cervical cancer (ICC)
General sources Based on meta-analysis performed by IARCs Infections and Cancer
Epidemiology Group up to November 2011, the ICO HPV Information Centre
has updated data until June 2014. Reference publications: 1) Guan P, Int J
Cancer 2012;131:2349 2) Li N, Int J Cancer 2011;128:927 3) Smith JS, Int J
Cancer 2007;121:621 4) Clifford GM, Br J Cancer 2003;88:63 5) Clifford GM, Br
J Cancer 2003;89:101.
Africa
Benin Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796
Botswana Contributing studies: Ermel A, Infect Agents Cancer 2014; 9: 22
Algeria Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Hammouda
D, Int J Cancer 2005; 113: 483
Ethiopia Contributing studies: Abate E, J Med Virol 2013; 85: 282 | Fanta BE, Ethiop
Med J 2005; 43: 151
Ghana Contributing studies: Awua AK, Infect Agents Cancer 2016; 11: 4 | Denny L, Int
J Cancer 2014; 134: 1389
Guinea Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Keita N, Br
J Cancer 2009; 101: 202
Kenya Contributing studies: De Vuyst H, Int J Cancer 2008; 122: 244 | De Vuyst H, Int
J Cancer 2012; 131: 949
Morocco Contributing studies: Chaouki N, Int J Cancer 1998; 75: 546 | El khair MM,
Med Oncol 2010; 27: 861
Mali Contributing studies: Bayo S, Int J Epidemiol 2002; 31: 202 | Bosch FX, J Natl
Cancer Inst 1995; 87: 796 | Ndiaye C, Trop Med Int Health 2012; 17: 1432
Mozambique Contributing studies: Castellsagu X, Int J Cancer 2008; 122: 1901 | Naucler P,
J Gen Virol 2004; 85: 2189
Nigeria Contributing studies: Denny L, Int J Cancer 2014; 134: 1389
Sudan Contributing studies: Abate E, J Med Virol 2013; 85: 282
Senegal Contributing studies: Lin P, Cancer Epidemiol Biomarkers Prev 2001; 10: 1037
| Ndiaye C, Trop Med Int Health 2012; 17: 1432 | Xi LF, Int J Cancer 2003; 103:
803
Tunisia Contributing studies: KrennHrubec K, J Med Virol 2011; 83: 651
Tanzania Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | ter Meulen
J, Int J Cancer 1992; 51: 515
Uganda Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Odida M,
BMC Infect Dis 2008; 8: 85 | Odida M, Infect Agent Cancer 2010; 5: 15
South Africa Contributing studies: De Vuyst H, Int J Cancer 2012; 131: 949 | Denny L, Int J
Cancer 2014; 134: 1389 | Kay P, J Med Virol 2003; 71: 265 | Pegoraro RJ, Int J
Gynecol Cancer 2002; 12: 383 | van Aardt MC, Int J Gynecol Cancer 2015; 25:
919 | Williamson AL, J Med Virol 1994; 43: 231
Zimbabwe Contributing studies: Stanczuk GA, Acta Obstet Gynecol Scand 2003; 82: 762
Americas
Argentina Contributing studies: Alonio LV, J Clin Virol 2003; 27: 263 | Bosch FX, J Natl
Cancer Inst 1995; 87: 796 | Golijow CD, Gynecol Oncol 2005; 96: 181 | Turazza
E, Acta Obstet Gynecol Scand 1997; 76: 271
Bolivia Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796
Brazil Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Cambruzzi
E, Pathol Oncol Res 2005; 11: 114 | de Oliveira CM, BMC Cancer 2013; 13: 357
| Eluf-Neto J, Br J Cancer 1994; 69: 114 | Lorenzato F, Int J Gynecol Cancer
2000; 10: 143 | Rabelo-Santos SH, Int J Gynecol Pathol 2009; 28: 272 |
Rabelo-Santos SH, Mem Inst Oswaldo Cruz 2003; 98: 181 | Serrano B, Cancer
Epidemiol 2014 | Tomita LY, Int J Cancer 2010; 126: 703
(Continued)

Table 32 Continued
Country Study
Canada Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Duggan MA,
Hum Pathol 1995; 26: 319 | Tran-Thanh D, Am J Obstet Gynecol 2003; 188: 129
Chile Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Roa JC, Int
J Gynaecol Obstet 2009; 105: 150 | Valdivia L IM, Rev Chilena Infectol 2010; 27:
11
Colombia Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 |
Moreno-Acosta P, Virus Genes 2008; 37: 22 | Murillo R, Infect Dis Obstet
Gynecol 2009; 2009: 653598 | Muoz N, Int J Cancer 1992; 52: 743
Costa Rica Contributing studies: Herrero R, J Infect Dis 2005; 191: 1796
Cuba Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796
Ecuador Contributing studies: Meja L, J Med Virol 2016; 88: 144
Honduras Contributing studies: Ferreira M, Mod Pathol 2008; 21: 968
Jamaica Contributing studies: Strickler HD, J Med Virol 1999; 59: 60
Mexico Contributing studies: Aguilar-Lemarroy A, J Med Virol 2015; 87: 871 |
Alarcn-Romero Ldel C, Salud Publica Mex 2009; 51: 134 | Carrillo-Garca A,
Gynecol Oncol 2014; 134: 534 | Flores-Miramontes MG, Virol J 2015; 12: 161 |
Gonzlez-Losa Mdel R, J Clin Virol 2004; 29: 202 | Guardado-Estrada M, PLoS
ONE 2014; 9: e109406 | Illades-Aguiar B, Cancer Detect Prev 2009; 32: 300 |
Meyer T, J Infect Dis 1998; 178: 252 | Pia-Snchez P, Int J Gynecol Cancer
2006; 16: 1041 | Serrano B, Cancer Epidemiol 2014 | Torroella-Kouri M,
Gynecol Oncol 1998; 70: 115 | Velzquez-Mrquez N, Int J Infect Dis 2009; 13:
690
Nicaragua Contributing studies: Hindryckx P, Sex Transm Infect 2006; 82: 334
Panama Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796
Peru Contributing studies: Martorell M, Genet Mol Res 2012; 11: 2099 | Santos C, Br
J Cancer 2001; 85: 966
Paraguay Contributing studies: Kasamatsu E, J Med Virol 2012; 84: 1628 | Roln PA, Int
J Cancer 2000; 85: 486
Suriname Contributing studies: De Boer MA, Int J Cancer 2005; 114: 422
Trinidad & Tobago Contributing studies: Hosein F, Rev Panam Salud Publica 2013; 33: 267
USA Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Bryan JT, J
Med Virol 2006; 78: 117 | Burger RA, J Natl Cancer Inst 1996; 88: 1361 |
Burnett AF, Gynecol Oncol 1992; 47: 343 | de Sanjose S, Lancet Oncol 2010; 11:
1048 | Ferguson AW, Mod Pathol 1998; 11: 11 | Guo M, Mod Pathol 2007; 20:
256 | Hariri S, PLoS ONE 2012; 7: e34044 | Hopenhayn C, J Low Genit Tract
Dis 2014; 18: 182 | Joste NE, Cancer Epidemiol Biomarkers Prev 2015; 24: 230
| Paquette RL, Cancer 1993; 72: 1272 | Patel DA, J Virol Methods 2009; 160: 78
| Pirog EC, Am J Pathol 2000; 157: 1055 | Quint KD, Gynecol Oncol 2009; 114:
390 | Resnick RM, J Natl Cancer Inst 1990; 82: 1477 | Schwartz SM, J Clin
Oncol 2001; 19: 1906 | Sebbelov AM, Microbes Infect 2000; 2: 121 | Wentzensen
N, Int J Cancer 2009; 124: 964 | Wheeler CM, J Natl Cancer Inst 2009; 101: 475
| Wistuba II, Cancer Res 1997; 57: 3154 | Zuna RE, Mod Pathol 2007; 20: 167
Venezuela Contributing studies: Snchez-Lander J, Cancer Epidemiol 2012; 36: e284
Asia
Bangladesh Contributing studies: Banik U, Cytojournal 2013; 10: 14
(Continued)

Table 32 Continued
Country Study
China Contributing studies: Cai HB, Eur J Gynaecol Oncol 2008; 29: 72 | Cai HB,
Oncology 2009; 76: 157 | Chan PK, Int J Cancer 2009; 125: 1671 | Chan PK, Int
J Cancer 2012; 131: 692 | Chen W, Cancer Causes Control 2009; 20: 1705 | Ding
X, J Med Virol 2014; 86: 1937 | Gao YE, Sheng Wu Hua Xue Yu Sheng Wu Wu
Li Xue Bao 2003; 35: 1029 | Hong D, Int J Gynecol Cancer 2008; 18: 104 |
Huang S, Int J Cancer 1997; 70: 408 | Li H, Eur J Obstet Gynecol Reprod Biol
2013; 170: 202 | Lin QQ, Int J Cancer 1998; 75: 484 | Liu GB, J First Mil Med
Univ 2005; 25: 1236 | Liu J, Gynecol Oncol 2004; 94: 803 | Liu SS, Tumour Biol
2008; 29: 105 | Liu X, Int J Gynecol Cancer 2010; 20: 147 | Lo KW, Gynecol
Obstet Invest 2001; 51: 202 | Lo KW, Int J Cancer 2002; 100: 327 | Peng HQ,
Int J Cancer 1991; 47: 711 | Qiu AD, Gynecol Oncol 2007; 104: 77 | Serrano B,
Cancer Epidemiol 2014 | Shah W, Clin Oncol (R Coll Radiol) 2009; 21: 768 |
Stephen AL, Int J Cancer 2000; 86: 695 | Tao PP, Zhonghua Fu Chan Ke Za Zhi
2006; 41: 43 | Wang L, J Med Virol 2015; 87: 516 | Wu EQ, BMC Cancer 2008;
8: 202 | Wu EQ, Int J Gynecol Cancer 2009; 19: 919 | Wu Y, J Med Virol 2008;
80: 1808 | Yu MY, Int J Cancer 2003; 105: 204 | Yuan X, Arch Gynecol Obstet
2011; 283: 1385 | Zhao Y, Pathol Int 2008; 58: 643
Georgia Contributing studies: Alibegashvili T, Cancer Epidemiol 2011; 35: 465
Indonesia Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | De Boer MA,
Int J Cancer 2005; 114: 422 | Schellekens MC, Gynecol Oncol 2004; 93: 49 |
Tobing MD, Asian Pac J Cancer Prev 2014; 15: 5781
India Contributing studies: Basu P, Asian Pac J Cancer Prev 2009; 10: 27 | Bhatla N,
Int J Gynecol Pathol 2006; 25: 398 | Deodhar K, J Med Virol 2012; 84: 1054 |
Franceschi S, Int J Cancer 2003; 107: 127 | Gheit T, Vaccine 2009; 27: 636 |
Munagala R, Int J Oncol 2009; 34: 263 | Munirajan AK, Gynecol Oncol 1998; 69:
205 | Munjal K, Int J Gynecol Pathol 2014; 33: 531 | Nagpal JK, Eur J Clin
Invest 2002; 32: 943 | Nair P, Pathol Oncol Res 1999; 5: 95 | Nambaru L, Asian
Pac J Cancer Prev 2009; 10: 355 | Neyaz MK, Biomarkers 2008; 13: 597 |
Peedicayil A, Int J Gynecol Cancer 2006; 16: 1591 | Peedicayil A, J Low Genit
Tract Dis 2009; 13: 102 | Serrano B, Cancer Epidemiol 2014 | Sowjanya AP,
BMC Infect Dis 2005; 5: 116
Iran Contributing studies: Esmaeili M, Gynecol Obstet Invest 2008; 66: 68 | Ghaffari
SR, Asian Pac J Cancer Prev 2006; 7: 529 | Hamkar R, East Mediterr Health J
2002; 8: 805 | Khodakarami N, Int J Cancer 2012; 131: E156 | Mortazavi S,
Asian Pac J Cancer Prev 2002; 3: 69 | Salehi-Vaziri M, Arch Virol 2015; 160:
1181
Israel Contributing studies: Bassal R, J Low Genit Tract Dis 2015; 19: 161 | Laskov I,
Int J Gynecol Cancer 2013; 23: 730
Jordan Contributing studies: Sughayer MA, Int J Gynaecol Obstet 2010; 108: 74
Japan Contributing studies: Asato T, J Infect Dis 2004; 189: 1829 | Azuma Y, Jpn J
Clin Oncol 2014 | Fujinaga Y, J Gen Virol 1991; 72 ( Pt 5): 1039 | Harima Y, Int
J Radiat Oncol Biol Phys 2002; 52: 1345 | Imajoh M, Virol J 2012; 9: 154 |
Inoue M, Int J Gynecol Cancer 2006; 16: 1007 | Ishikawa H, Cancer 2001; 91: 80
| Kanao H, Cancer Lett 2004; 213: 31 | Kashiwabara K, Acta Pathol Jpn 1992;
42: 876 | Maehama T, Infect Dis Obstet Gynecol 2005; 13: 77 | Maki H, Jpn J
Cancer Res 1991; 82: 411 | Nakagawa H, Anticancer Res 2002; 22: 1655 |
Nakagawa S, Cancer 1996; 78: 1935 | Nawa A, Cancer 1995; 75: 518 | Onuki M,
Cancer Sci 2009; 100: 1312 | Saito J, Gynecol Obstet Invest 2000; 49: 190 |
Sasagawa T, Cancer Epidemiol Biomarkers Prev 2001; 10: 45 | Takehara K,
Patholog Res Int 2011; 2011: 246936 | Tsuda H, Gynecol Oncol 2003; 91: 476 |
Watari H, Pathobiology 2011; 78: 220 | Yamakawa Y, Gynecol Oncol 1994; 53:
190 | Yamasaki K, J Obstet Gynaecol Res 2011; 37: 1666 | Yoshida T, Cancer
2004; 102: 100 | Yoshida T, Virchows Arch 2009; 455: 253
(Continued)

Table 32 Continued
Country Study
Republic of Korea Contributing studies: An HJ, Cancer 2003; 97: 1672 | An HJ, Mod Pathol 2005;
18: 528 | Cho NH, Am J Obstet Gynecol 2003; 188: 56 | Hwang T, J Korean Med
Sci 1999; 14: 593 | Hwang TS, Gynecol Oncol 2003; 90: 51 | Kim JY, J Clin
Oncol 2009; 27: 5088 | Kim KH, Yonsei Med J 1995; 36: 412 | Lee HS, Int J
Gynecol Cancer 2007; 17: 497 | Oh JK, Asian Pac J Cancer Prev 2010; 11: 993 |
Quek SC, Int J Gynecol Cancer 2013; 23: 148 | Song ES, J Korean Med Sci 2007;
22: 99 | Tong SY, Int J Gynecol Cancer 2007; 17: 1307
Kuwait Contributing studies: Al-Awadhi R, Diagn Cytopathol 2013; 41: 107
Sri Lanka Contributing studies: Karunaratne K, BMC Cancer 2014; 14: 116 |
Samarawickrema NA, Int J Gynaecol Obstet 2011; 115: 180
Myanmar Contributing studies: Mu-Mu-Shwe, Acta Med Okayama 2014; 68: 79
Mongolia Contributing studies: Chimeddorj B, Asian Pac J Cancer Prev 2008; 9: 563
Malaysia Contributing studies: Cheah PL, Malays J Pathol 2008; 30: 37 | Hamzi Abdul
Raub S, Asian Pac J Cancer Prev 2014; 15: 651 | Quek SC, Int J Gynecol Cancer
2013; 23: 148 | Sharifah NA, Asian Pac J Cancer Prev 2009; 10: 303 | Yadav M,
Med J Malaysia 1995; 50: 64
Nepal Contributing studies: Sherpa AT, Cancer Causes Control 2010; 21: 323
Pakistan Contributing studies: Khan S, Int J Infect Dis 2007; 11: 313 | Raza SA, Br J
Cancer 2010; 102: 1657
Philippines Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Ngelangel C,
J Natl Cancer Inst 1998; 90: 43 | Quek SC, Int J Gynecol Cancer 2013; 23: 148
Saudi Arabia Contributing studies: Alsbeih G, Gynecol Oncol 2011; 121: 522
Singapore Contributing studies: Quek SC, Int J Gynecol Cancer 2013; 23: 148
Syria Contributing studies: Darnel AD, Clin Microbiol Infect 2010; 16: 262
Thailand Contributing studies: Bhattarakosol P, J Med Assoc Thai 1996; 79 Suppl 1: S56
| Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Chansaenroj J, J Med Virol 2014;
86: 601 | Chichareon S, J Natl Cancer Inst 1998; 90: 50 | Chopjitt P, Int J Infect
Dis 2009; 13: 212 | Natphopsuk S, Asian Pac J Cancer Prev 2013; 14: 6961 |
Settheetham-Ishida W, Microbiol Immunol 2005; 49: 417 | Siriaunkgul S,
Gynecol Oncol 2008; 108: 555 | Siritantikorn S, Southeast Asian J Trop Med
Public Health 1997; 28: 707
Turkey Contributing studies: Ozgul N, J Obstet Gynaecol Res 2008; 34: 865 | Usubtn
A, Int J Gynecol Pathol 2009; 28: 541
Taiwan Contributing studies: Chao A, Int J Gynecol Pathol 2009; 28: 279 | Chen SL,
Cancer 1993; 72: 1939 | Chen TM, Int J Cancer 1994; 57: 181 | Ding DC, Eur J
Obstet Gynecol Reprod Biol 2008; 140: 245 | Ho CM, Gynecol Oncol 2005; 99:
615 | Huang HJ, Int J Gynecol Cancer 2004; 14: 639 | Huang LW, J Clin Virol
2004; 29: 271 | Lai CH, Int J Cancer 2007; 120: 1999 | Lai HC, Int J Cancer
1999; 84: 553 | Lin H, Gynecol Oncol 2005; 96: 84 | Su TH, Carcinogenesis
2007; 28: 1237 | Yang YC, Gynecol Oncol 1997; 64: 59 | Yang YY, J Microbiol
Immunol Infect 2004; 37: 282
Viet Nam Contributing studies: Quek SC, Int J Gynecol Cancer 2013; 23: 148
Europe
Austria Contributing studies: Bachtiary B, Int J Cancer 2002; 102: 237 | Widschwendter
A, Cancer Lett 2003; 202: 231
Belgium Contributing studies: Baay MF, Eur J Gynaecol Oncol 2001; 22: 204 | Beerens
E, Cytopathology 2005; 16: 199
Bulgaria Contributing studies: Todorova I, J Clin Pathol 2010; 63: 1121
Bosnia & Herzegovina Contributing studies: Iljazovi? E, Cancer Epidemiol 2014; 38: 504
Belarus Contributing studies: Kulmala SM, J Med Virol 2007; 79: 771
Czech Republic Contributing studies: Slama J, Int J Gynecol Cancer 2009; 19: 703 | Tachezy R,
J Med Virol 1999; 58: 378 | Tachezy R, PLoS ONE 2011; 6: e21913
Germany Contributing studies: Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Klug SJ, J
Med Virol 2007; 79: 616 | Milde-Langosch K, Int J Cancer 1995; 63: 639
(Continued)

Table 32 Continued
Country Study
Denmark Contributing studies: Hording U, APMIS 1997; 105: 313 | Kirschner B, Acta
Obstet Gynecol Scand 2013; 92: 1023 | Kjaer SK, Int J Cancer 2008; 123: 1864 |
Kjr SK, Cancer Causes Control 2014; 25: 179 | Sebbelov AM, Microbes Infect
2000; 2: 121
Spain Contributing studies: Alemany L, Gynecol Oncol 2012; 124: 512 | Bosch FX, J
Natl Cancer Inst 1995; 87: 796 | Darwich L, Int J Gynecol Cancer 2011; 21:
1486 | Gonzlez-Bosquet E, Gynecol Oncol 2008; 111: 9 | Herraez-Hernandez E,
J Virol Methods 2013; 193: 9 | Martr E, Enferm Infecc Microbiol Clin 2012; 30:
225 | Mazarico E, Gynecol Oncol 2012; 125: 181 | Muoz N, Int J Cancer 1992;
52: 743 | Rodriguez JA, Diagn Mol Pathol 1998; 7: 276
Finland Contributing studies: Iwasawa A, Cancer 1996; 77: 2275
France Contributing studies: de Cremoux P, Int J Cancer 2009; 124: 778 | Lombard I, J
Clin Oncol 1998; 16: 2613 | Prtet JL, Int J Cancer 2008; 122: 424 | Riou G,
Lancet 1990; 335: 1171
United Kingdom Contributing studies: Arends MJ, Hum Pathol 1993; 24: 432 | Crook T, Lancet
1992; 339: 1070 | Cuschieri K, Br J Cancer 2010; 102: 930 | Cuschieri K, Int J
Cancer 2014; 135: 2721 | Cuzick J, Br J Cancer 2000; 82: 1348 | Giannoudis A,
Int J Cancer 1999; 83: 66 | Howell-Jones R, Br J Cancer 2010; 103: 209 |
Mesher D, J Clin Pathol 2015; 68: 135 | Powell N, Int J Cancer 2009; 125: 2425
| Sargent A, Br J Cancer 2008; 98: 1704 | Tawfik El-Mansi M, Int J Gynecol
Cancer 2006; 16: 1025
Greece Contributing studies: Adamopoulou M, Anticancer Res 2009; 29: 3401 |
Daponte A, J Clin Virol 2006; 36: 189 | Dokianakis DN, Oncol Rep 1999; 6: 1327
| Koffa M, Int J Oncol 1994; 5: 189 | Labropoulou V, Sex Transm Dis 1997; 24:
469 | Panotopoulou E, J Med Virol 2007; 79: 1898
Croatia Contributing studies: Dabic MM, Acta Obstet Gynecol Scand 2008; 87: 366 |
Hadzisejdic I, Coll Antropol 2006; 30: 879
Hungary Contributing studies: Knya J, J Med Virol 1995; 46: 1
Ireland Contributing studies: Butler D, J Pathol 2000; 192: 502 | Fay J, J Med Virol
2009; 81: 897 | OLeary JJ, J Clin Pathol 1998; 51: 576 | Skyldberg BM, Mod
Pathol 1999; 12: 675
Iceland Contributing studies: Sigurdsson K, Int J Cancer 2007; 121: 2682
Italy Contributing studies: Carozzi FM, Cancer Epidemiol Biomarkers Prev 2010; 19:
2389 | Ciotti M, Oncol Rep 2006; 15: 143 | Del Mistro A, Infect Agents Cancer
2006; 1: 9 | Gargiulo F, Virus Res 2007; 125: 176 | Garzetti GG, Cancer 1998;
82: 886 | Lillo F, J Low Genit Tract Dis 2008; 12: 204 | Mariani L, BMC Cancer
2010; 10: 259 | Rolla M, Eur J Gynaecol Oncol 2009; 30: 557 | Sideri M, Vaccine
2009; 27 Suppl 1: A30 | Spinillo A, J Med Virol 2014; 86: 1145 | Tornesello ML,
Gynecol Oncol 2011; 121: 32 | Tornesello ML, J Med Virol 2006; 78: 1663 |
Venturoli S, J Med Virol 2008; 80: 1434 | Voglino G, Pathologica 2000; 92: 516
Lithuania Contributing studies: Gudleviciene Z, Medicina (Kaunas) 2005; 41: 910 |
Simanaviciene V, J Med Virol 2014
Luxembourg Contributing studies: Ressler S, Clin Cancer Res 2007; 13: 7067
Latvia Contributing studies: Kulmala SM, J Med Virol 2007; 79: 771 | Silins I, Gynecol
Oncol 2004; 93: 484
Netherlands Contributing studies: Baalbergen A, Gynecol Oncol 2013; 128: 530 | Baay MF, J
Clin Microbiol 1996; 34: 745 | Bulk S, Br J Cancer 2006; 94: 171 | Bulkmans
NW, Int J Cancer 2005; 117: 177 | De Boer MA, Int J Cancer 2005; 114: 422 |
Krul EJ, Int J Gynecol Cancer 1999; 9: 206 | Resnick RM, J Natl Cancer Inst
1990; 82: 1477 | Tang N, J Clin Virol 2009; 45 Suppl 1: S25 | Van Den Brule AJ,
Int J Cancer 1991; 48: 404 | Zielinski GD, J Pathol 2003; 201: 535
Norway Contributing studies: Bertelsen BI, Virchows Arch 2006; 449: 141 | Karlsen F, J
Clin Microbiol 1996; 34: 2095
(Continued)

Table 32 Continued
Country Study
Poland Contributing studies: Baay MF, Eur J Gynaecol Oncol 2009; 30: 162 | Bardin A,
Eur J Cancer 2008; 44: 557 | Biesaga B, Folia Histochem Cytobiol 2012; 50: 239
| Bosch FX, J Natl Cancer Inst 1995; 87: 796 | Dybikowska A, Oncol Rep 2002;
9: 871 | Kwasniewska A, Eur J Gynaecol Oncol 2009; 30: 65 | Pirog EC, Am J
Pathol 2000; 157: 1055
Portugal Contributing studies: Medeiros R, Eur J Cancer Prev 2005; 14: 467 | Nobre RJ,
J Med Virol 2010; 82: 1024 | Pista A, Int J Gynecol Cancer 2013; 23: 500
Russian Federation Contributing studies: Kleter B, J Clin Microbiol 1999; 37: 2508 | Kulmala SM, J
Med Virol 2007; 79: 771
Slovenia Contributing studies: Jancar N, Eur J Obstet Gynecol Reprod Biol 2009; 145:
184
Sweden Contributing studies: Andersson S, Acta Obstet Gynecol Scand 2003; 82: 960 |
Andersson S, Cancer Detect Prev 2005; 29: 37 | Andersson S, Eur J Cancer
2001; 37: 246 | Du J, Acta Oncol 2011; 50: 1215 | Graflund M, Int J Gynecol
Cancer 2004; 14: 896 | Hagmar B, Med Oncol Tumor Pharmacother 1992; 9: 113
| Skyldberg BM, Mod Pathol 1999; 12: 675 | Wallin KL, N Engl J Med 1999;
341: 1633 | Zehbe I, J Pathol 1997; 181: 270
Oceania
Australia Contributing studies: Brestovac B, J Med Virol 2005; 76: 106 | Chen S, Int J
Gynaecol Obstet 1999; 67: 163 | de Sanjose S, Lancet Oncol 2010; 11: 1048 | Liu
J, Gynecol Oncol 2004; 94: 803 | Plunkett M, Pathology 2003; 35: 397 | Stevens
MP, Int J Gynecol Cancer 2006; 16: 1017 | Thompson CH, Gynecol Oncol 1994;
54: 40
Papua New Guinea Contributing studies: Tabone T, Int J Gynaecol Obstet 2012; 117: 30
HPV type distribution for cervical high grade squamous intraepithelial lesions
Epidemiology Group up to November 2011, the ICO HPV Information Centre
has updated data until June 2015. Reference publications: 1) Guan P, Int J
Cancer 2012;131:2349 2) Smith JS, Int J Cancer 2007;121:621 3) Clifford GM, Br
J Cancer 2003;89:101.
Africa
Cte dIvoire Contributing studies: La Ruche G, Int J Cancer 1998; 76: 480
Cameroon Contributing studies: Untiet S, Int J Cancer 2014; 135: 1911
DR Congo Contributing studies: Hovland S, Br J Cancer 2010; 102: 957
Algeria Contributing studies: Hammouda D, Int J Cancer 2011; 128: 2224
Ethiopia Contributing studies: Abate E, J Med Virol 2013; 85: 282
Guinea Contributing studies: Keita N, Br J Cancer 2009; 101: 202
Equatorial Guinea Contributing studies: Garca-Espinosa B, Diagn Pathol 2009; 4: 31
Kenya Contributing studies: De Vuyst H, Cancer Causes Control 2010; 21: 2309 | De
Vuyst H, Int J Cancer 2012; 131: 949 | De Vuyst H, Sex Transm Dis 2003; 30:
137
Morocco Contributing studies: Alhamany Z, J Infect Dev Ctries 2010; 4: 732
Nigeria Contributing studies: Gage JC, Int J Cancer 2012; 131: 2903 | Haghshenas M,
Infect Agents Cancer 2013; 8: 20
Rwanda Contributing studies: Singh DK, J Infect Dis 2009; 199: 1851
Sudan Contributing studies: Abate E, J Med Virol 2013; 85: 282
Senegal Contributing studies: Chabaud M, J Med Virol 1996; 49: 259 | Xi LF, Int J
Cancer 2003; 103: 803
Tanzania Contributing studies: Dartell MA, Int J Cancer 2014; 135: 896
South Africa Contributing studies: Allan B, J Clin Microbiol 2008; 46: 740 | De Vuyst H, Int J
Cancer 2012; 131: 949 | Said HM, J Clin Virol 2009; 44: 318 | van Aardt MC,
Personal communication Unpublished
Zimbabwe Contributing studies: Sawaya GF, Obstet Gynecol 2008; 112: 990
(Continued)

Table 32 Continued
Country Study
Americas
Argentina Contributing studies: Abba MC, Rev Argent Microbiol 2003; 35: 74 | Alonio LV,
J Clin Virol 2003; 27: 263 | Chouhy D, Int J Mol Med 2006; 18: 995 | Deluca
GD, Rev Inst Med Trop Sao Paulo 2004; 46: 9 | Venezuela RF, Rev Inst Med
Trop Sao Paulo 2012; 54: 11
Belize Contributing studies: Cathro HP, Hum Pathol 2009; 40: 942
Brazil Contributing studies: Camara GN, Mem Inst Oswaldo Cruz 2003; 98: 879 |
Carestiato FN, Rev Soc Bras Med Trop 2006; 39: 428 | Chagas BS, PLoS ONE
2015; 10: e0132570 | Fernandes JV, BMC Res Notes 2010; 3: 96 | Fernandes JV,
Int J Gynaecol Obstet 2009; 105: 21 | Freitas TP, Rev Inst Med Trop Sao Paulo
2007; 49: 297 | Krambeck WM, Clin Exp Obstet Gynecol 2008; 35: 175 |
Lorenzato F, Int J Gynecol Cancer 2000; 10: 143 | Pitta DR, Rev Bras Ginecol
Obstet 2010; 32: 315 | Resende LS, BMC Infect Dis 2014; 14: 214 | Ribeiro AA,
Int J Gynecol Pathol 2011; 30: 288 | Terra AP, Tumori 2007; 93: 572 | Tomita
LY, Int J Cancer 2010; 126: 703
Canada Contributing studies: Antonishyn NA, Arch Pathol Lab Med 2008; 132: 54 |
Coutle F, J Med Virol 2011; 83: 1034 | Jiang Y, J Infect Public Health 2011; 4:
219 | Moore RA, Cancer Causes Control 2009; 20: 1387
Chile Contributing studies: Ili CG, J Med Virol 2011; 83: 833
Colombia Contributing studies: Bosch FX, Cancer Epidemiol Biomarkers Prev 1993; 2: 415
| Garca DA, Open Virol J 2011; 5: 70 | Muoz N, Int J Cancer 1992; 52: 743
Costa Rica Contributing studies: Herrero R, J Infect Dis 2005; 191: 1796
Cuba Contributing studies: Soto Y, Sex Transm Dis 2007; 34: 974
Ecuador Contributing studies: Meja L, J Med Virol 2016; 88: 144
Jamaica Contributing studies: Rattray C, J Infect Dis 1996; 173: 718 | Strickler HD, J
Med Virol 1999; 59: 60
Mexico Contributing studies: Giuliano AR, Cancer Epidemiol Biomarkers Prev 2001; 10:
1129 | Illades-Aguiar B, Gynecol Oncol 2010; 117: 291 | Pia-Snchez P, Int J
Gynecol Cancer 2006; 16: 1041 | Torroella-Kouri M, Gynecol Oncol 1998; 70:
115 | Velzquez-Mrquez N, Int J Infect Dis 2009; 13: 690
Peru Contributing studies: Martorell M, Genet Mol Res 2012; 11: 2099
Paraguay Contributing studies: Mendoza LP, J Med Virol 2011; 83: 1351
USA Contributing studies: Adam E, Am J Obstet Gynecol 1998; 178: 1235 | Bell MC,
Gynecol Oncol 2007; 107: 236 | Castle PE, Cancer Epidemiol Biomarkers Prev
2010; 19: 1675 | Castle PE, Cancer Epidemiol Biomarkers Prev 2011; 20: 946 |
Einstein MH, Int J Cancer 2007; 120: 55 | Evans MF, Cancer 2006; 106: 1054 |
Evans MF, Eur J Gynaecol Oncol 2003; 24: 373 | Giuliano AR, Cancer Epidemiol
Biomarkers Prev 2001; 10: 1129 | Guo M, Mod Pathol 2007; 20: 256 | Hariri S,
J Infect Dis 2012; 206: 1878 | Hariri S, PLoS ONE 2012; 7: e34044 | Hu L, Mod
Pathol 2005; 18: 267 | Joste NE, Cancer Epidemiol Biomarkers Prev 2015; 24:
230 | Kong CS, Am J Surg Pathol 2007; 31: 33 | Lee SH, Int J Gynaecol Obstet
2009; 105: 210 | Moscicki AB, Obstet Gynecol 2008; 112: 1335 | Stoler MH, Am
J Clin Pathol 2011; 135: 468 | Vidal AC, Cancer Causes Control 2014; 25: 1055
| Voss JS, Anal Quant Cytol Histol 2009; 31: 208 | Wentzensen N, Int J Cancer
2009; 124: 964 | Wheeler CM, J Infect Dis 2006; 194: 1291 | Wheeler CM, J
Natl Cancer Inst 2009; 101: 475 | Zuna RE, Mod Pathol 2007; 20: 167
Venezuela Contributing studies: Snchez-Lander J, Cancer Epidemiol 2012; 36: e284
Asia
(Continued)

Table 32 Continued
Country Study
China Contributing studies: Chan MK, Gynecol Oncol 1996; 60: 217 | Chan PK, Int J
Cancer 2006; 118: 243 | Chan PK, Int J Cancer 2012; 131: 692 | Chan PK, J
Med Virol 1999; 59: 232 | Ding X, J Med Virol 2014; 86: 1937 | Guo J, Scand J
Infect Dis 2010; 42: 72 | Jin Q, Chin Med J 2010; 123: 2004 | Li H, Eur J Obstet
Gynecol Reprod Biol 2013; 170: 202 | Li J, Int J Gynaecol Obstet 2011; 112: 131
| Li J, J Clin Microbiol 2012; 50: 1079 | Liu SS, Tumour Biol 2008; 29: 105 |
Singh S, Int J Clin Exp Pathol 2015; 8: 11901 | Sun B, Arch Virol 2014; 159:
1027 | Tao PP, Zhonghua Fu Chan Ke Za Zhi 2006; 41: 43 | Wu CH, Sex Transm
Dis 1994; 21: 309 | Wu EQ, Cancer Causes Control 2013; 24: 795 | Yuan X, Arch
Gynecol Obstet 2011; 283: 1385 | Zhang R, Cancer Epidemiol 2013; 37: 939 |
Zhao FH, Int J Cancer 2014; 135: 2604 | Zhao Y, Pathol Int 2008; 58: 643
India Contributing studies: Deodhar K, J Med Virol 2012; 84: 1054 | Franceschi S, Br
J Cancer 2005; 92: 601 | Nagpal JK, Eur J Clin Invest 2002; 32: 943 | Singh M,
Tumour Biol 2009; 30: 276
SR, Asian Pac J Cancer Prev 2006; 7: 529 | Khodakarami N, Int J Cancer 2012;
131: E156
Israel Contributing studies: Bassal R, J Low Genit Tract Dis 2015; 19: 161 | Laskov I,
Int J Gynecol Cancer 2013; 23: 730
Japan Contributing studies: Azuma Y, Jpn J Clin Oncol 2014 | Ichimura H, Int J Clin
Oncol 2003; 8: 322 | Inoue M, Int J Gynecol Cancer 2006; 16: 1007 | Konno R,
Cancer Sci 2011; 102: 877 | Matsumoto K, Int J Cancer 2011; 128: 2898 | Nagai
Y, Gynecol Oncol 2000; 79: 294 | Nakamura Y, Int J Clin Oncol 2015; 20: 974 |
Nishiwaki M, J Clin Microbiol 2008; 46: 1161 | Niwa K, Oncol Rep 2003; 10:
1437 | Okadome M, J Obstet Gynaecol Res 2014; 40: 561 | Onuki M, Cancer Sci
2009; 100: 1312 | Sasagawa T, Cancer Epidemiol Biomarkers Prev 2001; 10: 45
| Takehara K, Patholog Res Int 2011; 2011: 246936 | Tsuda H, Gynecol Oncol
2003; 91: 476 | Yamasaki K, J Obstet Gynaecol Res 2011; 37: 1666 | Yoshida T,
Cancer 2004; 102: 100
Republic of Korea Contributing studies: Cho NH, Am J Obstet Gynecol 2003; 188: 56 | Hwang TS,
Gynecol Oncol 2003; 90: 51 | Kahng J, Ann Lab Med 2014; 34: 127 | Kang WD,
Int J Gynecol Cancer 2009; 19: 924 | Oh YL, Cytopathology 2001; 12: 75 | Quek
SC, Int J Gynecol Cancer 2013; 23: 148
Kuwait Contributing studies: Al-Awadhi R, Diagn Cytopathol 2013; 41: 107 | Al-Awadhi
R, J Med Virol 2011; 83: 453
Sri Lanka Contributing studies: Karunaratne K, BMC Cancer 2014; 14: 116
Malaysia Contributing studies: Quek SC, Int J Gynecol Cancer 2013; 23: 148
Pakistan Contributing studies: Raza SA, Br J Cancer 2010; 102: 1657
Philippines Contributing studies: Quek SC, Int J Gynecol Cancer 2013; 23: 148
Singapore Contributing studies: Quek SC, Int J Gynecol Cancer 2013; 23: 148
Thailand Contributing studies: Chansaenroj J, Asian Pac J Cancer Prev 2010; 11: 117 |
Chansaenroj J, J Med Virol 2014; 86: 601 | Limpaiboon T, Southeast Asian J
Trop Med Public Health 2000; 31: 66 | Sukasem C, J Med Virol 2011; 83: 119 |
Suwannarurk K, Cancer Epidemiol 2009; 33: 56 | Swangvaree SS, Asian Pac J
Cancer Prev 2013; 14: 1023
Turkey Contributing studies: Baser E, Int J Gynaecol Obstet 2014; 125: 275 | Sahiner
F, Mikrobiyol Bul 2012; 46: 624 | Tezcan S, Asian Pac J Cancer Prev 2014; 15:
3997 | Yuce K, Arch Gynecol Obstet 2012; 286: 203
Taiwan Contributing studies: Chao A, Int J Cancer 2008; 122: 2835 | Chao A, Int J
Cancer 2010; 126: 191 | Ho CM, Gynecol Oncol 2005; 99: 615 | Lai HC, Int J
Cancer 2003; 103: 221 | Lin H, Gynecol Oncol 2005; 96: 84 | Yang YY, J
Microbiol Immunol Infect 2004; 37: 282
Viet Nam Contributing studies: Quek SC, Int J Gynecol Cancer 2013; 23: 148
(Continued)

Table 32 Continued
Country Study
Europe
Austria Contributing studies: Rssler L, Wien Klin Wochenschr 2013; 125: 591
Belgium Contributing studies: Arbyn M, Cancer Epidemiol Biomarkers Prev 2009; 18:
321 | Baay MF, Eur J Gynaecol Oncol 2001; 22: 204 | Beerens E, Cytopathology
2005; 16: 199 | Depuydt CE, Br J Cancer 2003; 88: 560
Switzerland Contributing studies: Dobec M, J Med Virol 2011; 83: 1370
Czech Republic Contributing studies: Tachezy R, PLoS ONE 2011; 6: e21913
Germany Contributing studies: de Jonge M, Acta Cytol 2013; 57: 591 | Klug SJ, J Med
Virol 2007; 79: 616 | Merkelbach-Bruse S, Diagn Mol Pathol 1999; 8: 32 | Meyer
T, Int J Gynecol Cancer 2001; 11: 198 | Nindl I, Int J Gynecol Pathol 1997; 16:
197 | Nindl I, J Clin Pathol 1999; 52: 17
Denmark Contributing studies: Bonde J, BMC Infect Dis 2014; 14: 413 | Hording U, Eur J
Obstet Gynecol Reprod Biol 1995; 62: 49 | Kirschner B, Acta Obstet Gynecol
Scand 2013; 92: 1032 | Kjaer SK, Int J Cancer 2008; 123: 1864 | Kjr SK,
Cancer Causes Control 2014; 25: 179 | Sebbelov AM, Res Virol 1994; 145: 83 |
Thomsen LT, Int J Cancer 2015; 137: 193
Spain Contributing studies: Bosch FX, Cancer Epidemiol Biomarkers Prev 1993; 2:
415 | Conesa-Zamora P, BMC Infect Dis 2009; 9: 124 | Darwich L, Int J Gynecol
Cancer 2011; 21: 1486 | de Mndez MT, Acta Cytol 2009; 53: 540 | de Oa M, J
Med Virol 2010; 82: 597 | Garca-Sierra N, J Clin Microbiol 2009; 47: 2165 |
Herraez-Hernandez E, J Virol Methods 2013; 193: 9 | Martn P, BMC Infect Dis
2011; 11: 316 | Muoz N, Int J Cancer 1992; 52: 743
France Contributing studies: Monsonego J, Int J STD AIDS 2008; 19: 385 | Prtet JL,
Int J Cancer 2008; 122: 424 | Vaucel E, Arch Gynecol Obstet 2011; 284: 989
United Kingdom Contributing studies: Anderson L, J Med Virol 2013; 85: 295 | Arends MJ, Hum
Pathol 1993; 24: 432 | Cuschieri KS, J Clin Pathol 2004; 57: 68 | Cuzick J, Br J
Cancer 1994; 69: 167 | Cuzick J, J Clin Virol 2014; 60: 44 | Geraets DT, J Clin
Microbiol 2014; 52: 3996 | Herrington CS, Br J Cancer 1995; 71: 206 | Hibbitts
S, Br J Cancer 2008; 99: 1929 | Howell-Jones R, Br J Cancer 2010; 103: 209 |
Jamison J, Cytopathology 2009; 20: 242 | Sargent A, Br J Cancer 2008; 98: 1704
| Southern SA, Diagn Mol Pathol 1998; 7: 114
Greece Contributing studies: Agorastos T, Eur J Obstet Gynecol Reprod Biol 2005; 121:
99 | Argyri E, BMC Infect Dis 2013; 13: 53 | Daponte A, J Clin Virol 2006; 36:
189 | Kroupis C, Epidemiol Infect 2007; 135: 943 | Labropoulou V, Sex Transm
Dis 1997; 24: 469 | Panotopoulou E, J Med Virol 2007; 79: 1898 | Paraskevaidis
E, Gynecol Oncol 2001; 82: 355 | Tsiodras S, Clin Microbiol Infect 2011; 17: 1185
Croatia Contributing studies: Grce M, Anticancer Res 2001; 21: 579 | Grce M, J Clin
Microbiol 2004; 42: 1341
Hungary Contributing studies: Szoke K, J Med Virol 2003; 71: 585
Ireland Contributing studies: Butler D, J Pathol 2000; 192: 502 | Keegan H, J Virol
Methods 2014; 201: 93 | Murphy N, J Clin Pathol 2003; 56: 56 | OLeary JJ, J
Clin Pathol 1998; 51: 576
Iceland Contributing studies: Sigurdsson K, Int J Cancer 2007; 121: 2682
Italy Contributing studies: Agarossi A, J Med Virol 2009; 81: 529 | Capra G, Virus
Res 2008; 133: 195 | Carozzi F, J Clin Virol 2014; 60: 257 | Carozzi FM, Cancer
Epidemiol Biomarkers Prev 2010; 19: 2389 | Gargiulo F, Virus Res 2007; 125:
176 | Giorgi Rossi P, BMC Infect Dis 2010; 10: 214 | Laconi S, Pathologica 2000;
92: 524 | Sandri MT, J Med Virol 2009; 81: 271 | Spinillo A, J Med Virol 2014;
86: 1145 | Tornesello ML, J Med Virol 2006; 78: 1663 | Venturoli S, J Med Virol
2008; 80: 1434 | Zerbini M, J Clin Pathol 2001; 54: 377
Lithuania Contributing studies: Gudleviciene Z, Medicina (Kaunas) 2005; 41: 910 |
Simanaviciene V, J Med Virol 2014
Latvia Contributing studies: Kulmala SM, J Med Virol 2007; 79: 771
(Continued)

Table 32 Continued
Country Study
Netherlands Contributing studies: Bulkmans NW, Int J Cancer 2005; 117: 177 | Cornelissen
MT, Virchows Arch, B, Cell Pathol 1992; 62: 167 | Prinsen CF, BJOG 2007; 114:
951 | Reesink-Peters N, Eur J Obstet Gynecol Reprod Biol 2001; 98: 199 | Tang
N, J Clin Virol 2009; 45 Suppl 1: S25 | van Duin M, Int J Cancer 2003; 105: 577
Norway Contributing studies: Kraus I, Br J Cancer 2004; 90: 1407 | Molden T, Cancer
Epidemiol Biomarkers Prev 2005; 14: 367 | Roberts CC, J Clin Virol 2006; 36:
277 | Sjoeborg KD, Gynecol Oncol 2010; 118: 29
J Med Virol 2010; 82: 1024 | Pista A, Clin Microbiol Infect 2011; 17: 941 | Pista
A, Int J Gynecol Cancer 2013; 23: 500
Romania Contributing studies: Anton G, APMIS 2011; 119: 1 | Ursu RG, Virol J 2011; 8:
558
Russian Federation Contributing studies: Kulmala SM, J Med Virol 2007; 79: 771
Slovenia Contributing studies: Kovanda A, Acta Dermatovenerol Alp Pannonica Adriat
2009; 18: 47
Sweden Contributing studies: Andersson S, Br J Cancer 2005; 92: 2195 | Kalantari M,
Hum Pathol 1997; 28: 899 | Zehbe I, Virchows Arch 1996; 428: 151
Oceania
Australia Contributing studies: Brestovac B, J Med Virol 2005; 76: 106 | Callegari ET,
Vaccine 2014; 32: 4082 | Garland SM, BMC Med 2011; 9: 104 | Stevens MP, Int
J Gynecol Cancer 2006; 16: 1017 | Stevens MP, J Med Virol 2009; 81: 1283
Fiji Contributing studies: Tabrizi SN, Sex Health 2011; 8: 338
New Zealand Contributing studies: Kang YJ, BMC Infect Dis 2015; 15: 365
HPV type distribution for cervical low grade squamous intraepithelial lesions
Epidemiology Group up to November 2011, the ICO HPV Information Centre has
updated data until June 2015. Reference publications: 1) Guan P, Int J Cancer
2012;131:2349 2) Clifford GM, Cancer Epidemiol Biomarkers Prev 2005;14:1157
Africa
Cte dIvoire Contributing studies: La Ruche G, Int J Cancer 1998; 76: 480
Cameroon Contributing studies: Untiet S, Int J Cancer 2014; 135: 1911
DR Congo Contributing studies: Hovland S, Br J Cancer 2010; 102: 957
Algeria Contributing studies: Hammouda D, Int J Cancer 2011; 128: 2224
Ethiopia Contributing studies: Abate E, J Med Virol 2013; 85: 282
Guinea Contributing studies: Keita N, Br J Cancer 2009; 101: 202
Kenya Contributing studies: De Vuyst H, Cancer Causes Control 2010; 21: 2309 | De
Vuyst H, Int J Cancer 2012; 131: 949 | De Vuyst H, Sex Transm Dis 2003; 30:
137
Morocco Contributing studies: Alhamany Z, J Infect Dev Ctries 2010; 4: 732
Nigeria Contributing studies: Gage JC, Int J Cancer 2012; 131: 2903 | Thomas JO, Br J
Cancer 2004; 90: 638
Senegal Contributing studies: Chabaud M, J Med Virol 1996; 49: 259 | Xi LF, Int J
Cancer 2003; 103: 803
South Africa Contributing studies: Allan B, J Clin Microbiol 2008; 46: 740 | van Aardt MC,
Personal communication Unpublished
Zimbabwe Contributing studies: Sawaya GF, Obstet Gynecol 2008; 112: 990
Americas
Argentina Contributing studies: Abba MC, Rev Argent Microbiol 2003; 35: 74 | Chouhy D,
Int J Mol Med 2006; 18: 995 | Deluca GD, Rev Inst Med Trop Sao Paulo 2004;
46: 9 | Eiguchi K, J Low Genit Tract Dis 2008; 12: 262 | Tonon SA, Infect Dis
Obstet Gynecol 1999; 7: 237 | Venezuela RF, Rev Inst Med Trop Sao Paulo 2012;
54: 11
Belize Contributing studies: Cathro HP, Hum Pathol 2009; 40: 942
(Continued)

Table 32 Continued
Country Study
Brazil Contributing studies: Carestiato FN, Rev Soc Bras Med Trop 2006; 39: 428 |
Fernandes JV, Int J Gynaecol Obstet 2009; 105: 21 | Franco E, Rev Panam
Salud Publica 1999; 6: 223 | Freitas TP, Rev Inst Med Trop Sao Paulo 2007; 49:
297 | Krambeck WM, Clin Exp Obstet Gynecol 2008; 35: 175 | Lorenzato F, Int
J Gynecol Cancer 2000; 10: 143 | Pitta DR, Rev Bras Ginecol Obstet 2010; 32:
315 | Resende LS, BMC Infect Dis 2014; 14: 214 | Ribeiro AA, Int J Gynecol
Pathol 2011; 30: 288 | Tomita LY, Int J Cancer 2010; 126: 703
Canada Contributing studies: Antonishyn NA, Arch Pathol Lab Med 2008; 132: 54 |
Coutle F, J Med Virol 2011; 83: 1034 | Jiang Y, J Infect Public Health 2011; 4:
219 | Koushik A, Cancer Detect Prev 2005; 29: 307 | Moore RA, Cancer Causes
Control 2009; 20: 1387 | Richardson H, Cancer Epidemiol Biomarkers Prev
2003; 12: 485 | Sellors JW, CMAJ 2000; 163: 503 | Sellors JW, CMAJ 2000; 163:
513 | Tran-Thanh D, Am J Obstet Gynecol 2003; 188: 129
Chile Contributing studies: Ili CG, J Med Virol 2011; 83: 833 | Lpez M J, Rev Med
Chil 2010; 138: 1343
Colombia Contributing studies: Del Ro-Ospina L, BMC Cancer 2015; 15: 100 | Garca
DA, Open Virol J 2011; 5: 70 | Molano M, Br J Cancer 2002; 87: 1417
Cuba Contributing studies: Soto Y, Sex Transm Dis 2007; 34: 974
Ecuador Contributing studies: Tornesello ML, J Med Virol 2008; 80: 1959
Jamaica Contributing studies: Rattray C, J Infect Dis 1996; 173: 718 | Strickler HD, J
Med Virol 1999; 59: 60
Mexico Contributing studies: Carrillo A, Salud Publica Mex 2004; 46: 7 | Giuliano AR,
Cancer Epidemiol Biomarkers Prev 2001; 10: 1129 | Gonzlez-Losa Mdel R, J
Clin Virol 2004; 29: 202 | Illades-Aguiar B, Gynecol Oncol 2010; 117: 291 |
Pia-Snchez P, Int J Gynecol Cancer 2006; 16: 1041 | Torroella-Kouri M,
Gynecol Oncol 1998; 70: 115 | Velzquez-Mrquez N, Int J Infect Dis 2009; 13:
690
Peru Contributing studies: Martorell M, Genet Mol Res 2012; 11: 2099
Paraguay Contributing studies: Mendoza LP, J Med Virol 2011; 83: 1351 | Tonon SA,
Infect Dis Obstet Gynecol 1999; 7: 237
Uruguay Contributing studies: Ramas V, J Med Virol 2013; 85: 845
USA Contributing studies: Adam E, Am J Obstet Gynecol 2000; 182: 257 | Bell MC,
Gynecol Oncol 2007; 107: 236 | Brown DR, Sex Transm Dis 2002; 29: 763 |
Castle PE, Cancer Epidemiol Biomarkers Prev 2011; 20: 946 | Einstein MH, Int
J Cancer 2007; 120: 55 | Evans MF, Cancer 2006; 106: 1054 | Evans MF, Mod
Pathol 2002; 15: 1339 | Giuliano AR, Cancer Epidemiol Biomarkers Prev 2001;
10: 1129 | Guo M, Mod Pathol 2007; 20: 256 | Hu L, Mod Pathol 2005; 18: 267 |
Jarboe EA, Hum Pathol 2004; 35: 396 | Kong CS, Am J Surg Pathol 2007; 31: 33
| Kulasingam SL, JAMA 2002; 288: 1749 | Lee SH, Int J Gynaecol Obstet 2009;
105: 210 | Liaw KL, J Natl Cancer Inst 1999; 91: 954 | Moscicki AB, Obstet
Gynecol 2008; 112: 1335 | Park K, Int J Gynecol Pathol 2007; 26: 457 | Schiff
M, Am J Epidemiol 2000; 152: 716 | Stoler MH, Am J Clin Pathol 2011; 135: 468
| Swan DC, J Clin Microbiol 1999; 37: 1030 | Tortolero-Luna G, Cad Saude
Publica 1998; 14 Suppl 3: 149 | Vidal AC, Cancer Causes Control 2014; 25: 1055
| Voss JS, Anal Quant Cytol Histol 2009; 31: 208 | Wentzensen N, Int J Cancer
2009; 124: 964 | Wheeler CM, J Infect Dis 2006; 194: 1291 | Wheeler CM, J
Natl Cancer Inst 2009; 101: 475 | Zuna RE, Mod Pathol 2007; 20: 167
Venezuela Contributing studies: Correnti M, Gynecol Oncol 2011; 121: 527
Asia
(Continued)

Table 32 Continued
Country Study
China Contributing studies: Chan PK, Int J Cancer 2006; 118: 243 | Chan PK, Int J
Cancer 2012; 131: 692 | Chan PK, J Med Virol 1999; 59: 232 | Ding X, J Med
Virol 2014; 86: 1937 | Guo J, Scand J Infect Dis 2010; 42: 72 | Hong D, Int J
Gynecol Cancer 2008; 18: 104 | Jin Q, Chin Med J 2010; 123: 2004 | Li H, Eur J
Obstet Gynecol Reprod Biol 2013; 170: 202 | Li J, J Clin Microbiol 2012; 50:
1079 | Liu SS, Tumour Biol 2008; 29: 105 | Liu X, Int J Gynecol Cancer 2010;
20: 147 | Sun B, Arch Virol 2014; 159: 1027 | Tao PP, Zhonghua Fu Chan Ke Za
Zhi 2006; 41: 43 | Wu D, Eur J Obstet Gynecol Reprod Biol 2010; 151: 86 | Wu
EQ, Cancer Causes Control 2013; 24: 795 | Yuan X, Arch Gynecol Obstet 2011;
283: 1385 | Zhang R, Cancer Epidemiol 2013; 37: 939 | Zhao FH, Int J Cancer
2014; 135: 2604 | Zhao Y, Pathol Int 2008; 58: 643
India Contributing studies: Berlin Grace VM, Indian J Cancer 2009; 46: 203 |
Franceschi S, Br J Cancer 2005; 92: 601 | Nagpal JK, Eur J Clin Invest 2002; 32:
943 | Nair P, Pathol Oncol Res 1999; 5: 95 | Singh M, Tumour Biol 2009; 30: 276
SR, Asian Pac J Cancer Prev 2006; 7: 529 | Khodakarami N, Int J Cancer 2012;
131: E156
Japan Contributing studies: Inoue M, Int J Gynecol Cancer 2006; 16: 1007 | Konno R,
Cancer Sci 2011; 102: 877 | Matsumoto K, Int J Cancer 2011; 128: 2898 |
Nishiwaki M, J Clin Microbiol 2008; 46: 1161 | Onuki M, Cancer Sci 2009; 100:
1312 | Saito J, Jap J Obstet Gynecol Pract 2001; 50: 871 | Sasagawa T, Cancer
Epidemiol Biomarkers Prev 2001; 10: 45 | Takehara K, Patholog Res Int 2011;
2011: 246936 | Tsuda H, Gynecol Oncol 2003; 91: 476 | Yamasaki K, J Obstet
Gynaecol Res 2011; 37: 1666 | Yoshida T, Cancer 2004; 102: 100
Republic of Korea Contributing studies: An HJ, Cancer 2003; 97: 1672 | Cho NH, Am J Obstet
Gynecol 2003; 188: 56 | Hwang TS, Gynecol Oncol 2003; 90: 51 | Kang WD, Int
J Gynecol Cancer 2009; 19: 924 | Lee HS, Int J Gynecol Cancer 2007; 17: 497 |
Oh YL, Cytopathology 2001; 12: 75
Kuwait Contributing studies: Al-Awadhi R, Diagn Cytopathol 2013; 41: 107 | Al-Awadhi
R, J Med Virol 2011; 83: 453
Malaysia Contributing studies: Sharifah NA, Asian Pac J Cancer Prev 2009; 10: 303
Pakistan Contributing studies: Raza SA, Br J Cancer 2010; 102: 1657
Thailand Contributing studies: Bhattarakosol P, J Med Assoc Thai 2002; 85 Suppl 1: S360
| Chaiwongkot A, Asian Pac J Cancer Prev 2007; 8: 279 | Chansaenroj J, Asian
Pac J Cancer Prev 2010; 11: 117 | Chansaenroj J, J Med Virol 2014; 86: 601 |
Ekalaksananan T, J Obstet Gynaecol Res 2001; 27: 117 | Suwannarurk K,
Cancer Epidemiol 2009; 33: 56
Turkey Contributing studies: Ergnay K, Mikrobiyol Bul 2008; 42: 273 | Ozgul N, J
Obstet Gynaecol Res 2008; 34: 865 | Sahiner F, Mikrobiyol Bul 2012; 46: 624 |
Tezcan S, Asian Pac J Cancer Prev 2014; 15: 3997 | Yuce K, Arch Gynecol
Obstet 2012; 286: 203
Taiwan Contributing studies: Chao A, Int J Cancer 2008; 122: 2835 | Ding DC, Eur J
Obstet Gynecol Reprod Biol 2008; 140: 245 | Huang YK, Br J Cancer 2008; 98:
863
Europe
Belgium Contributing studies: Arbyn M, Cancer Epidemiol Biomarkers Prev 2009; 18:
321 | Baay MF, Eur J Gynaecol Oncol 2001; 22: 204 | Beerens E, Cytopathology
2005; 16: 199 | Depuydt CE, Br J Cancer 2003; 88: 560 | Weyn C, Cancer
Epidemiol 2013; 37: 457
Switzerland Contributing studies: Dobec M, J Med Virol 2011; 83: 1370
Czech Republic Contributing studies: Tachezy R, PLoS ONE 2011; 6: e21913
Germany Contributing studies: de Jonge M, Acta Cytol 2013; 57: 591 | Klug SJ, J Med
Virol 2007; 79: 616 | Merkelbach-Bruse S, Diagn Mol Pathol 1999; 8: 32 | Meyer
T, Int J Gynecol Cancer 2001; 11: 198 | Nindl I, J Clin Pathol 1999; 52: 17
(Continued)

Table 32 Continued
Country Study
Denmark Contributing studies: Hording U, Eur J Obstet Gynecol Reprod Biol 1995; 62: 49
| Kjaer SK, Int J Cancer 2008; 123: 1864 | Kjr SK, Cancer Causes Control
2014; 25: 179
Spain Contributing studies: Conesa-Zamora P, BMC Infect Dis 2009; 9: 124 | de
Mndez MT, Acta Cytol 2009; 53: 540 | de Oa M, J Med Virol 2010; 82: 597 |
Domnech-Peris A, Gynecol Obstet Invest 2010; 70: 113 | Garca-Sierra N, J
Clin Microbiol 2009; 47: 2165 | Herraez-Hernandez E, J Virol Methods 2013;
193: 9 | Martn P, BMC Infect Dis 2011; 11: 316
France Contributing studies: Bergeron C, Am J Surg Pathol 1992; 16: 641 | Humbey O,
Eur J Obstet Gynecol Reprod Biol 2002; 103: 60 | Monsonego J, Int J STD AIDS
2008; 19: 385 | Prtet JL, Gynecol Oncol 2008; 110: 179 | Vaucel E, Arch
Gynecol Obstet 2011; 284: 989
United Kingdom Contributing studies: Anderson L, J Med Virol 2013; 85: 295 | Arends MJ, Hum
Pathol 1993; 24: 432 | Cuschieri KS, J Clin Pathol 2004; 57: 68 | Cuzick J, Br J
Cancer 1994; 69: 167 | Cuzick J, Br J Cancer 1999; 81: 554 | Giannoudis A, Int
J Cancer 1999; 83: 66 | Hibbitts S, Br J Cancer 2008; 99: 1929 | Howell-Jones
R, Br J Cancer 2010; 103: 209 | Jamison J, Cytopathology 2009; 20: 242 |
Sargent A, Br J Cancer 2008; 98: 1704 | Southern SA, Hum Pathol 2001; 32:
1351 | Woo YL, Int J Cancer 2010; 126: 133
Greece Contributing studies: Adamopoulou M, Anticancer Res 2009; 29: 3401 | Argyri
E, BMC Infect Dis 2013; 13: 53 | Kroupis C, Epidemiol Infect 2007; 135: 943 |
Labropoulou V, Sex Transm Dis 1997; 24: 469 | Mammas IN, Oncol Rep 2008;
20: 141 | Panotopoulou E, J Med Virol 2007; 79: 1898 | Tsiodras S, Clin
Microbiol Infect 2011; 17: 1185
Croatia Contributing studies: Grce M, Anticancer Res 2001; 21: 579 | Grce M, Eur J
Epidemiol 1997; 13: 645 | Grce M, J Clin Microbiol 2004; 42: 1341
Ireland Contributing studies: Butler D, J Pathol 2000; 192: 502 | Keegan H, J Virol
Methods 2014; 201: 93 | Murphy N, J Clin Pathol 2003; 56: 56
Italy Contributing studies: Agarossi A, J Med Virol 2009; 81: 529 | Agodi A, Int J
Gynecol Cancer 2009; 19: 1094 | Astori G, Virus Res 1997; 50: 57 | Capra G,
Virus Res 2008; 133: 195 | Chironna M, J Prev Med Hyg 2010; 51: 139 |
Gargiulo F, Virus Res 2007; 125: 176 | Giorgi Rossi P, BMC Infect Dis 2010; 10:
214 | Laconi S, Pathologica 2000; 92: 524 | Menegazzi P, Infect Dis Obstet
Gynecol 2009; 2009: 198425 | Sandri MT, J Med Virol 2009; 81: 271 | Spinillo A,
Gynecol Oncol 2009; 113: 115 | Spinillo A, J Med Virol 2014; 86: 1145 |
Tornesello ML, J Med Virol 2006; 78: 1663 | Venturoli S, J Clin Virol 2002; 25:
177 | Venturoli S, J Med Virol 2008; 80: 1434 | Voglino G, Pathologica 2000; 92:
516 | Zerbini M, J Clin Pathol 2001; 54: 377
Lithuania Contributing studies: Gudleviciene Z, Medicina (Kaunas) 2005; 41: 910
Latvia Contributing studies: Kulmala SM, J Med Virol 2007; 79: 771
Netherlands Contributing studies: Bollen LJ, Am J Obstet Gynecol 1997; 177: 548 | Prinsen
CF, BJOG 2007; 114: 951 | Reesink-Peters N, Eur J Obstet Gynecol Reprod Biol
2001; 98: 199
Norway Contributing studies: Molden T, Cancer Epidemiol Biomarkers Prev 2005; 14:
367 | Roberts CC, J Clin Virol 2006; 36: 277
J Med Virol 2010; 82: 1024
Romania Contributing studies: Anton G, APMIS 2011; 119: 1 | Ursu RG, Virol J 2011; 8:
558
Russian Federation Contributing studies: Kulmala SM, J Med Virol 2007; 79: 771
Sweden Contributing studies: Andersson S, Br J Cancer 2005; 92: 2195 |
Brismar-Wendel S, Br J Cancer 2009; 101: 511 | Kalantari M, Hum Pathol 1997;
28: 899 | Sderlund-Strand A, Am J Obstet Gynecol 2011; 205: 145.e1 | Zehbe I,
Virchows Arch 1996; 428: 151
(Continued)

Table 32 Continued
Country Study
Oceania
Australia Contributing studies: Brestovac B, J Med Virol 2005; 76: 106 | Garland SM,
BMC Med 2011; 9: 104 | Stevens MP, J Med Virol 2009; 81: 1283
HPV type distribution for invasive anal cancer
General sources Based on systematic reviews (up to 2008) performed by ICO for the IARC
Monograph on the Evaluation of Carcinogenic Risks to Humans volume 100B
and IARCs Infections and Cancer Epidemiology Group. The ICO HPV
Information Centre has updated data until June 2015. Reference publications: 1)
Bouvard V, Lancet Oncol 2009;10:321 2) De Vuyst H, Int J Cancer 2009;124:1626
Africa
Mali Alemany L, Int J Cancer 2015; 136: 98
Nigeria Alemany L, Int J Cancer 2015; 136: 98
Senegal Alemany L, Int J Cancer 2015; 136: 98
Americas
Canada Ouhoummane N, Cancer Epidemiol 2013; 37: 807
Chile Alemany L, Int J Cancer 2015; 136: 98
Colombia Alemany L, Int J Cancer 2015; 136: 98
Ecuador Alemany L, Int J Cancer 2015; 136: 98
Guatemala Alemany L, Int J Cancer 2015; 136: 98
Honduras Alemany L, Int J Cancer 2015; 136: 98
Mexico Alemany L, Int J Cancer 2015; 136: 98
Paraguay Alemany L, Int J Cancer 2015; 136: 98
USA Alemany L, Int J Cancer 2015; 136: 98 | Daling JR, Cancer 2004; 101: 270 |
Noffsinger AE, Mod Pathol 1995; 8: 509 | Palefsky JM, Cancer Res 1991; 51:
1014 | Shroyer KR, Am J Clin Pathol 1995; 104: 299 | Zaki SR, Am J Pathol
1992; 140: 1345
Asia
Bangladesh Alemany L, Int J Cancer 2015; 136: 98
China Lai MD, World J Gastroenterol 1998; 4: 298
India Alemany L, Int J Cancer 2015; 136: 98
Republic of Korea Alemany L, Int J Cancer 2015; 136: 98 | Yhim HY, Int J Cancer 2011; 129: 1752
| Youk EG, Dis Colon Rectum 2001; 44: 236
Europe
Bosnia & Herzegovina Alemany L, Int J Cancer 2015; 136: 98
Switzerland Poletti PA, Int J Colorectal Dis 1998; 13: 108
Czech Republic Alemany L, Int J Cancer 2015; 136: 98 | Tachezy R, PLoS ONE 2011; 6: e21913
Germany Alemany L, Int J Cancer 2015; 136: 98 | Kreuter A, Br J Dermatol 2010; 162:
1269 | Rdel F, Int J Cancer 2015; 136: 278 | Varnai AD, Int J Colorectal Dis
2006; 21: 135
Denmark Frisch M, N Engl J Med 1997; 337: 1350 | Serup-Hansen E, J Clin Oncol 2014;
32: 1812
Spain Alemany L, Int J Cancer 2015; 136: 98
France Abramowitz L, Int J Cancer 2011; 129: 433 | Alemany L, Int J Cancer 2015;
136: 98 | Valmary-Degano S, Hum Pathol 2013; 44: 992 | Vincent-Salomon A,
Mod Pathol 1996; 9: 614
United Kingdom Alemany L, Int J Cancer 2015; 136: 98 | Baricevic I, Eur J Cancer 2015; 51: 776
| Crook T, Oncogene 1991; 6: 1251 | Ogunbiyi OA, J Clin Pathol 1993; 46: 507
Italy Indinnimeo M, J Exp Clin Cancer Res 1999; 18: 47
Poland Alemany L, Int J Cancer 2015; 136: 98
Portugal Alemany L, Int J Cancer 2015; 136: 98
Slovenia Alemany L, Int J Cancer 2015; 136: 98
Sweden Frisch M, N Engl J Med 1997; 337: 1350 | Laytragoon-Lewin N, Anticancer Res
2007; 27: 4473
(Continued)

Table 32 Continued
Country Study
Oceania
Australia Hillman RJ, Int J Cancer 2014; 135: 996
HPV type distribution for anal intraepithelial neoplasia (AIN)
Americas
Canada Gohy L, J Acquir Immune Defic Syndr 2008; 49: 32 | Salit IE, Cancer Epidemiol
Biomarkers Prev 2009; 18: 1986
Chile Alemany L, Int J Cancer 2015; 136: 98
Colombia Alemany L, Int J Cancer 2015; 136: 98
Ecuador Alemany L, Int J Cancer 2015; 136: 98
Guatemala Alemany L, Int J Cancer 2015; 136: 98
Honduras Alemany L, Int J Cancer 2015; 136: 98
Mexico Alemany L, Int J Cancer 2015; 136: 98
Paraguay Alemany L, Int J Cancer 2015; 136: 98
USA Sahasrabuddhe VV, J Infect Dis 2013; 207: 392
Asia
Thailand Phanuphak N, PLoS ONE 2013; 8: e78291
Europe
Bosnia & Herzegovina Alemany L, Int J Cancer 2015; 136: 98
Czech Republic Alemany L, Int J Cancer 2015; 136: 98
Germany Alemany L, Int J Cancer 2015; 136: 98 | Hampl M, J Cancer Res Clin Oncol
2007; 133: 235 | Hampl M, Obstet Gynecol 2006; 108: 1361 | Kreuter A, Br J
Dermatol 2010; 162: 1269 | Silling S, J Clin Virol 2012; 53: 325 | Varnai AD, Int
J Colorectal Dis 2006; 21: 135 | Wieland U, Arch Dermatol 2006; 142: 1438
Spain Alemany L, Int J Cancer 2015; 136: 98 | Caadas MP, J Clin Virol 2010; 48: 198
| Garca-Espinosa B, Diagn Pathol 2013; 8: 204 | Sirera G, AIDS 2013; 27: 951
| Torres M, J Clin Microbiol 2013; 51: 3512
France Alemany L, Int J Cancer 2015; 136: 98
United Kingdom Alemany L, Int J Cancer 2015; 136: 98 | Fox PA, Sex Transm Infect 2005; 81:
142 | Ogunbiyi OA, J Clin Pathol 1993; 46: 507 | Ogunbiyi OA, Obstet Gynecol
1994; 83: 212
Italy Tanzi E, Vaccine 2009; 27 Suppl 1: A17
Netherlands Richel O, J Infect Dis 2014; 210: 111
Poland Alemany L, Int J Cancer 2015; 136: 98
Portugal Alemany L, Int J Cancer 2015; 136: 98
Slovenia Alemany L, Int J Cancer 2015; 136: 98
Oceania
Australia Hillman RJ, Sex Health 2012; 9: 574
HPV type distribution for invasive vulvar cancer
Africa
Mali de Sanjos S, Eur J Cancer 2013; 49: 3450
Mozambique de Sanjos S, Eur J Cancer 2013; 49: 3450
Nigeria de Sanjos S, Eur J Cancer 2013; 49: 3450
Senegal de Sanjos S, Eur J Cancer 2013; 49: 3450
(Continued)

Table 32 Continued
Country Study
Americas
Argentina de Sanjos S, Eur J Cancer 2013; 49: 3450
Brazil de Sanjos S, Eur J Cancer 2013; 49: 3450 | Pinto AP, Gynecol Oncol 1999; 74:
61
Canada Al-Ghamdi A, Gynecol Oncol 2002; 84: 94
Chile de Sanjos S, Eur J Cancer 2013; 49: 3450
Colombia de Sanjos S, Eur J Cancer 2013; 49: 3450
Ecuador de Sanjos S, Eur J Cancer 2013; 49: 3450
Guatemala de Sanjos S, Eur J Cancer 2013; 49: 3450
Honduras de Sanjos S, Eur J Cancer 2013; 49: 3450
Mexico de Sanjos S, Eur J Cancer 2013; 49: 3450
Paraguay de Sanjos S, Eur J Cancer 2013; 49: 3450
Uruguay de Sanjos S, Eur J Cancer 2013; 49: 3450
USA Bloss JD, Hum Pathol 1991; 22: 711 | Carter JJ, Cancer Res 2001; 61: 1934 | de
Sanjos S, Eur J Cancer 2013; 49: 3450 | Gargano JW, J Low Genit Tract Dis
2012; 16: 471 | Kim YT, Hum Pathol 1996; 27: 389 | Lee YY, Oncogene 1994; 9:
1655 | Madeleine MM, J Natl Cancer Inst 1997; 89: 1516 | Monk BJ, Obstet
Gynecol 1995; 85: 709 | Nuovo GJ, Gynecol Oncol 1991; 43: 275 | Pinto AP, Am
J Pathol 1999; 154: 1009 | Riethdorf S, Hum Pathol 2004; 35: 1477 | Sagerman
PM, Gynecol Oncol 1996; 61: 328 | Sutton BC, Mod Pathol 2008; 21: 345 | Tate
JE, Gynecol Oncol 1994; 53: 78
Venezuela de Sanjos S, Eur J Cancer 2013; 49: 3450
Asia
Bangladesh de Sanjos S, Eur J Cancer 2013; 49: 3450
China Gao X, Dermatol Surg 1997; 23: 1025 | Guo L, Zhonghua Fu Chan Ke Za Zhi
1996; 31: 551 | Ngan HY, Eur J Cancer 1999; 35: 481
India de Sanjos S, Eur J Cancer 2013; 49: 3450
Israel de Sanjos S, Eur J Cancer 2013; 49: 3450
Japan Koyamatsu Y, Gynecol Oncol 2003; 90: 547 | Nagano H, J Obstet Gynaecol Res
1996; 22: 1 | Osakabe M, Pathol Int 2007; 57: 322
Republic of Korea de Sanjos S, Eur J Cancer 2013; 49: 3450
Kuwait de Sanjos S, Eur J Cancer 2013; 49: 3450
Lebanon de Sanjos S, Eur J Cancer 2013; 49: 3450
Philippines de Sanjos S, Eur J Cancer 2013; 49: 3450
Thailand Ngamkham J, Asian Pac J Cancer Prev 2013; 14: 2355
Turkey de Sanjos S, Eur J Cancer 2013; 49: 3450
Taiwan de Sanjos S, Eur J Cancer 2013; 49: 3450
Europe
Austria de Sanjos S, Eur J Cancer 2013; 49: 3450
Bosnia & Herzegovina de Sanjos S, Eur J Cancer 2013; 49: 3450
Belarus de Sanjos S, Eur J Cancer 2013; 49: 3450
Czech Republic de Sanjos S, Eur J Cancer 2013; 49: 3450 | Skapa P, Am J Surg Pathol 2007;
31: 1834 | Tachezy R, PLoS ONE 2011; 6: e21913
Germany Choschzick M, Int J Gynecol Pathol 2011; 30: 497 | de Sanjos S, Eur J Cancer
2013; 49: 3450 | Hampl M, Gynecol Oncol 2008; 109: 340 | Hampl M, Obstet
Gynecol 2006; 108: 1361 | Milde-Langosch K, Int J Cancer 1995; 63: 639 |
Reuschenbach M, J Low Genit Tract Dis 2013; 17: 289 | Riethdorf S, Hum
Pathol 2004; 35: 1477
Denmark Bryndorf T, Cytogenet Genome Res 2004; 106: 43 | Hrding U, Gynecol Oncol
1991; 42: 22 | Hrding U, Gynecol Oncol 1994; 52: 241 | Hrding U, Int J
Cancer 1993; 55: 394 | Madsen BS, Int J Cancer 2008; 122: 2827
Spain Alonso I, Gynecol Oncol 2011; 122: 509 | de Sanjos S, Eur J Cancer 2013; 49:
3450 | Guerrero D, Int J Cancer 2011; 128: 2853 | Lerma E, Int J Gynecol
Pathol 1999; 18: 191 | Santos M, Am J Surg Pathol 2006; 30: 1347
(Continued)

Table 32 Continued
Country Study
Finland Iwasawa A, Obstet Gynecol 1997; 89: 81
France de Sanjos S, Eur J Cancer 2013; 49: 3450
United Kingdom Abdel-Hady ES, Cancer Res 2001; 61: 192 | de Sanjos S, Eur J Cancer 2013; 49:
3450 | Gasco M, Oncogene 2002; 21: 1876 | Ogunbiyi OA, Obstet Gynecol 1994;
83: 212
Greece de Sanjos S, Eur J Cancer 2013; 49: 3450
Italy Bonvicini F, J Med Virol 2005; 77: 102 | de Sanjos S, Eur J Cancer 2013; 49:
3450 | Della Torre G, Diagn Mol Pathol 1992; 1: 25 | Pilotti S, Diagn Mol Pathol
1995; 4: 239
Netherlands Ansink AC, Gynecol Oncol 1994; 52: 180 | Kagie MJ, Gynecol Oncol 1997; 67:
178 | Trietsch MD, Br J Cancer 2013; 109: 2259 | van de Nieuwenhof HP,
Cancer Epidemiol Biomarkers Prev 2009; 18: 2061 | van der Avoort IA, Int J
Gynecol Pathol 2006; 25: 22
Poland Bujko M, Acta Obstet Gynecol Scand 2012; 91: 391 | de Sanjos S, Eur J Cancer
2013; 49: 3450 | Kowalewska M, Int J Gynecol Cancer 2010; 20: 434 | Liss J,
Ginekol Pol 1998; 69: 330
Portugal de Sanjos S, Eur J Cancer 2013; 49: 3450
Sweden Larsson GL, Int J Gynecol Cancer 2012; 22: 1413 | Lindell G, Gynecol Oncol
2010; 117: 312
Oceania
Australia Allen DG, Br J Cancer 2002; 86: 924 | de Sanjos S, Eur J Cancer 2013; 49:
3450 | Tan SE, Sex Health 2013; 10: 18
New Zealand de Sanjos S, Eur J Cancer 2013; 49: 3450
HPV type distribution for vulvar intraepithelial neoplasia (VIN)
Americas
Argentina de Sanjos S, Eur J Cancer 2013; 49: 3450
Brazil de Sanjos S, Eur J Cancer 2013; 49: 3450
Chile de Sanjos S, Eur J Cancer 2013; 49: 3450
Colombia de Sanjos S, Eur J Cancer 2013; 49: 3450
Ecuador de Sanjos S, Eur J Cancer 2013; 49: 3450
Guatemala de Sanjos S, Eur J Cancer 2013; 49: 3450
Honduras de Sanjos S, Eur J Cancer 2013; 49: 3450
Mexico de Sanjos S, Eur J Cancer 2013; 49: 3450
Paraguay de Sanjos S, Eur J Cancer 2013; 49: 3450
Uruguay de Sanjos S, Eur J Cancer 2013; 49: 3450
USA Gargano JW, J Low Genit Tract Dis 2012; 16: 471 | Madeleine MM, J Natl
Cancer Inst 1997; 89: 1516 | Riethdorf S, Hum Pathol 2004; 35: 1477 | Srodon
M, Am J Surg Pathol 2006; 30: 1513
Venezuela de Sanjos S, Eur J Cancer 2013; 49: 3450
Asia
Bangladesh de Sanjos S, Eur J Cancer 2013; 49: 3450
India de Sanjos S, Eur J Cancer 2013; 49: 3450
Israel de Sanjos S, Eur J Cancer 2013; 49: 3450
Republic of Korea de Sanjos S, Eur J Cancer 2013; 49: 3450
Kuwait de Sanjos S, Eur J Cancer 2013; 49: 3450
Lebanon de Sanjos S, Eur J Cancer 2013; 49: 3450
Philippines de Sanjos S, Eur J Cancer 2013; 49: 3450
Turkey de Sanjos S, Eur J Cancer 2013; 49: 3450
Taiwan de Sanjos S, Eur J Cancer 2013; 49: 3450
(Continued)

Table 32 Continued
Country Study
Europe
Austria de Sanjos S, Eur J Cancer 2013; 49: 3450
Bosnia & Herzegovina de Sanjos S, Eur J Cancer 2013; 49: 3450
Belarus de Sanjos S, Eur J Cancer 2013; 49: 3450
Czech Republic de Sanjos S, Eur J Cancer 2013; 49: 3450 | Skapa P, Am J Surg Pathol 2007;
31: 1834 | Tachezy R, PLoS ONE 2011; 6: e21913
Germany de Sanjos S, Eur J Cancer 2013; 49: 3450 | Hampl M, Obstet Gynecol 2006;
108: 1361 | Hillemanns P, Gynecol Oncol 2006; 100: 276 | Riethdorf S, Hum
Pathol 2004; 35: 1477
Denmark Hrding U, Gynecol Oncol 1991; 42: 22 | Junge J, APMIS 1995; 103: 501
Spain de Sanjos S, Eur J Cancer 2013; 49: 3450 | Lerma E, Int J Gynecol Pathol
1999; 18: 191
France de Sanjos S, Eur J Cancer 2013; 49: 3450
United Kingdom Abdel-Hady ES, Cancer Res 2001; 61: 192 | Baldwin PJ, Clin Cancer Res 2003;
9: 5205 | Baldwin SB, J Infect Dis 2003; 187: 1064 | Bryant D, J Med Virol
2011; 83: 1358 | Daayana S, Br J Cancer 2010; 102: 1129 | de Sanjos S, Eur J
Cancer 2013; 49: 3450 | Gasco M, Oncogene 2002; 21: 1876 | Winters U, Clin
Cancer Res 2008; 14: 5292
Greece de Sanjos S, Eur J Cancer 2013; 49: 3450 | Tsimplaki E, J Oncol 2012; 2012:
893275
Italy Bonvicini F, J Med Virol 2005; 77: 102 | de Sanjos S, Eur J Cancer 2013; 49:
3450
Netherlands van Beurden M, Cancer 1995; 75: 2879 | van der Avoort IA, Int J Gynecol Pathol
2006; 25: 22 | van Esch EM, Int J Cancer 2014; 135: 830 | van Seters M, N Engl
J Med 2008; 358: 1465
Poland de Sanjos S, Eur J Cancer 2013; 49: 3450
Portugal de Sanjos S, Eur J Cancer 2013; 49: 3450
Oceania
Australia de Sanjos S, Eur J Cancer 2013; 49: 3450 | Tan SE, Sex Health 2013; 10: 18
New Zealand de Sanjos S, Eur J Cancer 2013; 49: 3450
HPV type distribution for invasive vaginal cancer
Africa
Mozambique Alemany L, Eur J Cancer 2014; 50: 2846
Nigeria Alemany L, Eur J Cancer 2014; 50: 2846
Americas
Argentina Alemany L, Eur J Cancer 2014; 50: 2846
Brazil Alemany L, Eur J Cancer 2014; 50: 2846
Chile Alemany L, Eur J Cancer 2014; 50: 2846
Colombia Alemany L, Eur J Cancer 2014; 50: 2846
Ecuador Alemany L, Eur J Cancer 2014; 50: 2846
Guatemala Alemany L, Eur J Cancer 2014; 50: 2846
Mexico Alemany L, Eur J Cancer 2014; 50: 2846
Paraguay Alemany L, Eur J Cancer 2014; 50: 2846
Uruguay Alemany L, Eur J Cancer 2014; 50: 2846
USA Alemany L, Eur J Cancer 2014; 50: 2846 | Carter JJ, Cancer Res 2001; 61: 1934
| Daling JR, Gynecol Oncol 2002; 84: 263 | Kiyabu MT, Am J Surg Pathol 1989;
13: 221
Venezuela Alemany L, Eur J Cancer 2014; 50: 2846
(Continued)

Table 32 Continued
Country Study
Asia
Bangladesh Alemany L, Eur J Cancer 2014; 50: 2846
India Alemany L, Eur J Cancer 2014; 50: 2846
Israel Alemany L, Eur J Cancer 2014; 50: 2846
Japan Koyamatsu Y, Gynecol Oncol 2003; 90: 547
Republic of Korea Alemany L, Eur J Cancer 2014; 50: 2846
Kuwait Alemany L, Eur J Cancer 2014; 50: 2846
Lebanon Alemany L, Eur J Cancer 2014; 50: 2846
Philippines Alemany L, Eur J Cancer 2014; 50: 2846
Turkey Alemany L, Eur J Cancer 2014; 50: 2846
Taiwan Alemany L, Eur J Cancer 2014; 50: 2846
Europe
Austria Alemany L, Eur J Cancer 2014; 50: 2846
Belarus Alemany L, Eur J Cancer 2014; 50: 2846
Czech Republic Alemany L, Eur J Cancer 2014; 50: 2846
Germany Alemany L, Eur J Cancer 2014; 50: 2846
Denmark Madsen BS, Int J Cancer 2008; 122: 2827
Spain Alemany L, Eur J Cancer 2014; 50: 2846 | Fuste V, Histopathology 2010; 57: 907
France Alemany L, Eur J Cancer 2014; 50: 2846
United Kingdom Alemany L, Eur J Cancer 2014; 50: 2846
Greece Alemany L, Eur J Cancer 2014; 50: 2846
Poland Alemany L, Eur J Cancer 2014; 50: 2846
Portugal Ferreira M, Mod Pathol 2008; 21: 968
Sweden Larsson GL, Gynecol Oncol 2013; 129: 406
Oceania
Australia Alemany L, Eur J Cancer 2014; 50: 2846
HPV type distribution for vaginal intraepithelial neoplasia (VAIN)
Americas
Argentina Alemany L, Eur J Cancer 2014; 50: 2846
Brazil Alemany L, Eur J Cancer 2014; 50: 2846
Chile Alemany L, Eur J Cancer 2014; 50: 2846
Colombia Alemany L, Eur J Cancer 2014; 50: 2846
Ecuador Alemany L, Eur J Cancer 2014; 50: 2846
Guatemala Alemany L, Eur J Cancer 2014; 50: 2846
Mexico Alemany L, Eur J Cancer 2014; 50: 2846
Paraguay Alemany L, Eur J Cancer 2014; 50: 2846
Uruguay Alemany L, Eur J Cancer 2014; 50: 2846
USA Alemany L, Eur J Cancer 2014; 50: 2846 | Daling JR, Gynecol Oncol 2002; 84:
263 | Srodon M, Am J Surg Pathol 2006; 30: 1513
Venezuela Alemany L, Eur J Cancer 2014; 50: 2846
Asia
Bangladesh Alemany L, Eur J Cancer 2014; 50: 2846
India Alemany L, Eur J Cancer 2014; 50: 2846
Israel Alemany L, Eur J Cancer 2014; 50: 2846
Japan Sugase M, Int J Cancer 1997; 72: 412
Republic of Korea Alemany L, Eur J Cancer 2014; 50: 2846
Kuwait Alemany L, Eur J Cancer 2014; 50: 2846
Lebanon Alemany L, Eur J Cancer 2014; 50: 2846
(Continued)

Table 32 Continued
Country Study
Philippines Alemany L, Eur J Cancer 2014; 50: 2846
Turkey Alemany L, Eur J Cancer 2014; 50: 2846
Taiwan Alemany L, Eur J Cancer 2014; 50: 2846
Europe
Austria Alemany L, Eur J Cancer 2014; 50: 2846
Belarus Alemany L, Eur J Cancer 2014; 50: 2846
Czech Republic Alemany L, Eur J Cancer 2014; 50: 2846
Germany Alemany L, Eur J Cancer 2014; 50: 2846 | Hampl M, J Cancer Res Clin Oncol
2007; 133: 235 | Hampl M, Obstet Gynecol 2006; 108: 1361
Spain Alemany L, Eur J Cancer 2014; 50: 2846
France Alemany L, Eur J Cancer 2014; 50: 2846
United Kingdom Alemany L, Eur J Cancer 2014; 50: 2846
Greece Alemany L, Eur J Cancer 2014; 50: 2846 | Tsimplaki E, J Oncol 2012; 2012:
893275
Italy Frega A, Cancer Lett 2007; 249: 235
Poland Alemany L, Eur J Cancer 2014; 50: 2846
Oceania
Australia Alemany L, Eur J Cancer 2014; 50: 2846
HPV type distribution for invasive penile cancer
General sources The ICO HPV Information Centre has updated data until June 2015. Reference
publications (up to 2008): 1) Bouvard V, Lancet Oncol 2009;10:321 2)
Miralles-Guri C,J Clin Pathol 2009;62:870
Africa
Uganda Tornesello ML, Cancer Lett 2008; 269: 159
South Africa Lebelo RL, J Med Virol 2014; 86: 257
Americas
Argentina Picconi MA, J Med Virol 2000; 61: 65
Brazil Afonso LA, Mem Inst Oswaldo Cruz 2012; 107: 18 | Bezerra AL, Cancer 2001;
91: 2315 | Calmon MF, PLoS ONE 2013; 8: e53260 | de Sousa ID, BMC Urol
2015; 15: 13 | Fonseca AG, Int Braz J Urol 2013; 39: 542 | Levi JE, Int J Cancer
1998; 76: 779 | Scheiner MA, Int Braz J Urol 2008; 34: 467
Canada Maden C, J Natl Cancer Inst 1993; 85: 19
Mexico Lpez-Romero R, Int J Clin Exp Pathol 2013; 6: 1409 | Salazar EL, Arch Androl
2005; 51: 327
Paraguay Cubilla AL, Am J Surg Pathol 2010; 34: 104 | Gregoire L, J Natl Cancer Inst
1995; 87: 1705 | Rubin MA, Am J Pathol 2001; 159: 1211
USA Alemany L, Eur Urol 2016; 69: 953 | Cupp MR, J Urol 1995; 154: 1024 | Daling
JR, Int J Cancer 2005; 116: 606 | Gregoire L, J Natl Cancer Inst 1995; 87: 1705
| Hernandez BY, Front Oncol 2014; 4: 9 | Rubin MA, Am J Pathol 2001; 159:
1211 | Sarkar FH, J Urol 1992; 147: 389 | Varma VA, Hum Pathol 1991; 22: 908
Asia
China Chan KW, J Clin Pathol 1994; 47: 823
Japan Iwasawa A, J Urol 1993; 149: 59 | Suzuki H, Jpn J Clin Oncol 1994; 24: 1 |
Yanagawa N, Pathol Int 2008; 58: 477
Thailand Senba M, J Med Virol 2006; 78: 1341
Viet Nam Do HT, Br J Cancer 2013; 108: 229
Europe
Austria Mannweiler S, J Am Acad Dermatol 2013; 69: 73
Belgium DHauwers KW, Vaccine 2012; 30: 6573
Germany Perceau G, Br J Dermatol 2003; 148: 934 | Poetsch M, Virchows Arch 2011; 458:
221
Denmark Krustrup D, Int J Exp Pathol 2009; 90: 182
Spain Ferrndiz-Pulido C, J Am Acad Dermatol 2013; 68: 73 | Guerrero D, BJU Int
2008; 102: 747 | Pascual A, Histol Histopathol 2007; 22: 177
(Continued)

Table 32 Continued
Country Study
France Humbey O, Eur J Cancer 2003; 39: 684 | Perceau G, Br J Dermatol 2003; 148:
934
United Kingdom Prowse DM, Br J Dermatol 2008; 158: 261 | Stankiewicz E, Histopathology
2011; 58: 433
Italy Barzon L, Am J Pathol 2014; 184: 3376 | Gentile V, Int J Immunopathol
Pharmacol 2006; 19: 209 | Tornesello ML, Cancer Lett 2008; 269: 159
Netherlands Heideman DA, J Clin Oncol 2007; 25: 4550 | Lont AP, Int J Cancer 2006; 119:
1078
Sweden Kirrander P, BJU Int 2011; 108: 355
HPV type distribution for penile intraepithelial neoplasia (PEIN)
General sources The ICO HPV Information Centre has updated data until June 2014. Reference
publication (up to 2008): Bouvard V, Lancet Oncol 2009;10:321
Americas
Mexico Lpez-Romero R, Int J Clin Exp Pathol 2013; 6: 1409
USA Cupp MR, J Urol 1995; 154: 1024
Europe
Austria Mannweiler S, J Am Acad Dermatol 2013; 69: 73
Belgium DHauwers KW, Vaccine 2012; 30: 6573
Sweden Kirrander P, BJU Int 2011; 108: 355 | Wikstrm A, J Eur Acad Dermatol
Venereol 2012; 26: 325
The anogenital prevalence of HPV-DNA in men: HPV in men
General sources Based on published systematic reviews, the ICO HPV Information Centre has
updated data until September 2014. Reference publications: 1) Dunne EF, J
Infect Dis 2006; 194: 1044 2) Smith JS, J Adolesc Health 2011; 48: 540 3) Olesen
TB, Sex Transm Infect 2014; 90: 455 4) Hebnes JB, J Sex Med 2014; 11: 2630.
Africa
Kenya Ngayo MO, Sex Transm Infect 2008; 84: 62 | Smith JS, Int J Cancer 2010; 126:
572
Rwanda Veldhuijzen NJ, Sex Transm Dis 2012; 39: 128
Tanzania Olesen TB, Sex Transm Dis 2013; 40: 592
South Africa Auvert B, J Acquir Immune Defic Syndr 2010; 53: 111
Americas
Brazil Franceschi S, Br J Cancer 2002; 86: 705 | Giuliano AR, Cancer Epidemiol
Biomarkers Prev 2008; 17: 2036 | Nyitray AG, J Infect Dis 2011; 203: 49 |
Rosenblatt C, Int J Gynaecol Obstet 2004; 84: 156
Chile Guzmn P, Rev Med Chil 2008; 136: 1381
Colombia Franceschi S, Br J Cancer 2002; 86: 705
Mexico Giuliano AR, Cancer Epidemiol Biomarkers Prev 2008; 17: 2036 | Lajous M,
Cancer Epidemiol Biomarkers Prev 2005; 14: 1710 | Lazcano-Ponce E, Sex
Transm Dis 2001; 28: 277 | Nyitray AG, J Infect Dis 2011; 203: 49 |
Snchez-Alemn MA, Salud Publica Mex 2002; 44: 442 | Vaccarella S, Int J
Cancer 2006; 119: 1934
USA Giuliano AR, J Infect Dis 2008; 198: 827 | Giuliano AR, Cancer Epidemiol
Biomarkers Prev 2008; 17: 2036 | Hernandez BY, J Infect Dis 2008; 197: 787 |
Nielson CM, Cancer Epidemiol Biomarkers Prev 2007; 16: 1107 | Nyitray AG, J
Infect Dis 2011; 203: 49 | Partridge JM, J Infect Dis 2007; 196: 1128 | Weaver
BA, J Infect Dis 2004; 189: 677
Asia
China Liu M, Cancer Epidemiol Biomarkers Prev 2014
India Gupta A, J Clin Virol 2006; 37: 190
Japan Takahashi S, Sex Transm Dis 2003; 30: 629
Republic of Korea Shin HR, J Infect Dis 2004; 190: 468
Philippines Franceschi S, Br J Cancer 2002; 86: 705
Thailand Franceschi S, Br J Cancer 2002; 86: 705
(Continued)

Table 32 Continued
Country Study
Europe
Germany Grussendorf-Conen EI, Arch Dermatol Res 1987; 279 Suppl: S73
Denmark Kjaer SK, Cancer Epidemiol Biomarkers Prev 2005; 14: 1528
Spain Franceschi S, Br J Cancer 2002; 86: 705
Finland Hippelinen M, Sex Transm Dis 1993; 20: 321 | Kero K, J Sex Med 2011; 8: 2522
Croatia Grce M, Anticancer Res 1996; 16: 1039
Italy Lorenzon L, J Clin Virol 2014; 60: 264 | Nasca MR, Int J Dermatol 2006; 45: 681
Sweden Forslund O, J Clin Microbiol 1993; 31: 1975 | Kataoka A, J Med Virol 1991; 33:
159
The anogenital prevalence of HPV-DNA in men: HPV in special subgroups (HIV, MSM, etc)
General sources Based on published systematic reviews, the ICO HPV Information Centre has
updated data until September 2014. Reference publications: 1) Dunne EF, J
Infect Dis 2006; 194: 1044 2) Smith JS, J Adolesc Health 2011; 48: 540 3) Olesen
TB, Sex Transm Infect 2014; 90: 455 4) Hebnes JB, J Sex Med 2014; 11: 2630.
Africa
Uganda Tobian AA, Sex Transm Infect 2013; 89: 122
South Africa Firnhaber C, Int J STD AIDS 2011; 22: 107 | Mbulawa ZZ, J Gen Virol 2010; 91:
3023 | Mller EE, Sex Transm Infect 2010; 86: 175 | Vogt SL, Front Oncol 2013;
3: 60
Americas
Brazil de Lima Rocha MG, PLoS ONE 2012; 7: 105 | Franceschi S, Br J Cancer 2002;
86: 705 | Freire MP, Int Braz J Urol 2014; 40: 67 | Goldstone S, J Infect Dis
2011; 203: 66 | Guimares MD, J Acquir Immune Defic Syndr 2011; 57 Suppl 3:
S217 | Nicolau SM, Urology 2005; 65: 251 | Nyitray AG, J Infect Dis 2011; 203:
49 | Rombaldi RL, Braz J Med Biol Res 2006; 39: 177 | Rosenblatt C, Int J
Gynaecol Obstet 2004; 84: 156 | Vardas E, J Infect Dis 2011; 203: 58
Canada de Pokomandy A, J Infect Dis 2009; 199: 965 | Goldstone S, J Infect Dis 2011;
203: 66 | Ogilvie GS, Sex Transm Infect 2009; 85: 221 | Salit IE, Cancer
Epidemiol Biomarkers Prev 2009; 18: 1986 | Salit IE, AIDS 2010; 24: 1307 |
Vardas E, J Infect Dis 2011; 203: 58
Colombia Franceschi S, Br J Cancer 2002; 86: 705
Mexico Goldstone S, J Infect Dis 2011; 203: 66 | Leyva-Lpez AG, Salud Publica Mex
2003; 45 Supp 5: S589 | Nyitray AG, J Infect Dis 2011; 203: 49 | Torres-Ibarra
L, Prev Med 2014; 69C: 157 | Vardas E, J Infect Dis 2011; 203: 58
USA Baken LA, J Infect Dis 1995; 171: 429 | Baldwin SB, J Infect Dis 2003; 187:
1064 | Berry JM, Dis Colon Rectum 2009; 52: 239 | Caussy D, Int J Cancer
1990; 46: 214 | Chin-Hong PV, J Infect Dis 2004; 190: 2070 | Chin-Hong PV,
Ann Intern Med 2008; 149: 300 | Coln-Lpez V, PLoS ONE 2014; 9: 109 |
Conley L, J Infect Dis 2010; 202: 1567 | Critchlow CW, AIDS 1998; 12: 1177 |
Fife KH, Sex Transm Dis 2003; 30: 246 | Friedman HB, J Infect Dis 1998; 178:
45 | Goldstone S, J Infect Dis 2011; 203: 66 | Kiviat NB, AIDS 1993; 7: 43 |
Moscicki AB, AIDS 2003; 17: 311 | Nyitray AG, J Infect Dis 2011; 203: 49 |
Palefsky JM, Genitourin Med 1997; 73: 174 | Palefsky JM, J Infect Dis 1998;
177: 361 | Palefsky JM, AIDS 2005; 19: 1407 | Vardas E, J Infect Dis 2011; 203:
58 | Wiley DJ, PLoS ONE 2013; 8: 108 | Wilkin TJ, J Infect Dis 2004; 190: 1685
Asia
China Gao L, PLoS ONE 2010; 5: 103 | Tang X, Biomed Environ Sci 2006; 19: 153 |
Yang Y, PLoS ONE 2012; 7: 104 | Zhang DY, PLoS ONE 2014; 9: 111
India Gupta A, J Clin Virol 2006; 37: 190
Japan Shigehara K, Int J Urol 2010; 17: 563 | Takahashi S, Sex Transm Dis 2003; 30:
629 | Takahashi S, J Infect Chemother 2005; 11: 270
Philippines Franceschi S, Br J Cancer 2002; 86: 705
Thailand Franceschi S, Br J Cancer 2002; 86: 705 | Phanuphak N, J Acquir Immune Defic
Syndr 2013; 63: 472
(Continued)

Table 32 Continued
Country Study
Europe
Germany Goldstone S, J Infect Dis 2011; 203: 66 | Schneider A, J Urol 1988; 140: 1431 |
Vardas E, J Infect Dis 2011; 203: 58
Denmark Svare EI, Sex Transm Infect 2002; 78: 215
Spain lvarez-Argelles ME, PLoS ONE 2013; 8: 106 | Franceschi S, Br J Cancer
2002; 86: 705 | Goldstone S, J Infect Dis 2011; 203: 66 | Sendagorta E, Dis
Colon Rectum 2014; 57: 475 | Torres M, J Clin Microbiol 2013; 51: 3512 |
Vardas E, J Infect Dis 2011; 203: 58 | Videla S, Sex Transm Dis 2013; 40: 03
France Aynaud O, Urology 2003; 61: 1098 | Damay A, J Med Virol 2010; 82: 592 |
Piketty C, Sex Transm Dis 2004; 31: 96
United Kingdom Bissett SL, J Med Virol 2011; 83: 1744 | Cuschieri K, J Med Virol 2011; 83: 1983
| Hillman RJ, Genitourin Med 1993; 69: 187 | Jalal H, Int J STD AIDS 2007;
18: 617 | Lacey HB, Sex Transm Infect 1999; 75: 172
Greece Hadjivassiliou M, Int J STD AIDS 2007; 18: 329
Croatia Goldstone S, J Infect Dis 2011; 203: 66 | Vardas E, J Infect Dis 2011; 203: 58
Italy Barzon L, J Med Virol 2010; 82: 1424 | Benevolo M, J Med Virol 2008; 80: 1275
| Chiarini F, Minerva Urol Nefrol 1998; 50: 225 | Della Torre G, Am J Pathol
1992; 141: 1181 | Giovannelli L, J Clin Microbiol 2007; 45: 248 | Latini A, J Int
AIDS Soc 2014; 17: 39 | Orlando G, J Acquir Immune Defic Syndr 2008; 47: 129
| Pierangeli A, AIDS 2008; 22: 1929
Netherlands Bleeker MC, J Am Acad Dermatol 2002; 47: 351 | Bleeker MC, Int J Cancer
2005; 113: 36 | Bleeker MC, Clin Infect Dis 2005; 41: 612 | van der Snoek EM,
Sex Transm Dis 2003; 30: 639 | Van Doornum GJ, Genitourin Med 1994; 70: 240
| van Rijn VM, PLoS ONE 2014; 9: 110 | Vriend HJ, PLoS ONE 2013; 8: 107
Slovenia Golob B, Biomed Res Int 2014; 2014: 100 | Milosevic M, Cent Eur J Med 2010; 5:
698
Sweden Kataoka A, J Med Virol 1991; 33: 159 | Lwhagen GB, Int J STD AIDS 1999; 10:
615 | Strand A, Genitourin Med 1993; 69: 446 | Voog E, Int J STD AIDS 1997;
8: 772 | Wikstrm A, Int J STD AIDS 1991; 2: 105 | Wikstrm A, Int J STD
AIDS 2000; 11: 80
Oceania
Australia Anderson J, Sex Transm Infect 2008; 84: 94 | Goldstone S, J Infect Dis 2011;
203: 66 | Vajdic CM, Sex Transm Infect 2009; 85: 330 | Vardas E, J Infect Dis
2011; 203: 58
HPV prevalence and type distribution in oral specimens collected from healthy population
General sources Systematic review and meta-analysis was performed by ICO HPV Information
Centre until July 2012. Pubmed was searched using the keywords oral and
papillomavirus. Inclusion criteria: studies reporting oral HPV prevalence in
healthy population in Europe; n > 50. Exclusion criteria: focused only in children
or immunosuppressed population; not written in English; case-control studies;
commentaries and systematic reviews and studies that did not use HPV DNA
detection methods.
Europe
Denmark Eike A, Clin Otolaryngol 1995;20:171
Denmark Eike A, Clin Otolaryngol 1995;20:171
Spain Caadas MP, J Clin Microbiol 2004;42:1330
Spain Caadas MP, J Clin Microbiol 2004;42:1330
Finland Kero K, Eur Urol 2012;62(6):1063-70
Finland Leimola-Virtanen R, Clin Infect Dis 1996;22:593
Finland Kero K, J Sex Med 2011;8:2522
Finland Kero K, Eur Urol 2012;62(6):1063-70
Finland Leimola-Virtanen R, Clin Infect Dis 1996;22:593
Finland Kero K, J Sex Med 2011;8:2522
United Kingdom Kujan O, Oral Oncol 2006;42:810
United Kingdom Kujan O, Oral Oncol 2006;42:810
(Continued)

Table 32 Continued
Country Study
Greece Lambropoulos AF, Eur J Oral Sci 1997;105:294
Greece Lambropoulos AF, Eur J Oral Sci 1997;105:294
Italy Montaldo C, J Oral Pathol Med 2007;36:482
Italy Migaldi M, J Oral Pathol Med 2012;41:16
Italy Migaldi M, J Oral Pathol Med 2012;41:16
Italy Montaldo C, J Oral Pathol Med 2007;36:482
HPV prevalence and type distribution in invasive oral cavity squamous cell carcinoma
General sources Based on systematic reviews and meta-analysis performed by ICO. Reference
publications: 1) Ndiaye C, Lancet Oncol 2014; 15: 1319 2) Kreimer AR, Cancer
Africa
Sudan Herrero R, J Natl Cancer Inst 2003; 95: 1772
South Africa Boy S, J Oral Pathol Med 2006; 35: 86 | Van Rensburg EJ, Anticancer Res 1996;
16: 969
Americas
Argentina Gonzlez JV, Medicina (B Aires) 2007; 67: 363 | Ribeiro KB, Int J Epidemiol
2011; 40: 489
Brazil Oliveira MC, Auris Nasus Larynx 2009; 36: 450 | Ribeiro KB, Int J Epidemiol
2011; 40: 489 | Rivero ER, Braz Oral Res 2006; 20: 21
Canada Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Noble-Topham SE, Arch
Otolaryngol Head Neck Surg 1993; 119: 1299
Cuba Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Ribeiro KB, Int J Epidemiol
2011; 40: 489
Mexico Anaya-Saavedra G, Arch Med Res 2008; 39: 189 | Ibieta BR, Oral Surg Oral
Med Oral Pathol Oral Radiol Endod 2005; 99: 311
USA Chuang AY, Oral Oncol 2008; 44: 915 | Furniss CS, Int J Cancer 2007; 120: 2386
| Ha PK, Clin Cancer Res 2002; 8: 1203 | Harris SL, Head Neck 2011; 33: 1622
| Holladay EB, Am J Clin Pathol 1993; 100: 36 | Liang XH, J Oral Maxillofac
Surg 2008; 66: 1875 | Lohavanichbutr P, Arch Otolaryngol Head Neck Surg
2009; 135: 180 | Paz IB, Cancer 1997; 79: 595 | Schlecht NF, Mod Pathol 2011;
24: 1295 | Schwartz SM, J Natl Cancer Inst 1998; 90: 1626 | Smith EM, Int J
Cancer 2004; 108: 766 | Zhao M, Int J Cancer 2005; 117: 605
Venezuela Miller CS, Oral Surg Oral Med Oral Pathol 1994; 77: 480 | Premoli-De-Percoco
G, J Oral Pathol Med 2001; 30: 355
Asia
China Tang X, J Oral Pathol Med 2003; 32: 393 | Wen S, Anticancer Res 1997; 17: 307
| Zhang ZY, Int J Oral Maxillofac Surg 2004; 33: 71
India Balaram P, Int J Cancer 1995; 61: 450 | Bhattacharya N, J Oral Pathol Med
2009; 38: 759 | Chaudhary AK, Virol J 2010; 7: 253 | DCosta J, Oral Oncol
1998; 34: 413 | Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Mishra A, Int J
Cancer 2006; 119: 2840
Iran Saghravanian N, Acta Odontol Scand 2011; 69: 406
Japan Bhawal UK, Arch Otolaryngol Head Neck Surg 2008; 134: 1055 | Chiba I,
Oncogene 1996; 12: 1663 | Higa M, Oral Oncol 2003; 39: 405 | Kojima A, Oral
Oncol 2002; 38: 591 | Shima K, Br J Oral Maxillofac Surg 2000; 38: 445 |
Shimizu M, J Dermatol Sci 2004; 36: 33 | Sugiyama M, Oral Surg Oral Med
Oral Pathol Oral Radiol Endod 2003; 95: 594 | Tang X, J Oral Pathol Med 2003;
32: 393 | Tsuhako K, J Oral Pathol Med 2000; 29: 70
Republic of Korea Shin KH, Int J Oncol 2002; 21: 297
Malaysia Lim KP, Oncol Rep 2007; 17: 1321
Taiwan Chang JY, Am J Clin Pathol 2003; 120: 909 | Chen PC, J Oral Pathol Med 2002;
31: 317 | Yang YY, Jpn J Clin Oncol 2004; 34: 176
Europe
Czech Republic Ribeiro KB, Int J Epidemiol 2011; 40: 489
(Continued)

Table 32 Continued
Country Study
Germany Klussmann JP, Cancer 2001; 92: 2875 | Ostwald C, Med Microbiol Immunol
2003; 192: 145 | Weiss D, Head Neck 2011; 33: 856
Spain Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Llamas-Martnez S, Anticancer
Res 2008; 28: 3733
Finland Koskinen WJ, Int J Cancer 2003; 107: 401 | Mork J, N Engl J Med 2001; 344:
1125
United Kingdom Lopes V, Oral Oncol 2011; 47: 698 | Snijders PJ, Int J Cancer 1996; 66: 464 |
Yeudall WA, J Gen Virol 1991; 72 ( Pt 1): 173
Greece Aggelopoulou EP, Anticancer Res 1999; 19: 1391 | Romanitan M, Anticancer Res
2008; 28: 2077
Hungary Nemes JA, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 344 |
Szarka K, Oral Microbiol Immunol 2009; 24: 314
Ireland Herrero R, J Natl Cancer Inst 2003; 95: 1772
Italy Badaracco G, Anticancer Res 2000; 20: 1301 | Badaracco G, Oncol Rep 2007; 17:
931 | Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Ritt M, Head Neck 2009;
31: 318 | Scapoli L, Mod Pathol 2009; 22: 366
Netherlands Braakhuis BJ, J Natl Cancer Inst 2004; 96: 998 | Cruz IB, Eur J Cancer, B, Oral
Oncol 1996; 32B: 55
Norway Matzow T, Acta Oncol 1998; 37: 73 | Mork J, N Engl J Med 2001; 344: 1125
Poland Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Ribeiro KB, Int J Epidemiol
2011; 40: 489 | Snietura M, Pol J Pathol 2010; 61: 133
Romania Ribeiro KB, Int J Epidemiol 2011; 40: 489
Russian Federation Ribeiro KB, Int J Epidemiol 2011; 40: 489
Serbia Kozomara R, J Craniomaxillofac Surg 2005; 33: 342
Slovakia Ribeiro KB, Int J Epidemiol 2011; 40: 489
Slovenia Kansky AA, Acta Virol 2003; 47: 11
Sweden Dahlgren L, Int J Cancer 2004; 112: 1015 | Mork J, N Engl J Med 2001; 344:
1125 | Sand L, Anticancer Res 2000; 20: 1183
HPV prevalence and type distribution in invasive oropharyngeal squamous cell carcinoma
Americas
Argentina Ribeiro KB, Int J Epidemiol 2011; 40: 489
Brazil Cortezzi SS, Cancer Genet Cytogenet 2004; 150: 44 | Ribeiro KB, Int J
Epidemiol 2011; 40: 489
Cuba Herrero R, J Natl Cancer Inst 2003; 95: 1772 | Ribeiro KB, Int J Epidemiol
2011; 40: 489
USA Agoston ES, Am J Clin Pathol 2010; 134: 36 | Chaturvedi AK, J Clin Oncol 2011;
29: 4294 | Cohen MA, Acta Otolaryngol 2008; 128: 583 | DSouza G, N Engl J
Med 2007; 356: 1944 | Ernster JA, Laryngoscope 2007; 117: 2115 | Furniss CS,
Int J Cancer 2007; 120: 2386 | Kingma DW, Anticancer Res 2010; 30: 5099 |
Kong CS, Int J Radiat Oncol Biol Phys 2009; 74: 553 | Lohavanichbutr P, Arch
Otolaryngol Head Neck Surg 2009; 135: 180 | Posner MR, Ann Oncol 2011; 22:
1071 | Schlecht NF, Mod Pathol 2011; 24: 1295 | Schwartz SM, J Natl Cancer
Inst 1998; 90: 1626 | Smith EM, Int J Cancer 2004; 108: 766 | Strome SE, Clin
Cancer Res 2002; 8: 1093 | Tezal M, Arch Otolaryngol Head Neck Surg 2009;
135: 391 | Zhao M, Int J Cancer 2005; 117: 605
Asia
China Li W, Pathology 2007; 39: 217
Republic of Korea Kim SH, Int J Cancer 2007; 120: 1418 | Oh TJ, J Clin Microbiol 2004; 42: 3272
Taiwan Al-Swiahb JN, Arch Otolaryngol Head Neck Surg 2010; 136: 502 | Kuo KT, Mod
Pathol 2008; 21: 376
Europe
Switzerland Lindel K, Cancer 2001; 92: 805
(Continued)

Table 32 Continued
Country Study
Czech Republic Klozar J, Eur Arch Otorhinolaryngol 2008; 265 Suppl 1: S75 | Ribeiro KB, Int J
Epidemiol 2011; 40: 489 | Rotnglov E, Int J Cancer 2011; 129: 101
Germany Andl T, Cancer Res 1998; 58: 5 | Hoffmann M, Acta Otolaryngol 1998; 118: 138
| Hoffmann M, Int J Cancer 2010; 127: 1595 | Klussmann JP, Cancer 2001; 92:
2875 | Reimers N, Int J Cancer 2007; 120: 1731 | Weiss D, Head Neck 2011; 33:
856 | Wittekindt C, Adv Otorhinolaryngol 2005; 62: 72
Spain Herrero R, J Natl Cancer Inst 2003; 95: 1772
France Charfi L, Cancer Lett 2008; 260: 72 | Fouret P, Arch Otolaryngol Head Neck
Surg 1997; 123: 513
United Kingdom Anderson CE, J Clin Pathol 2007; 60: 439 | Schache AG, Clin Cancer Res 2011;
17: 6262 | Thavaraj S, J Clin Pathol 2011; 64: 308
Greece Romanitan M, Anticancer Res 2008; 28: 2077
Italy Boscolo-Rizzo P, J Cancer Res Clin Oncol 2009; 135: 559 | Herrero R, J Natl
Cancer Inst 2003; 95: 1772 | Licitra L, J Clin Oncol 2006; 24: 5630 | Ritt M,
Head Neck 2009; 31: 318
Netherlands Braakhuis BJ, J Natl Cancer Inst 2004; 96: 998
Norway Hannisdal K, Acta Otolaryngol 2010; 130: 293
Poland Ribeiro KB, Int J Epidemiol 2011; 40: 489 | Snietura M, Pol J Pathol 2010; 61:
133 | Szkaradkiewicz A, Clin Exp Med 2002; 2: 137
Sweden Attner P, Int J Cancer 2010; 126: 2879 | Dahlgren L, Int J Cancer 2004; 112:
1015 | Hammarstedt L, Int J Cancer 2006; 119: 2620 | Lindquist D, Anticancer
Res 2012; 32: 153 | Nsman A, Int J Cancer 2009; 125: 362
Oceania
Australia Hong AM, Vaccine 2010; 28: 3269
HPV prevalence and type distribution in invasive hypopharyngeal squamous cell carcinoma
Americas
Argentina Ribeiro KB, Int J Epidemiol 2011; 40: 489
Brazil Miranda FA, J Histochem Cytochem 2009; 57: 665 | Ribeiro KB, Int J Epidemiol
2011; 40: 489
Canada Fliss DM, Laryngoscope 1994; 104: 146
Chile Torrente MC, Acta Otolaryngol 2005; 125: 888
Cuba Garca-Milin R, Acta Otolaryngol 1998; 118: 754 | Ribeiro KB, Int J Epidemiol
2011; 40: 489
USA Brandwein MS, Ann Otol Rhinol Laryngol 1993; 102: 309 | Furniss CS, Int J
Cancer 2007; 120: 2386 | Paz IB, Cancer 1997; 79: 595 | Schlecht NF, Mod
Pathol 2011; 24: 1295 | Shen J, Mod Pathol 1996; 9: 15 | Zhao M, Int J Cancer
2005; 117: 605
Asia
China Liu B, Neoplasma 2010; 57: 594 | Ma XL, J Med Virol 1998; 54: 186
India Jacob SE, J Surg Oncol 2002; 79: 142
Japan Anwar K, Int J Cancer 1993; 53: 22 | Mineta H, Anticancer Res 1998; 18: 4765 |
Ogura H, Jpn J Cancer Res 1991; 82: 1184 | Shidara K, Laryngoscope 1994;
104: 1008
Turkey Bozdayi G, J Otolaryngol Head Neck Surg 2009; 38: 119 | Dnmez M, Kuwait
Med J 2000 | Gungor A, J Laryngol Otol 2007; 121: 772
Europe
Belgium Duray A, Int J Oncol 2011; 39: 51
Switzerland Adams V, Anticancer Res 1999; 19: 1
(Continued)

Table 32 Continued
Country Study
Czech Republic Ribeiro KB, Int J Epidemiol 2011; 40: 489
Germany Fischer M, Acta Otolaryngol 2003; 123: 752 | Hoffmann M, Acta Otolaryngol
1998; 118: 138 | Hoffmann M, Anticancer Res 2006; 26: 663 | Hoffmann M,
Oncol Rep 2009; 21: 809 | Kleist B, J Oral Pathol Med 2000; 29: 432 |
Klussmann JP, Cancer 2001; 92: 2875
Denmark Lindeberg H, Cancer Lett 1999; 146: 9
Spain Alvarez Alvarez I, Am J Otolaryngol 1997; 18: 375 | Prez-Ayala M, Int J
Cancer 1990; 46: 8
Finland Koskinen WJ, Int J Cancer 2003; 107: 401 | Koskinen WJ, J Cancer Res Clin
Oncol 2007; 133: 673 | Mork J, N Engl J Med 2001; 344: 1125
France Fouret P, Arch Otolaryngol Head Neck Surg 1997; 123: 513
United Kingdom Anderson CE, J Clin Pathol 2007; 60: 439 | Salam M, Eur J Surg Oncol 1995;
21: 290 | Snijders PJ, Int J Cancer 1996; 66: 464
Greece Gorgoulis VG, Hum Pathol 1999; 30: 274 | Vlachtsis K, Eur Arch
Otorhinolaryngol 2005; 262: 890
Hungary Major T, J Clin Pathol 2005; 58: 51
Italy Azzimonti B, Histopathology 2004; 45: 560 | Badaracco G, Anticancer Res 2000;
20: 1301 | Badaracco G, Oncol Rep 2007; 17: 931 | Boscolo-Rizzo P, J Cancer
Res Clin Oncol 2009; 135: 559 | Cattani P, Clin Cancer Res 1998; 4: 2585 |
Gallo A, Otolaryngol Head Neck Surg 2009; 141: 276
Lithuania Gudleviciene Z, Oncology 2009; 76: 205
Norway Koskinen WJ, J Cancer Res Clin Oncol 2007; 133: 673 | Lie ES, Acta
Otolaryngol 1996; 116: 900 | Mork J, N Engl J Med 2001; 344: 1125
Poland Morshed K, Eur Arch Otorhinolaryngol 2008; 265 Suppl 1: S89 | Ribeiro KB, Int
J Epidemiol 2011; 40: 489 | Snietura M, Eur Arch Otorhinolaryngol 2011; 268:
721
Slovenia Poljak M, Acta Otolaryngol Suppl 1997; 527: 66
Sweden Koskinen WJ, J Cancer Res Clin Oncol 2007; 133: 673 | Mork J, N Engl J Med
2001; 344: 1125

10 GLOSSARY - 298 -
10 Glossary
Table 33: Glossary

Term Definition
Incidence Incidence is the number of new cases arising in a given period in a specified
population. This information is collected routinely by cancer registries. It can be
expressed as an absolute number of cases per year or as a rate per 100,000
persons per year (see Crude rate and ASR below). The rate provides an
approximation of the average risk of developing a cancer.
Mortality Mortality is the number of deaths occurring in a given period in a specified
population. It can be expressed as an absolute number of deaths per year or as a
rate per 100,000 persons per year.
Prevalence The prevalence of a particular cancer can be defined as the number of persons in
a defined population who have been diagnosed with that type of cancer, and who
are still alive at the end of a given year, the survivors. Complete prevalence
represents the number of persons alive at certain point in time who previously
had a diagnosis of the disease, regardless of how long ago the diagnosis was, or if
the patient is still under treatment or is considered cured. Partial prevalence ,
which limits the number of patients to those diagnosed during a fixed time in the
past, is a particularly useful measure of cancer burden. Prevalence of cancers
based on cases diagnosed within one, three and five are presented as they are
likely to be of relevance to the different stages of cancer therapy, namely, initial
treatment (one year), clinical follow-up (three years) and cure (five years).
Patients who are still alive five years after diagnosis are usually considered
cured since the death rates of such patients are similar to those in the general
population. There are exceptions, particularly breast cancer. Prevalence is
presented for the adult population only (ages 15 and over), and is available both
as numbers and as proportions per 100,000 persons.
Crude rate Data on incidence or mortality are often presented as rates. For a specific
tumour and population, a crude rate is calculated simply by dividing the number
of new cancers or cancer deaths observed during a given time period by the
corresponding number of person years in the population at risk. For cancer, the
result is usually expressed as an annual rate per 100,000 persons at risk.
ASR (age-standardised An age-standardised rate (ASR) is a summary measure of the rate that a
rate) population would have if it had a standard age structure. Standardization is
necessary when comparing several populations that differ with respect to age
because age has a powerful influence on the risk of cancer. The ASR is a
weighted mean of the age-specific rates; the weights are taken from population
distribution of the standard population. The most frequently used standard
population is the World Standard Population. The calculated incidence or
mortality rate is then called age-standardised incidence or mortality rate
(world). It is also expressed per 100,000. The world standard population used in
GLOBOCAN is as proposed by Segi [1] and modified by Doll and al. [2]. The
age-standardised rate is calculated using 10 age-groups. The result may be
slightly different from that computed using the same data categorised using the
traditional 5 year age bands.
Cumulative risk Cumulative incidence/mortality is the probability or risk of individuals
getting/dying from the disease during a specified period. For cancer, it is
expressed as the number of new born children (out of 100, or 1000) who would be
expected to develop/die from a particular cancer before the age of 75 if they had
the rates of cancer observed in the period in the absence of competing causes.
Cytologically normal No abnormal cells are observed on the surface of their cervix upon cytology.
women
(Continued)

10 GLOSSARY - 299 -
Table 33 Continued
Term Definition
Cervical Intraepithelial SIL and CIN are two commonly used terms to describe precancerous lesions or
Neoplasia (CIN) / the abnormal growth of squamous cells observed in the cervix. SIL is an
Squamous Intraepithelial abnormal result derived from cervical cytological screening or Pap smear testing.
Lesions (SIL) CIN is a histological diagnosis made upon analysis of cervical tissue obtained by
biopsy or surgical excision. The condition is graded as CIN 1, 2 or 3, according to
the thickness of the abnormal epithelium (1/3, 2/3 or the entire thickness).
Low-grade cervical lesions Low-grade cervical lesions are defined by early changes in size, shape, and
(LSIL/CIN-1) number of ab-normal cells formed on the surface of the cervix and may be
referred to as mild dysplasia, LSIL, or CIN-1.
High-grade cervical High-grade cervical lesions are defined by a large number of precancerous cells
lesions (HSIL / CIN-2 / on the sur-face of the cervix that are distinctly different from normal cells. They
CIN-3 / CIS) have the potential to become cancerous cells and invade deeper tissues of the
cervix. These lesions may be referred to as moderate or severe dysplasia, HSIL,
CIN-2, CIN-3 or cervical carcinoma in situ (CIS).
Carcinoma in situ (CIS) Preinvasive malignancy limited to the epithelium without invasion of the
basement membrane. CIN 3 encompasses the squamous carcinoma in situ.
Invasive cervical cancer If the high-grade precancerous cells invade the basement membrane is called
(ICC) / Cervical cancer ICC. ICC stages range from stage I (cancer is in the cervix or uterus only) to
stage IV (the cancer has spread to distant organs, such as the liver).
Invasive squamous cell Invasive carcinoma composed of cells resembling those of squamous epithelium
carcinoma
Adenocarcinoma Invasive tumour with glandular and squamous elements intermingled.
Eastern Europe References included in Belarus, Bulgaria, Czech Republic, Hungary, Poland,
Republic of Moldova, Romania, Russian Federation, Slovakia, and Ukraine.
Northern Europe References included in Denmark, Estonia, Finland, Iceland, Ireland, Latvia,
Lithuania, Norway, Sweden, and United Kingdom of Great Britain and Northern
Ireland.
Southern Europe References included in Albania, Bosnia and Herzegovina, Croatia, Greece, Italy,
Malta, Montenegro, Portugal, Serbia, Slovenia, Spain, The former Yugoslav
Republic of Macedonia.
Western Europe References included in Austria, Belgium, France, Germany, Liechtenstein,
Luxembourg, Netherlands, and Switzerland.
Europe PREHDICT References included in Albania, Austria, Belarus, Belgium, Bosnia and
Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia,
Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy,
Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Montenegro,
Netherlands, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian
Federation, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, The former
Yugoslav Republic of Macedonia, Turkey, Ukraine, and United Kingdom of Great
Britain and Northern Ireland.

10 GLOSSARY - 300 -
Acknowledgments
This report has been developed by the Unit of Infections and Cancer, Cancer Epidemiology Research
Program, at the Institut Catal dOncologia (ICO, Catalan Institute of Oncology) within the PREHDICT
project (7th Framework Programme grant HEALTH-F3-2010-242061, PREHDICT). The HPV Informa-
tion Centre is being developed by the Institut Catal dOncologia (ICO). The Centre was originally
launched by ICO with the collaboration of WHOs Immunisation, Vaccines and Biologicals (IVB) depart-
ment and support from the Bill and Melinda Gates Foundation.
Institut Catal dOncologia (ICO), in alphabetic order

Albero G, Barrionuevo-Rosas L, Bosch FX, Bruni L, de Sanjos S, Gmez D, Mena M, Muoz J, Serrano
B.
7th Framework Programme grant PREHDICT project: health-economic modelling of PREvention

strategies for Hpv-related Diseases in European CounTries. Coordinated by Drs. Johannes Berkhof
and Chris Meijer at VUMC, Vereniging Voor Christelijk Hoger Onderwijs Wetenschappelijk Onderzoek
En Patientenzorg, the Netherlands.
(http://cordis.europa.eu/projects/rcn/94423_en.html)
7th Framework Programme grant HPV AHEAD project: Role of human papillomavirus infec-
tion and other co-factors in the aetiology of head and neck cancer in India and Europe. Coordinated by
Dr. Massimo Tommasino at IARC, International Agency of Research on Cancer, Lyon, France.
(http://cordis.europa.eu/project/rcn/100268_en.html)
International Agency for Research on Cancer (IARC)

- 301 -
Note to the reader

Anyone who is aware of relevant published data that may not have been included in the present report
is encouraged to contact the HPV Information Centre for potential contributions.
Although efforts have been made by the HPV Information Centre to prepare and include as accurately
as possible the data presented, mistakes may occur. Readers are requested to communicate any errors
to the HPV Information Centre, so that corrections can be made in future volumes.
Disclaimer
The information in this database is provided as a service to our users. Any digital or printed publica-
tion of the information provided in the web site should be accompanied by an acknowledgment of HPV
Information Centre as the source. Systematic retrieval of data to create, directly or indirectly, a scien-
tific publication, collection, database, directory or website requires a permission from HPV Information
Centre.
The responsibility for the interpretation and use of the material contained in the HPV Information
Centre lies on the user. In no event shall the HPV Information Centre be liable for any damages arising
from the use of the information.
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Use, reproduction, copying, or redistribution of PREHDICT or HPV Information Centre logos are strictly
prohibited without explicit written permission from the HPV Information Centre.
Contact information:

Institut Catal dOncologia
Avda. Gran Via de lHospitalet, 199-203
08908 LHospitalet de Llobregat (Barcelona, Spain)
e-mail: [email protected]
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Table 2: Key statistics

More developed regions

ICO HPV Information Centre

2 Demographic and socioeconomic factors 3

3 Burden of HPV related cancers 7

4 HPV related statistics 79

5 Factors contributing to cervical cancer 239

6 Sexual behaviour and reproductive health indicators 244

7 HPV preventive strategies 245

8 Protective factors for cervical cancer 260

ICO HPV Information Centre

ICO HPV Information Centre

ICO HPV Information Centre

ICO HPV Information Centre

ICO HPV Information Centre

Figure 1: World geographical regions

Northern America Central Asia

Southern Europe Eastern Asia

Western Asia Southern Asia

Western Africa SouthEastern Asia Micronesia

South America Australia and New Zealand

ICO HPV Information Centre

introduction, and recommendations for national immunization programmes.

ICO HPV Information Centre

2 Demographic and socioeconomic factors

80+ 48,276,426 76,996,744

Less developed regions

80+ 27,402,564 38,764,751

More developed regions

80+ 20,873,862 38,231,993

Population by sex and age group

Data accessed on 26 Aug 2015.

ICO HPV Information Centre

Women 1524 yrs

Number of women (in millions)

Number of women (in millions)

Number of women (in millions)

Female population trends

ICO HPV Information Centre

Table 3: World population estimates (in millions), 2015

Table 4: World sociodemographic indicators, 2015

(Continued on next page)

ICO HPV Information Centre

( Table 4 continued from previous page)

ICO HPV Information Centre

3 Burden of HPV related cancers

About 527,624 new cervical cancer cases are diagnosed annually in

Cervical cancer ranks* as the 4 th leading cause of female cancer in the

Data accessed on 15 Nov 2015.

ICO HPV Information Centre

ICO HPV Information Centre

Data accessed on 15 Nov 2015.

ICO HPV Information Centre

World 14.0 Western Africa 29.3

Europe 11.4 Northern Africa 6.6

Cervical cancer: Agestandardised mortality rate per 100,000 women

Data accessed on 15 Nov 2015.

ICO HPV Information Centre

World More developed regions