HPV infection in Europe.

In order to estimate the impact of primary cervical cancer screening with human papillomavirus (HPV) testing, and implementation of the current HPV vaccines, we have summarised the most recent and largest HPV studies in Europe. Eighteen studies including between 897 and 46,900 women from 14, mostly Northern and Western European, countries were included. Everywhere, high-risk (HR) HPV prevalence peaked before age 25 or 30years with steady declines thereafter. For women in the 30-64-year age-range, for whom primary HPV testing is considered, age-adjusted HR HPV prevalence ranged from 2% in Spain to approximately 12% in Belgium and France, where sustained elevated levels were found in women aged > or = 35years. HPV16 and 18, the two HR types prevented by current HPV vaccines, accounted for 30% (range 19-43%) and 12% (range 0-22%) of all HR HPV positives, respectively, and varied according to the presence of cervical lesions. Based on an updated meta-analysis of HPV type distribution in the whole of Europe, HPV16 and/or 18 are estimated to be present in 52%, 61% and 76% of cytologically detected high-grade squamous intraepithelial lesions, histologically confirmed cervical intraepithelial neoplasia grade 2/3, and invasive cervical carcinoma, respectively.