Human papillomavirus infection, risk for subsequent development of cervical neoplasia and associated population attributable fraction

J Clin Virol. 2001 Aug;22(1):117-24. doi: 10.1016/s1386-6532(01)00172-x.


Background: Human papillomavirus (HPV) is the major cause of cervical neoplasia but estimates of the population attributable fraction (PAR%), of HPV vary. PAR% has not been derived from longitudinal studies although assessment of HPV exposure prior to the neoplasia diagnosis should increase validity of such estimates.

Aims: Systematic review and meta-analysis of longitudinal studies on HPV associated relative risk (RR) for and PAR% of HPV16 in cervical neoplasia.

Methods: Pertinent data from longitudinal studies was made available through Medline and substituted by various hand searches. HPV associated weighted mean RR, with 95% confidence interval (CI) of cervical neoplasia, and the PAR% of HPV16 in cervical carcinoma were estimated both for unselected and low HPV prevalence populations.

Results: HPV associated RR of cervical carcinoma in PCR-based studies was 17 (95% CI 8.2-33). HPV16 associated RRs in seroepidemiological studies were 3.3 (95% CI 2.2-4.9) for the unselected population, HPV16 seroprevalence 11.0%, and 12.5 (95% CI 5.5-29) for a population with low HPV16 seroprevalence of 5.3%. Corresponding PAR% estimates of HPV16 were 27 and 44%, respectively.

Conclusion: Protective vaccination against HPV16 infection would prevent up to 44% of cervical carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • DNA, Viral / analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Meta-Analysis as Topic
  • Papillomaviridae / genetics
  • Papillomaviridae / immunology
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / blood
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / immunology
  • Papillomavirus Infections / virology*
  • Polymerase Chain Reaction / methods
  • Retrospective Studies
  • Risk Factors
  • Seroepidemiologic Studies
  • Tumor Virus Infections / blood
  • Tumor Virus Infections / epidemiology
  • Tumor Virus Infections / immunology
  • Tumor Virus Infections / virology*
  • Uterine Cervical Dysplasia / blood
  • Uterine Cervical Dysplasia / epidemiology
  • Uterine Cervical Dysplasia / immunology
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / blood
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / immunology
  • Uterine Cervical Neoplasms / virology*


  • DNA, Viral