Age-dependent prevalence of 14 high-risk HPV types in the Netherlands: implications for prophylactic vaccination and screening

Br J Cancer. 2008 Feb 12;98(3):646-51. doi: 10.1038/sj.bjc.6604162. Epub 2008 Jan 8.


We determined the prevalence of type-specific hrHPV infections in the Netherlands on cervical scrapes of 45 362 women aged 18-65 years. The overall hrHPV prevalence peaked at the age of 22 with peak prevalence of 24%. Each of the 14 hrHPV types decreased significantly with age (P-values between 0.0009 and 0.03). The proportion of HPV16 in hrHPV-positive infections also decreased with age (OR=0.76 (10-year scale), 95% CI=0.67-0.85), and a similar trend was observed for HPV16 when selecting hrHPV-positive women with cervical intraepithelial neoplasia grade 2 or worse (CIN2+) (OR=0.76, 95% CI=0.56-1.01). In women eligible for routine screening (age 29-61 years) with confirmed CIN2+, 65% was infected with HPV16 and/or HPV18. When HPV16/18-positive infections in women eligible for routine screening were discarded, the positive predictive value of cytology for the detection of CIN2+ decreased from 27 to 15%, the positive predictive value of hrHPV testing decreased from 26 to 15%, and the predictive value of a double-positive test (positive HPV test and a positive cytology) decreased from 54 to 41%. In women vaccinated against HPV16/18, screening remains important to detect cervical lesions caused by non-HPV16/18 types. To maintain a high-positive predictive value, screening algorithms must be carefully re-evaluated with regard to the screening modalities and length of the screening interval.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Alphapapillomavirus / classification*
  • Alphapapillomavirus / isolation & purification*
  • Cohort Studies
  • Female
  • Humans
  • Middle Aged
  • Netherlands / epidemiology
  • Papillomavirus Infections / classification*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Vaccines / therapeutic use
  • Prevalence
  • Vaccination*
  • Vaginal Smears


  • Papillomavirus Vaccines