How common is non-HPV Cervical Cancer?

Each year about 604,000 women are diagnosed with cervical cancer worldwide. Globally, it is estimated that approximately 5.5–11% of cervical cancers are HPV-negative.

Human Papillomavirus is the leading cause of cervical cancer. About 900 women are diagnosed with cervical cancer in Australia each year and almost all cases are caused by the HPV infection. In Australia, just two of HPV types, 16 and 18, account for 70%–80% of cases of cervical cancer.

Some rare types of cervical cancer are not caused by HPV, and are called HPV-negative. A review of studies found there has been a reduction in the amount of HPV-negative cases in the past few decades.

Cartoon picture of doctor and patient

Studies have shown that some sub-types of adenocarcinoma can be HPV-negative. Rare subtypes such as clear cell, mesonephric, or gastric-type adenocarcinomas also account for most of the HPV-negative cervical cancers. Some cervical cancers when HPV was not detected at diagnosis will have been HPV positive in the preceding years – and could have been detected – but now are HPV negative now due to the progression of the cancer.

Unfortunately, there isn't a suitable screening test for HPV-negative cervical cancers. The previous Pap test and the current Cervical Screening Test are not able to detect these types of rare, HPV-negative cervical cancers. The HPV vaccine can only protect against HPV-related (positive) cervical cancers.

How are non-HPV cervical cancers diagnosed?

Non-HPV cervical cancers are generally found when women report symptoms such as pain and abnormal vaginal bleeding. Women who experience these symptoms should see a doctor for a gynaecological, internal examination, regardless of how long it has been since their last Cervical Screening Test. Women with HPV-negative cervical cancer tend to be diagnosed at later stages resulting in a poorer prognosis.  A meta-analysis combining 17 studies that included 2838 patients concluded that HPV-positive cervical cancers have a better prognosis. This may be due to the lack of screening options and symptoms showing at an advanced stage. Researchers also suggest that that HPV-negative tumours might be a more aggressive subtype of cervical cancer. As a rare cancer, more research is needed for HPV-negative cervical cancers.

What are the treatments for HPV-negative cervical cancers?

Currently, there is no specific therapy for HPV-negative cervical cancers and we currently treat them the same way as HPV-positive cervical cancer. 

Having HPV does not mean you have or will get cervical cancer. While HPV is common, and while the majority of women and men who have been sexually active at least once had HPV at least temporarily, cervical cancer is not common. The symptoms of non-HPV cervical cancer are similar to HPV cervical cancer, so know the symptoms, and speak to your doctor if you are concerned. Overall, non-HPV cervical cancer only makes up a minority of cervical cancer cases.

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