Human Papillomavirus (HPV) infection is causally linked to invasive cervical cancer (ICC) [1]. In Portugal the incidence of ICC is high (age-standardized rate of 10.8 cases per 100,000 women), and mortality is estimated to be 4.9 deaths per 100,000 women [2]. Accordingly with the results of the CLEOPATRE Portuguese study, overall HPV prevalence was estimated to be 19.4%, in the general female population [3]. This was the first large study on HPV infection in the general population and the extrapolated prevalence for HPV infection was higher than the one obtained in other neighbor countries such as Spain, with HPV prevalence in general female of a 14.3% [4]. The higher incidence and mortality of cervical carcinoma in Portugal could be related to a higher prevalence of HPV infection and most probably related with the absence of a National Cervical Cancer Screening Programme, although planed, is still not implemented. In Portugal, in 2008, quadrivalent HPV vaccination was included in the National Immunization Plan for girls aged 13, having an overall coverage rate of 88 and 93% [5].
There is scarce data regarding HPV distribution in ICC in the Portuguese population [6] and [7]. Large international series demonstrate that, although a small number of different types are more prevalent than others, there are some geographical differences regarding HPV type distribution [8]. Our aim was to describe the HPV genotype distribution in ICC in Portugal, to analyze differences in along nine decades (from 1928 to 2005). This study is part of a larger study, RIS HPV TT study [9], whose objective was to describe the HPV genotype distribution in invasive cervical cancer worldwide.