HPV16 in women with subsequent in situ or invasive cervical cancer

The human papillomavirus (HPV) rate of evolution is essential for cancer-preventive strategies targeting HPV. We analyzed variability over time in a prospective, population-based nested case-control study of in situ (CIS) and invasive squamous cervical cancer (SCC). We found that all women had the same HPV16 lineage in both serial smears, mainly lineage A. We conclude that in most women with HPV16 persistence, the nucleotide substitution rate was not even measurable within up to 15-years follow-up. The slow rate of evolution has important implications for both HPV-based screening and HPV vaccination.