了解不同人乳头瘤病毒 (HPV) 基因型引起的浸润性宫颈癌 (ICC) 的比例可以为针对特定 HPV 基因型的一级（即疫苗接种）和二级（即筛查）预防工作提供信息。然而，使用全球文献来估计人群归因分数 (AF) 需要一个方法框架来从汇总数据中解决 HPV 基因型特异性因果关系。我们的目的是估计全球、区域和国家层面上不同 HPV 基因型引起的 ICC 的比例。这项系统综述确定了报告 ICC 或宫颈细胞学正常人群中 HPV 基因型特异性患病率的研究。我们使用搜索词“cervix”和“HPV”检索了截至 2024 年 2 月 29 日的 PubMed、Embase、Scopus 和 Web of Science，没有语言限制。通过使用逻辑回归模型比较 HPV 阳性 ICC 和正常宫颈细胞学之间的 HPV 基因型特异性患病率，并根据地区、论文发表年份和 HPV 引物或测试进行调整，估计优势比 (OR)。 OR 95% CI 下限大于 1·0 的 HPV 基因型被判断为 ICC 的因果关系。相应的区域基因型特异性 AF 计算为 ICC 区域 HPV 患病率乘以 (1 - [1 / OR])，并按比例调整至总数 100%。全球 AF 是根据 2022 年区域 ICC 病例数加权的区域 AF 计算得出的 (GLOBOCAN)。系统评价确定了 1174 项研究，其中 111 902 例 HPV 阳性 ICC 病例和 2 755 734 例正常宫颈细胞学病例。 17 种 HPV 基因型被认为与 ICC 相关，OR 范围广泛，从 HPV16 的 48·3 (95% CI 45·7-50·9) 到 HPV51 的 1·4 (1·2-1·7)。 HPV16 的全球 AF 最高（61·7%），其次是 HPV18（15·3%）、HPV45（4·8%）、HPV33（3·8%）、HPV58（3·5%）、HPV31（2 ·8%) 和 HPV52 (2·8%)。其余致病基因型（HPV35、59、39、56、51、68、73、26、69 和 82）的总 AF 率为 5·3%。 HPV16 和 18 以及 HPV16、18、31、33、45、52 和 58 组合的 AF 在非洲最低（分别为 71·9% 和 92·1%），在中亚、西亚和南亚最高（83分别为·2% 和 95·9%）。 HPV35 在非洲的 AF 率 (3·6%) 高于其他地区 (0·6-1·6%)。这项研究提供了在 HPV 疫苗接种影响之前，ICC 中 HPV 基因型特异性 AF 的全面全球情况。这些数据可以为 HPV 基因型特异性疫苗接种和筛查策略提供信息，以减轻 ICC.EU Horizo​​n 2020 研究和创新计划的负担。版权所有 © 2024 世界卫生组织。由 Elsevier Ltd 出版。保留所有权利，包括文本和数据挖掘、人工智能培训和类似技术的权利。

Understanding the proportion of invasive cervical cancer (ICC) caused by different human papillomavirus (HPV) genotypes can inform primary (ie, vaccination) and secondary (ie, screening) prevention efforts that target specific HPV genotypes. However, using the global literature to estimate population attributable fractions (AFs) requires a methodological framework to address HPV genotype-specific causality from aggregated data. We aimed to estimate the proportion of ICC caused by different HPV genotypes at the global, regional, and national level.This systematic review identified studies reporting HPV genotype-specific prevalence in ICC or people with normal cervical cytology. We searched PubMed, Embase, Scopus, and Web of Science up to Feb 29, 2024, using the search terms "cervix" and "HPV", with no language restrictions. Odds ratios (ORs) were estimated by comparing HPV genotype-specific prevalence between HPV-positive ICC and normal cervical cytology with logistic regression models, adjusting for region, year of paper publication, and HPV primer or test. HPV genotypes with a lower bound to the 95% CI of the OR greater than 1·0 were judged as causal to ICC. Corresponding regional genotype-specific AFs were calculated as regional HPV prevalence in ICC multiplied by (1 - [1 / OR]) and were proportionally adjusted to total 100%. Global AFs were calculated from regional AFs weighted by number of regional ICC cases in 2022 (GLOBOCAN).The systematic review identified 1174 studies with 111 902 cases of HPV-positive ICC and 2 755 734 of normal cervical cytology. 17 HPV genotypes were considered causal to ICC, with ORs ranging widely from 48·3 (95% CI 45·7-50·9) for HPV16 to 1·4 (1·2-1·7) for HPV51. HPV16 had the highest global AF (61·7%), followed by HPV18 (15·3%), HPV45 (4·8%), HPV33 (3·8%), HPV58 (3·5%), HPV31 (2·8%), and HPV52 (2·8%). Remaining causal genotypes (HPV35, 59, 39, 56, 51, 68, 73, 26, 69, and 82) had a combined global AF of 5·3%. AFs for HPV16 and 18 and HPV16, 18, 31, 33, 45, 52, and 58 combined were lowest in Africa (71·9% and 92·1%, respectively) and highest in central, western, and southern Asia (83·2% and 95·9%, respectively). HPV35 had a higher AF in Africa (3·6%) than other regions (0·6-1·6%).This study provides a comprehensive global picture of HPV genotype-specific AFs in ICC, before the influence of HPV vaccination. These data can inform HPV genotype-specific vaccination and screening strategies to reduce the burden of ICC.EU Horizon 2020 Research and Innovation Programme.Copyright © 2024 World Health Organization. Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.