Monitoring of HPV in the Norwegian Surveillance System for Communicable Diseases (MSIS)
The vaccine against human papillomavirus (HPV) was introduced into the childhood immunisation programme in 2009. The effectiveness of the vaccine is evaluated through the national surveillance of the HPV vaccination programme. Since 2017, the incidence of HPV genotypes in cervical cancer and precursors to cervical cancer is monitored in MSIS.
Following the introduction of the HPV vaccine into the childhood immunisation programme in 2009, the incidence and changes in human papillomavirus (HPV) genotypes in precursors to cervical cancer or cervical cancer in the population are being tracked.
Changes are monitored by testing samples from the cervix taken during the investigation of precursors to cervical cancer or cervical cancer for HPV. The results of these tests are stored in the Norwegian Surveillance System for Communicable Diseases (MSIS) at the Norwegian Institute of Public Health.
Information in the registry
The Cancer Registry reports information to MSIS about patients who have been diagnosed with cancer or precursors to cancer (MSIS regulations § 2-3 last sub-section).
A selection of samples taken from the cervix in connection with screening for cervical cancer precursors or for cervical cancer are sent from pathology laboratories for HPV testing at the national HPV reference laboratory.
The purpose of the testing is to evaluate the effectiveness of the HPV vaccine on HPV incidence and the distribution of HPV genotypes. Once the reference laboratory has tested and genotyped the material, the analysis results will be transferred to MSIS. The test result has no practical significance for the patient or their treatment, and the result is not communicated to the patient. The patient cannot opt out of the registration of positive HPV results.
After the HPV testing is performed, a small portion of the tissue sample is stored in a biobank associated with MSIS so that the material can be retested in the event of a transition to new analysis methods. The patient has the right to opt out of the storage of this tissue sample (see MSIS regulations § 1-8 a).
For samples that do not test positive for HPV, only anonymised information is retained in MSIS, and the sample material is not stored in the biobank.
Information flow for HPV in MSIS
- Information about HPV vaccine evaluation and the right to opt-out is provided by healthcare professionals during sample collection.
- The Cancer Registry records cases and monitors cancer incidence.
- The national reference laboratory for HPV at Akershus University Hospital analyses cervical samples for HPV genotype.
- The Norwegian Institute of Public Health records positive HPV results in MSIS and monitors changes in HPV genotype.
- A small portion of the HPV positive samples are stored in a biobank associated with MSIS. The woman may opt out of the storage of this sample.
- The Norwegian Institute of Public Health only retains anonymised information about samples where HPV is not detected.