Research group - Karin Sundström

We study human papillomavirus (HPV) which causes cervical cancer. Our research focuses on the whole chain from HPV infection (primary prevention), through risk for cervical precancerous lesions (secondary prevention), to prognostic markers for women with invasive cervical cancer (tertiary prevention).

Human papillomavirus and risk of cancer

HPV is a small double-stranded DNA-virus which can cause condyloma (external genital warts), cervical precancerous lesions, and invasive cervical cancer. HPV is sexually transmitted in the majority of cases, and is very common in sexual contacts. Most often, the infection will clear on its own, but in a minority of cases the viral infection will persist for a long time in the mucosa, and can then cause cervical precancerous lesions and ultimately cancer. The cancer development, however, requires time and several steps of development to take place, which means we have room to intervene at several points in time. Therefore, most high-resource settings in the world have introduced cervical screening, where samples are taken from a woman’s cervix and precancer can be detected and cured early, before true cancer develops.

The fact remains that screening can always be improved, and that the participation of women needs to be continuously evaluated. Therefore, we work both with the development of new biomarkers for screening, and studies of participation/engagement in health practices.


Since the year 2006-2007, we have access to effective HPV-vaccines which protect against vaccine-HPV-type related HPV infection, condyloma, and cervical precancerous lesions. We recently showed from Karolinska Institutet that HPV-vaccination also prevents true invasive cervical cancer on the population-level, as predicted by clinical trials. A particular interest of mine is to perform long-term follow-up studies of HPV vaccination using the Swedish register infrastructure, to evaluate comprehensively and continuously the HPV vaccines effectiveness over time.

HPV-test and prognosis for survival

In collaboration with the Department for Medical Epidemiology and Biostatistics (MEB), we perform research to understand the potential of HPV-testing to serve as a prognostic indicator/determinant in cervical cancer.

Research group leader Karin Sundström

Karin Sundström

Principal researcher
H9 Department of Clinical Science, Intervention and Technology

Group members

Research techniques

  • Epidemiology, biostatistics with a focus on register-based and biobank-based applications.
  • HPV-testing and deep sequencing/NGS in collaboration with group Joakim Dillner and the Center for Cervical Cancer Prevention at Karolinska University Hospital.

External funding

Biomarkers and screening: The Swedish Society of Medicine, Center for Innovative Medicine (CIMED)/Region Stockholm. HPV-vaccination: academic projects, collaborative projects and commissioned research funded by Merck and Co., Inc.

Teaching assignments

We teach within a number of KI programmes:

The Master Programme in Diagnostic Cytology, The Bachelor’s Programme in Biomedicine, The Study Programme in Specialist Nursing, PhD-traning courses in epidemiology.

Selected publications

HPV Vaccination and the Risk of Invasive Cervical Cancer.
Lei J, Ploner A, Elfström KM, Wang J, Roth A, Fang F, Sundström K, Dillner J, Sparén P
N Engl J Med 2020 10;383(14):1340-1348

Mode of HPV vaccination delivery and equity in vaccine uptake: A nationwide cohort study.
Wang J, Ploner A, Sparén P, Lepp T, Roth A, Arnheim-Dahlström L, Sundström K
Prev Med 2019 03;120():26-33

Human papillomavirus type 16 genomic variation in women with subsequent in situ or invasive cervical cancer: prospective population-based study.
Arroyo-Mühr LS, Lagheden C, Hultin E, Eklund C, Adami HO, Dillner J, Sundström K
Br J Cancer 2018 10;119(9):1163-1168

The HPV16 Genome Is Stable in Women Who Progress to In Situ or Invasive Cervical Cancer: A Prospective Population-Based Study.
Arroyo-Mühr LS, Lagheden C, Hultin E, Eklund C, Adami HO, Dillner J, Sundström K
Cancer Res 2019 09;79(17):4532-4538

High-risk human papillomavirus status and prognosis in invasive cervical cancer: A nationwide cohort study.
Lei J, Ploner A, Lagheden C, Eklund C, Nordqvist Kleppe S, Andrae B, Elfström KM, Dillner J, Sparén P, Sundström K
PLoS Med 2018 10;15(10):e1002666

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