The causal relation between human papillomavirus and cervical cancer.
Journal: 2002/May - Journal of Clinical Pathology
ISSN: 0021-9746
PUBMED: 11919208
Abstract:
The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented.
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J Clin Pathol 55(4): 244-265

The causal relation between human papillomavirus and cervical cancer

Institut Català d'Oncologia, Servei d'Epidemiologia i Registre del Càncer, Gran Via Km 2.7 s/n 08907 L'Hospitalet de Llobregat, 08907 Barcelona, Spain
Digene Corporation, 1201 Clopper Road, Gaithersburg, MD 20878, USA
International Agency for Research on Cancer (IARC), Unit of Field and Intervention Studies, 150 Cours Albert-Thomas, F-69372 Lyon, Cedex 08, France
Vrije Universiteit Medical Center, Department of Pathology, De Boelelaan 1117, PO Box 7057–1007, 1081 HV Amsterdam, The Netherlands
The John Hopkins School of Public Health, Department of Molecular Microbiology and Immunology, 615 North Wolfe Street, Baltimore, MD 21205, USA
Correspondence to:
Dr F X Bosch, Epidemiology and Cancer Registry Unit (SERC), Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, Gran Via km 2,7, L'Hospitalet de Llobregat, 08907 Barcelona, Spain;
se.scs.oci@hcsob.x
Correspondence to:
Dr F X Bosch, Epidemiology and Cancer Registry Unit (SERC), Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, Gran Via km 2,7, L'Hospitalet de Llobregat, 08907 Barcelona, Spain;
se.scs.oci@hcsob.x
Accepted 2002 Jan 22.

Abstract

The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented.

Keywords: human papillomavirus, cervical cancer, causality, review
Abstract
Strength of association. Evaluation
Consistency. Evaluation
Specificity. Evaluation
Temporality. Evaluation
Biological gradient. Evaluation
Biological plausibility and coherence. Evaluation
Biological mechanisms of HPV carcinogensis. Evaluation
Experimental evidence. Evaluation
Analogy. Evaluation
Exclusion of alternative explanations. Evaluation
Overall evaluation
Likely components of sufficient causes of cervical cancer. Evaluation

Acknowledgments

This work has been partially supported by research grant FIS 01/1237 and a non-restricted collaborative research agreement between the Institut Català d'Oncologia (ICO) in Barcelona, Spain and Digene Corporation in Gaithersburg, Maryland, USA.

Advanced versions of this text have been reviewed by a number of researchers in the field of the viral aetiology of cervical cancer. Their comments and contributions are deeply appreciated: LA Brinton, National Cancer Institute, Bethesda, USA; TR Broker, University of Alabama, Birmingham, USA; RD Burk, Albert Einstein College of Medicine, New York, USA; X Castellsagué, Catalan Institute of Oncology, Barcelona, Spain; J Cuzick, Imperial Cancer Research Foundation, London, UK; S de Sanjosé, Catalan Institute of Oncology, Barcelona, Spain; M Del Vecchio, Digene Corporation, Gaithesburg, USA; ELF Franco, McGill University, Montreal, Canada; S Franceschi, International Agency for Research on Cancer, Lyon, France, I Frazer, Center for Immunology and Cancer Research, Brisbane, Australia; R Herrero, Proyecto Epidemiológico Guanacaste, San Jose, Costa Rica; S Krüger Kjaer, Danish Cancer Society, Copenhagen, Denmark; CJN Lacey, Imperial College School of Medicine, London, UK; DR Lowy, National Institutes of Health, Bethesda, USA; V Moreno, Catalan Institute of Oncology, Barcelona, Spain; A Muñoz, John Hopkins School of Hygiene and Public Health, Baltimore, USA; M Plummer, International Agency for Reasearch on Cancer, Lyon, France; WC Reeves, Centers for Disease Control and Prevention, Atlanta, USA; M Schiffman, National Cancer Institute, Bethesda, USA; JT Schiller, National Cancer Institute, Bethesda, USA; H-R Shin, National Cancer Centre Research Institute, Kyonggi, Korea; J Smith, International Agency for Research on Cancer, Lyon, France; PJF Snijders, Vrije Universiteit Medical Center, Amsterdam, The Netherlands; BM Steinberg, Long Island Jewish Hillside Medical Center, New York, USA; MH Stoler, University of Virginia, Charlottesville, USA; D Thomas, Fred Hutchinson Cancer Research Center, Seattle, USA; H Vainio, International Agency for Research on Cancer, Lyon, France; AJ van den Brule, Free University Hospital, Amsterdam, The Netherlands; LL Villa, Ludwig Institute for Cancer Research, Sao Paulo, Brazil; TC Wright, Columbia University, New York, USA. Many other researchers have contributed to understanding cervical cancer aetiology and to this review with their work, presentations at meetings, and coffee break discussions. We are grateful to them and hope this review is of use to anyone involved in the task of cervical cancer prevention. Many thanks to M Diaz and E Guinó for statistical support and to C Rajo and M Gonzalez, for secretarial help.

Acknowledgments

Abbreviations

  • AF, attributable fraction

  • ASCUS, atypical squamous cells of undetermined significance

  • CI, confidence interval

  • CIN, cervical intraepithelial neoplasia

  • EBV, Epstein-Barr virus

  • GP, general primer

  • HCV, hepatitis C virus

  • HIV, human immunodeficiency virus

  • HPV, human papillomavirus

  • HSIL, high grade squamous intraepithelial lesion

  • HSV-2

  • type 2 herpes simplex virus

  • IARC, International Agency for Research on Cancer

  • IBSCC, international biological study on cervical cancer

  • OC, oral contraceptive

  • OR, odds ratio

  • ORF, open reading frame

  • Pap, Papanicolaou

  • PF, protective fraction

  • PCR, polymerase chain reaction

  • RB, retinoblastoma

  • RR, relative risk

  • STD, sexually transmitted disease

  • Th1, T helper cell type 1

Abbreviations

Footnotes

This paper is dedicated to the memory of the late Jan M M Walboomers.

Footnotes

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