engleski

HPV is the Cause of Cervical Cancer

Persistent infection with certain types of the Human papillomavirus (HPV) is the necessary cause for cervical cancer (1). HPV DNA is identified in almost all (99.7%) cases of cervical cancer worlwide. More than 100 HPV genotypes have been characterized with approximately 40 types that infect the human anogenital area. Some HPV types can cause genital warts while others can cause cervical intraepithelial neoplasia (CIN) and cervical cancer. At least 15 HPV types are strongly associated to the development of cervical cancer and are considered carcinogenic or high-risk (HR) HPV types. Thus, HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82 have been classified as HR, HPV 26, 53 and 66 as probably HR, while HPV 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81 and CP6108 as low-risk (LR)(2). In contrast to HR HPV types, LR types are associated with benign genital warts and are only very rarely found in cervical carcinomas. In a worldwide survey, HPV 16 was found to be the most prevalent type in cervical cancer (51.0%), followed by HPV 18 (16.2%) and other types such as HPV 45, 31, 33, 58 and 52 (collectively accounting for 18.3% cases)(3). Over the last two decades, a number of different HPV tests have been developed based on highly specific DNA or RNA analysis. These tests were first used as research tools, with some now adapted for use in clinical setting. Results of studies on the use of HPV testing for primary screening are very encouraging and highlight the usefulness of HPV testing for the early detection of clinically relevant CIN. A second major consequence arising from HPV research is the development of HPV virus-like particles (VLPs). These VLPs are the foundation of the new prophylactic vaccines designed to generate neutralizing antibodies that can effectively prevent HPV infection in humans. Clinical trials on these vaccines are very encouraging and the vaccines stand to revolutionise cervical cancer prevention in the future (4). References: 1. Walboomers J.M.M., Jacobs M.V., Manos M.M., Bosch F.X., Kummer J.A., Shan K.V., Snijders P.J.F., Peto J., Meijer C.J.L.M., Munoz N.: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J. Pathol., 189 (1999) 12. – 2. Munoz N., Bosch F.X., , De Sanjose S., Herrero R., Castellsague X., Shan K.V., Snijders P.J.F., Meijer C.: IARC Multicenter Cervical Cancer Study Group. Epidemiologic classification of Human papillomavirus types associated with cervical cancer. N. Engl. J. Med. 384 (2003) 518. – 3. Clifford G.M., SMITH J.S., Plummer M., Mun, OZ N., Franceschi S.: Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br. J. Cancer 88 (2003) 63. 4. – Lowy D.R., Schiller J.T.: Prophylactic Human papillomavirus vaccines. J. Clin. Invest. 116 (2006)1167.

Human papillomaviruses (HPV); cervical cancer

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