The viral etiology of cervical cancer. 2002

F Xavier Bosch, and Nubia Muñoz
Institut Català d'Oncologia, Servei d'Epidemiologia i Registre del Càncer, Hospital Duran i Reynals, Gran Via km 2,7, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. x.bosch@ico.scs.es

Epidemiological studies supported by molecular technology have provided sufficient evidence on the causal role of some Human Papillomavirus (HPV) infections in the development of cervical cancer. This association has been evaluated under all proposed sets of causality criteria and endorsed by the scientific community and major review institutes. HPV has been proposed as the first-ever identified, necessary cause of a human cancer. In practical terms, the concept of a necessary cause implies that cervical cancer does not and will not develop in the absence of the persistent presence of HPV-deoxyribonucleic acid (DNA). This important advancement has two practical implications in prevention. Firstly, screening programs can be enhanced if HPV testing is judiciously incorporated into solving the fraction of ambiguous cytology readings. In some populations HPV screening as a primary test may prove to be the strategy of choice. Secondly, like in the hepatitis B disease model, intense efforts are currently being put into the development and testing of vaccines that may prevent the relevant HPV infections, and presumably, cervical cancer. At this stage of development, regulatory agencies are requested to evaluate the scientific evidence and weigh its implications in relation to costs, public health investments and policy. This is a subjective evaluation that could be guided by a careful description of the most relevant studies and findings.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002583 Uterine Cervical Neoplasms Tumors or cancer of the UTERINE CERVIX. Cancer of Cervix,Cancer of the Cervix,Cancer of the Uterine Cervix,Cervical Cancer,Cervical Neoplasms,Cervix Cancer,Cervix Neoplasms,Neoplasms, Cervical,Neoplasms, Cervix,Uterine Cervical Cancer,Cancer, Cervical,Cancer, Cervix,Cancer, Uterine Cervical,Cervical Cancer, Uterine,Cervical Cancers,Cervical Neoplasm,Cervical Neoplasm, Uterine,Cervix Neoplasm,Neoplasm, Cervix,Neoplasm, Uterine Cervical,Uterine Cervical Cancers,Uterine Cervical Neoplasm
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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