Human papillomavirus and cervical cancer

Mark Schiffman, Philip E. Castle, Jose Jeronimo, Ana C. Rodriguez, Sholom Wacholder

Research output: Contribution to journalReview article

1519 Citations (Scopus)

Abstract

Cervical cancer is the second most common cancer in women worldwide, and knowledge regarding its cause and pathogenesis is expanding rapidly. Persistent infection with one of about 15 genotypes of carcinogenic human papillomavirus (HPV) causes almost all cases. There are four major steps in cervical cancer development: infection of metaplastic epithelium at the cervical transformation zone, viral persistence, progression of persistently infected epithelium to cervical precancer, and invasion through the basement membrane of the epithelium. Infection is extremely common in young women in their first decade of sexual activity. Persistent infections and precancer are established, typically within 5-10 years, from less than 10% of new infections. Invasive cancer arises over many years, even decades, in a minority of women with precancer, with a peak or plateau in risk at about 35-55 years of age. Each genotype of HPV acts as an independent infection, with differing carcinogenic risks linked to evolutionary species. Our understanding has led to improved prevention and clinical management strategies, including improved screening tests and vaccines. The new HPV-oriented model of cervical carcinogenesis should gradually replace older morphological models based only on cytology and histology. If applied wisely, HPV-related technology can minimise the incidence of cervical cancer, and the morbidity and mortality it causes, even in low-resource settings.

Original languageEnglish (US)
Pages (from-to)890-907
Number of pages18
JournalLancet
Volume370
Issue number9590
DOIs
StatePublished - Sep 8 2007
Externally publishedYes

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Uterine Cervical Neoplasms
Infection
Epithelium
Genotype
Basement Membrane
Sexual Behavior
Cell Biology
Neoplasms
Histology
Carcinogenesis
Vaccines
Technology
Morbidity
Mortality
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Schiffman, M., Castle, P. E., Jeronimo, J., Rodriguez, A. C., & Wacholder, S. (2007). Human papillomavirus and cervical cancer. Lancet, 370(9590), 890-907. https://doi.org/10.1016/S0140-6736(07)61416-0

Human papillomavirus and cervical cancer. / Schiffman, Mark; Castle, Philip E.; Jeronimo, Jose; Rodriguez, Ana C.; Wacholder, Sholom.

In: Lancet, Vol. 370, No. 9590, 08.09.2007, p. 890-907.

Research output: Contribution to journalReview article

Schiffman, M, Castle, PE, Jeronimo, J, Rodriguez, AC & Wacholder, S 2007, 'Human papillomavirus and cervical cancer', Lancet, vol. 370, no. 9590, pp. 890-907. https://doi.org/10.1016/S0140-6736(07)61416-0
Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007 Sep 8;370(9590):890-907. https://doi.org/10.1016/S0140-6736(07)61416-0
Schiffman, Mark ; Castle, Philip E. ; Jeronimo, Jose ; Rodriguez, Ana C. ; Wacholder, Sholom. / Human papillomavirus and cervical cancer. In: Lancet. 2007 ; Vol. 370, No. 9590. pp. 890-907.
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