3IN - From hypothesis to prevention in 40 years

Date 29 September 2012
Event ESMO Congress 2012
Session HPV biology and implications in gynecological malignancies
Topics Cancer Aetiology, Epidemiology, Prevention
Gynaecologic Malignancies
Presenter Susanne Kjaer
Authors S.K. Kjaer
  • Department Of Viruses, Hormones And Cancer, Danish Cancer Society Research Center, 2100 - Copenhagen/DK

Abstract

Indications of a relationship between cervical cancer and sexual activity have been available for over a century. Early studies described sexual variables mainly in terms of marital status, age at first marriage and reproductive life, whereas more recent epidemiological studies have assessed the role of sexual habits and specifically identified the number of sexual partners and age at first intercourse as the most important risk factors. The finding of an independent effect of the number of sexual partners, and the increased risk for women whose husbands reported multiple sexual partners strongly pointed to the importance of a sexually transmitted infectious agent, although other factors such as smoking, parity and oral contraceptive use were also suggested to be important. For more than two decades, attention focused on herpes simplex virus type 2 as an etiological agent. However, subsequently it was suggested by Professor zur Hausen that certain types of human papillomavirus (HPV) might play a key etiological role. Although there at that time was laboratory evidence supporting this hypothesis, it was initially difficult to test it epidemiologically. With the technological development and the collaboration between epidemiologists, virologists and clinicians it became increasingly clear that HPV is a necessary factor in the development of cervical cancer and also is causing a proportion of other anogenital cancers in both women and men such as cancer of the vagina, vulva, penis and anus. In addition, it is associated with certain types of head and neck cancer. Based on the research within this area, vaccines against certain types of HPV have now been developed and we have moved from hypothesis to prevention in some 40 years.

Disclosure

S.K. Kjaer: Received lecture fees, advisory board fees, and research grants through her institution from Merck and Sanofi Pasteur MSD.