© 2003 by Oxford University Press
Journal of the National Cancer Institute, Vol. 95, No. 6, E2,
March 19, 2003
© 2003 Oxford University Press
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Epidemiologic Studies of a Necessary Causal Risk Factor: Human Papillomavirus Infection and Cervical Neoplasia
Affiliation of authors: M. H. Schiffman, P. Castle, Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Bethesda, MD.
Correspondence to: Mark H. Schiffman, M.D., M.P.H., National Institutes of Health, Executive Plaza South, Rm. 7066, 6120 Executive Blvd., Rockville, MD 20892 (e-mail: schiffmm@epndce.nci.nih.gov).
| The first 150 words of the full text of this article appear below. |
In the 1990s, interdisciplinary research teams showed that human papillomavirus (HPV) infection causes virtually all cases of cervical cancer and its preinvasive cytopathologic precursors. Two such studies from the Journal are discussed here. Bosch et al. (1) demonstrated that virtually all cases of invasive cervical cancer worldwide contain DNA of the same 13 oncogenic HPV types. Schiffman et al. (2) showed that oncogenic HPV infection is so tightly linked to the diagnosis of preinvasive cytopathologic precursors that statistical adjustment for HPV infection explains previously established sexual risk factors for cervical neoplasia. It was important to confirm that HPV is the necessary cause of cervical cancer, which annually kills 200,000 women worldwide. No similarly important cancers have such clearly known necessary causes. Few other carcinogens are as powerful as these small, deceptively simple viruses. Many years later, prevention researchers are already introducing clinically useful HPV DNA tests
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