© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 17, 1350,
September 5, 2001
© 2001 Oxford University Press
CORRESPONDENCE |
RESPONSE: Re: Cervical Carcinoma and Human Papillomavirus: On the Road to Preventing a Major Human Cancer
Correspondence to: Harald zur Hausen, M.D., Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany (e-mail: zurhausen{at}dkfz-heidelberg.de).
I appreciate the comments of Dr. Bosch and his colleagues. The final remarks of the cited editorial included the following sentences: "...it wasstated in a publication of the International Agency for Research on Cancer in 1989 that 'the available data, although suggestive, do not allow further inferences on causality' [(1)].... In the personal experience of this author, up to this period it has not been possible to convince the pharmaceutical industry to consider the initiation of vaccination programs against high-risk HPV infections and, in all likelihood, several years have been lost. If we calculate an annual incidence rate of 400 000 cases per year globally [(2)], this delay may turn out to be costly."
I certainly agree with Bosch et al. that, in the end, "HPV research has benefited from a remarkable collaboration between epidemiologists and basic scientists." Concerning early industrial involvement, however, one should not underestimate the role of statements from co-workers of internationally well-known epidemiology centers [see (1)], particularly if underlined by numerous presentations at international meetings and presented in an official scientific publication of the respective center.
The virus-like particle technology was not (and even today is not) the sole option for HPV vaccines in the late 1980s. In addition, it has been stated much earlier than in the late 1990s that HPV represents a "necessary, non-sufficient cause" of a human cancer (3,4). Besides these small inconsistencies in the correspondence of Bosch et al., however, it has not been my intention to blame specific scientists for a potentially costly delay in HPV vaccine development. We all should be pleased that, at least in the foreseeable future, HPV vaccines are clearly on their way to a broad application in groups at risk for cervical cancer. In my opinion, the only lesson we can take from this history is to argue for an early commitment of scientists to prevention and control of common human diseases (in this case, a deadly cancer), if there exists a reasonable basis for the involvement of a specific agent. For cancer of the cervix, substantial evidence was available by the end of 1987, as summarized in the editorial.
REFERENCES
1 Bosch FX, Munoz N. Human papillomavirus and cervical neoplasia: a critical review of the epidemiological evidence. IARC Sci Publ1989;94:135-51.
2 Parkin DM, Pisani P, Ferlay J. Estimates of worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999;80:827-41.[CrossRef][Web of Science][Medline]cancerlit;99173209
3
zur Hausen H. Papillomaviruses in anogenital cancer as a model to understand the role of viruses in human cancers. Cancer Res 1989;49:4677-81.
4 zur Hausen H. Are human papillomavirus infections not necessary or sufficient causal factors for invasive cancer of the cervix? [letter].Int J Cancer 1995;63:315-6.[Web of Science][Medline]cancerlit;96043746
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