© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 6, 506-511,
March 17, 1999
© 1999 Oxford University Press
COMMENTARY |
Epidemiologic Evidence and Human Papillomavirus Infection as a Necessary Cause of Cervical Cancer
Affiliations of authors: E. L. Franco, Departments of Oncology and Epidemiology, McGill University, Montreal, Canada; T. E. Rohan, Department of Population Health Sciences, University of Toronto, and Department of Oncology, McGill University, Montreal; L. L. Villa, Ludwig Institute for Cancer Research, São Paulo, Brazil.
Correspondence to: Eduardo L. Franco, Ph.D., Department of Oncology, McGill University, 546 Pine Ave. West, Montreal, PQ, Canada H2W 1S6 (e-mail: eduardof@oncology.lan.mcgill.ca).
As with other malignant neoplasms, epidemiologic and laboratory
studies conducted during the past 20 years have shown cervical cancer
to be a disease with multifactorial causes and long latency. Unlike
most other cancers, however, in which multiple environmental, biologic,
and lifestyle determinants contribute independently or jointly to
carcinogenesis, cervical cancer has been shown to have a central
causal agent, human papillomavirus (HPV) infection (1-3),
whose contribution to the risk of the disease is much greater than
that of any other recognized determinant (4). On the basis of
recent evidence from an international collaborative study
(5) of more than 1000 cervical cancer specimens that used a
highly sensitive polymerase chain reaction (PCR) protocol, researchers
found that the prevalence of HPV DNA in cervical tumors was 93%.
This is a higher estimate than had been observed previously in
studies that used less meticulous methods
MATERIALS AND METHODS
Effect of Misclassification
Causality Assumptions
Modeling
RESULTS
DISCUSSION
NOTES
REFERENCES
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