HPV Vaccine and Pap Test Both Essential in the Fight Against Cervical Cancer

In those 30 years, much progress has been made in the diagnosis, treatment and now prevention of cervical cancer. In a special issue of Disease Markers, published this month, twelve articles explore the epidemiology of HPV, testing strategies for HPV infections, new HPV detection methods, and other potential biomarkers that might prove useful in cervical cancer diagnosis.

Guest Editors of this special issue, Magnus von Knebel Doeberitz, and Nicolas Wentzensen, both of the University of Heidelberg, have gathered a series of insightful articles that present both historical background and recent research into HPV and cervical cancer. They stress that, “Despite all this success a word of caution: we have not yet reached all the goals. Cervical cancer still is an important public health issue and the prevention approach will only work if at least most women in the world will have access to these vaccines. To achieve this, we will certainly need a lot of efforts and resources. The worst thing to do now would be to neglect the very successful screening programs for cervical cancer that made cervical cancer the prime paradigm for successful cancer prevention strategies.”

Jenkins summarizes the various histo- and cyto-pathological features associated with acute and persistent HPV-infections and provides the reader with the essential knowledge to understand how HPV gene products alter shape and function of normal epithelial cells.

Bosch and de Sanjose present a current and extensive survey of HPV and cervical cancer epidemiology. Moscicki gives an overview of HPV infections, screening, triage, and treatment in adolescents that is highly relevant for vaccination programs, since adolescents represent the primary target population and HPV infection in ever younger girls emerges as a new arising problem. Shah and Westra provide an up-to-date review of HPV associated disease in the aerodigestive tract, including the benign recurrent respiratory papillomatosis as well as head and neck cancers. Nindl and colleagues have summarized biological and clinical data on the role of human papilloma viruses in non-melanoma skin cancer. Palefsky contributes a comprehensive overview of HPV infections in men with respect to disease patterns observed in men, transmission of the virus to women and the related issues concerning the possible vaccination of women and men. Moving towards new approaches in screening, Meijer and colleagues present an extensive survey of different HPV detection methods including genotyping and mRNA detection together with different possible scenarios of their application. Pagliusi contributes an important article on the international standardization of HPV testing.

Further articles address the emerging research on new biomarkers for cervical cancer screening that appear to help to overcome several of the important limitations of the current cancer early detection strategies. Doorbar extensively reviews molecular processes in transition from viral infection to the development of high grade disease and cervical cancer. A special focus is put on the changes of the viral life cycle with effects on cellular genes and proteins. Wentzensen and von Knebel Doeberitz summarize the current state of the most promising biomarkers that have been identified so far for revised cervical cancer screening, triage programs and potential clinical applications. The last two articles deal with the important topic of prophylactic and therapeutic vaccines. Müller and Gissmann contribute an exciting historical essay of the discovery of HPV and the development of therapeutic and prophylactic vaccines. Kast and colleagues present an excellent and very timely survey on therapeutic vaccines against HPV and associated disease with a detailed description of the lessons learned from the limitations of previous vaccination trials and of novel promising approaches.

These articles appear in a special, single-topic issue of Disease Markers, Volume 23:4 (July 2007), published by IOS Press.

Disease Markers, Volume 23:4
HUMAN PAPILLOMAVIRUSES AND CERVICAL CANCER
Guest editors: Magnus von Knebel Doeberitz and Nicolas Wentzensen
Table of Contents
Foreword
M. von Knebel Doeberitz and N. Wentzensen
Histopathology and cytopathology of cervical cancer
D. Jenkins
The epidemiology of human papillomavirus infection and cervical cancer
F.X. Bosch and Silvia de Sanjosé
HPV infections in adolescents
A.-B. Moscicki
Genital HPVs in the aerodigestive tract: Etiologic association with a subset of oropharyngeal/tonsillar cancers and with recurrent respiratory papillomatosis

K.V. Shah and W.H. Westra

Human papillomaviruses and non-melanoma skin cancer: Basic virology and clinical manifestations

I. Nindl, M. Gottschling and E. Stockfleth

HPV infection in men
J.M. Palefsky
HPV detection methods
A.A.T.P. Brink, P.J.F. Snijders and C.J.L.M. Meijer
International standard reagents for HPV detection
S.R. Pagliusi and S.M. Garland
Papillomavirus life cycle organization and biomarker selection
J. Doorbar
Biomarkers in cervical cancer screening
N. Wentzensen and M. von Knebel Doeberitz
A long way: History of the prophylactic papillomavirus vaccine
M. Müller and L. Gissmann
Therapeutic vaccination for HPV induced cervical cancers
J.A. Brinkman, S.H. Hughes, P. Stone, A.S. Caffrey, L.I. Muderspach, L.D. Roman, J.S. Weber and W.M. Kast

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