Cervix Carcinoma and HPV

摘要

Cervical cancer is one of the leading causes of cancer mortality in women in the world. For the year 2002, 493,000 new cases and 274,000 deaths have been reported worldwide. 83% Of all cases of cervical cancer occur in developing countries, where it accounts for 15% of all female cancers. A persistent infection with a high-risk human papillomavirus (hrHPV) has been identified as the key causative agent of cervical cancer. At this moment, thirteen high-risk HPV types have been identified by the World Health Organisation (WHO). Worldwide HPV 16 accounts for more than 60% of all cervical cancers, with HPV 18 adding approximately another 10%. HPV is a sexually transmitted virus. Primary infection occurs mostly in young adults, shortly after they become sexually active. The prevalence is so high that the chance of acquiring a HPV infection during lifetime is estimated up to 85%. But, only if a hrHPV infection is persistent, progression of a pre-malignant lesion occurs. Approximately 80% of all hrHPV infections however are transient and asymptomatic. Therefore, a cervical carcinoma can be seen as a rare complication of a frequent infection. Clearance of hrHPV precedes regression of pre-malignant lesions. After a period of 3 years, 50% of all mild and moderate dysplasia will regress, while the regression rate of high-grade lesions in women with hrHPV is much lower. Since hrHPV infection has been established as the primary cause of cervical cancer the development of prophylactic vaccines has been subject to research.