Cervical Cancer: Molecular

Impact of an Infectious Disease

HPV16E6andE7
genesinteractwith
cellcycle
machinery

Background
Worldwide, cervical cancer is the 2nd leading
cause of cancer death in women
Most cervical cancer is either squamous cell
(85%) or adenocarcinoma (12%)
Risk factors for squamous cell cancer

Early coitarche
Greater than 6-8 partners
Cigarette smoking
Oral contraceptives

 During the sexual lifespan of a woman,

approximately 70% will have been exposed
to HPV
The vast majority of HPV infections will
regress
Primary prevention is not utilized
Stigma
High prevalence
Easy transmission

 Cervical cancer is most strongly associated

with sexually transmitted HPV infection
HPV is endemic among sexually active
humans
HPV subtypes are classified into high and
low risk groups

ProgressiveinfectionofWashingtonStateUniversityfemaleswith
HumanPapillomaVirusovertime

ProgressiveinfectionovertimewithHPVincollegeagepopulation
measuredfromtimeoffirstintercourse

HPVsubtypesingenitalinfectioninfemaleWSUcohort

 Current management of cervical cancer is

based on detection of disease-secondary
prevention
Papanicolaou technique for detection is
flawed

Acquisition error
Preparation error
Interpretation error
Patient error
Reporting error

 Common reasons for presentation

Abnormal vaginal bleeding, esp following
intercourse (57%)
Abnormal pap smear (28%)
Low abdominal pain (9%)
Vaginal discharge (4%)

Normaltransitioningtodysplasticepitheliumincervix,
Withaccompanyinginflammationduetopoorbarrierfunction

Squamousdysplasia

Future
Topicals
Retinoids
Difluormethylornithine

Development of prophylactic and

therapeutic vaccines
VLP (L1/L2)
E6/E7