Human Papillomavirus

Human Papillomavirus: Proving and Using a Viral Cause for Cancer presents a steady and massive accumulation of evidence about the role of HPV and prevention of HPV-induced cancer, along with the role and personal commitment of many scientists of different backgrounds in establishing global relevance. This exercise involved years of personal commitment to proving or disproving an idea that aroused initial skepticism, and that still has difficult implications for some. It remains one of the big successes of medicine that exploited both established medical science dating back to the nineteenth century and new molecular genetic science during a time of transition in medicine.

• Presents a comprehensive, up-to-date review of the role of HPV in cancer from those involved in its study
• Includes the way evidence on the role and utility of HPV based prevention has been accumulated over almost 40 years
• Gives a series of vignettes of individual scientists involved in the development of the science of HPV and cancer at different stages and their experiences and reasons for involvement

Clinical and scientific virology and cancer research; public health, diagnostic and pharmaceutical industries; modern medical history and sociology. Graduate level scientists in virology, molecular biology, pathology, screening, vaccines and epidemiology and public health

Section 1: Early questions and their slow answers
1. Introduction: Implications and responses to a possible specific infectious cause for a solid cancer, approaches to proving the role of HPV, and exploring its potential uses against conventional medical practice
2. Cervical and other cancers now associated with HPV prior to recognition of HPV in cervical cancer
3. Cervical screening and its basis in ideas of precancer in classical microscopic pathology
4. The "discovery" of HPV I6 in cervical cancer and studies of its transforming role, P53 and pRB
5. Growing numbers of carcinogenic papillomaviruses and understanding of their differences
6. The impact of HPV on conventional morphological pathology of cancer and precancer. Bethesda classification, molecular markers relating morphology to molecular mechanisms
7. The proof of causality in humans
8. Progression from infection to cancer
9. Sexuality and HPV: sexual transmission, male role
10. Genital warts
11. HPV and non-cervical cancer
12. Immune responses, and antibodies to HPV, making viral antigens
13. Developing and standardising HPV tests
14. HPV and non-HPV pathways to cancer

Section 2: Prevention of cancer and HPV infection
15. Introduction: Evidence-based medicine, HPV and cancer prevention
16. Triage of women with low-grade smear abnormalities and HPV testing, HC1 and 2, GP5+/6+, ALTS trial, Netherlands, other trials
17. Primary screening by HPV testing
18. Prophylactic vaccines, proving their value and the role and limitations of the pharmaceutical industry and its regulators, safety and efficacy
19. Modelling disease, prevention and cost-effectiveness – a developing process, different types of models, what does cost-effectiveness mean?
20. Changing global concerns about screening and vaccination