Viruses and carcinogenesis in the female lower genital tract

Abstract

The importance of papillomaviruses in lower genital tract neoplasia Cervical cancer is the second commonest cancer worldwide with over 500000 new cases each year, and is the most important neoplasm among both sexes in the developing world. It is now widely accepted that human papillomaviruses (HPV) are the major causal factor in most, if not all cervical cancers,’ and precancerous and other lesions of the cervix and lower genital tract.2 This makes cervical cancer the commonest virally caused cancer. The evidence for the role of HPV in cervical carcinogenesis is a synthesis of molecular biology with clinical and epidemiological study of a virus which has been resistant to attempts to grow it in conventional tissue culture systems or animal models. Its detection has been almost entirely dependent on molecular biological methods. Outside the cervix papillomaviruses appear to be of more limited importance. There is a close relationship between vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN). A part, at least, of vulva1 intraepithelial neoplasia (VIN), perianal intraepithelial neoplasia (PAIN) and the respective invasive cancers are related to papillomavirus.3s4