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Human Papillomaviruses
IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 90
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans.
This ninetieth volume of the IARC Monographs on the Evaluation of Carcinogenic Risks to Humans considers human papillomaviruses (HPVs), which were evaluated by a previous Working Group (IARC, 1995). The monograph in the present volume incorporates new data that have become available during the past decade.
HPVs represent the most common infectious agents that are transmitted sexually throughout the world; the major risk factors are behaviours associated with sexual activity. Although most infections are asymptomatic and are cleared within a period of 2 years, genital HPV infection can lead to clinical disease, including anogenital warts, cervical neoplasia, cervical cancer and other anogenital cancers. The risk for persistence of infection and progression of the more than 40 genital HPV types to grade 3 cervical intraepithelial neoplasia (CIN3) and cancer differs widely. Persistent infection with carcinogenic HPVs occurs in virtually all cases of cervical cancer.
Previous evaluations of HPVs have classified types 16 and 18 as carcinogenic to humans (group 1), types 31 and 33 as probably carcinogenic to humans (Group 2A) and some types other than 16, 18, 31 and 33 as possibly carcinogenic to humans (Group 2B). At that time, the evaluation of types 16 and 18 was based on the strong association between infection with these HPVs and cervical cancer. For types 31 and 33, the association was less strong.
The new epidemiological data reviewed in the present volume strongly support and further confirm the previous evaluation of types 16 and 18, and provide new evidence for other HPVs. This information, which includes strong evidence of carcinogenicity at sites other than the cervix, supports new evaluations for several other HPV types in addition to those mentioned above. Since the Working Group was convened in 2005, important innovations in HPV prophylaxis have occurred and these needed to be included in this volume. To date two prophylactic vaccines have been developed and used in large multicentric trials. This prophylactic vaccination is expected to reduce the incidence of HPV-related genital diseases. However, the benefits of prophylactic vaccines in a broad public health perspective will be achieved only if such vaccines can be provided to those groups of women for whom access to cervical cancer screening services is most problematic. Therefore, the development of second-generation vaccines that are expected to be cheaper, easier to deliver and/or to provide T-cell response against pre-existing HPV infections is highly desirable.
Contents
- NOTE TO THE READER
- LIST OF PARTICIPANTS
- PREAMBLE
- GENERAL REMARKS
- MONOGRAPH ON HUMAN PAPILLOMAVIRUSES
- Human Papillomaviruses
- 1. Human Papillomavirus (HPV) Infection
- 1.1. Evolution, structure and molecular biology
- 1.2. Serological response
- 1.3. Methods for the detection of HPV infection
- 1.4. Natural history and epidemiology of HPV infection
- 1.5. Pathology of HPV infection of the genital tract and evidence therefrom for progression to malignancy
- 1.6. Non-malignant clinical lesions (other than precursors of cancer) of established HPV etiology
- 1.7. Therapy and vaccination
- 1.8. Prophylaxis
- 2. Studies of Cancer in Humans
- 3. Studies of Animal Papillomaviruses
- 3.1. Non-human primate papillomaviruses (Table 75)
- 3.2. Bovine papillomavirus (BPV)
- 3.3. Equine papillomavirus (EqPV)
- 3.4. Papillomavirus in cervidae
- 3.5. Cottontail rabbit papillomavirus (CRPV)
- 3.6. Domestic rabbit oral papillomavirus (ROPV)
- 3.7. Ovine papillomatosis (OVP) (Table 79)
- 3.8. Mastomys natalensis papillomavirus (MnPV)
- 3.9. Mouse papillomavirus (MmPV)
- 3.10. Canine oral papillomavirus (COPV)
- 3.11. Feline papillomas
- 3.12. Avian papillomavirus
- 4. Molecular Mechanisms of HPV-induced Carcinogenesis
- 5. Summary of Data Reported and Evaluation
- 6. References
- 1. Human Papillomavirus (HPV) Infection
- Human Papillomaviruses
- LIST OF ABBREVIATIONS
Corrigenda to the IARC Monographs are published online at: http://monographs.iarc.fr/ENG/Publications/corrigenda.php
LIBRARY CATALOGUING DATA
This publication represents the views and expert opinions of an IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, which met in Lyon, 15–22 February 2005
Lyon, France - 2007
IARC MONOGRAPHS
In 1969, the International Agency for Research on Cancer (IARC) initiated a programme on the evaluation of the carcinogenic risk of chemicals to humans involving the production of critically evaluated monographs on individual chemicals. The programme was subsequently expanded to include evaluations of carcinogenic risks associated with exposures to complex mixtures, life-style factors and biological and physical agents, as well as those in specific occupations.
The objective of the programme is to elaborate and publish in the form of monographs critical reviews of data on carcinogenicity for agents to which humans are known to be exposed and on specific exposure situations; to evaluate these data in terms of human risk with the help of international working groups of experts in chemical carcinogenesis and related fields; and to indicate where additional research efforts are needed.
The lists of IARC evaluations are regularly updated and are available on the Internet at http://monographs.iarc.fr/.
This programme has been supported by Cooperative Agreement 5 UO1 CA33193 awarded since 1982 by the United States National Cancer Institute, Department of Health and Human Services. Additional support has been provided since 1986 by the European Commission, Directorate-General EMPL (Employment, and Social Affairs), Health, Safety and Hygiene at Work Unit, and since 1992 by the United States National Institute of Environmental Health Sciences.
- Published by the International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
- ©International Agency for Research on Cancer, 2007
- Distributed by WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob).
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IARC Library Cataloguing in Publication Data
Human Papillomaviruses/IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2005 : Lyon, France)
- (IARC monographs on the evaluation of carcinogenic risks to humans ; v. 90)
- 1. Genital Neoplasms, Female – virology 2. Papillomavirus Infections – complications 3. Tumour Virus Infections – virology 4. Uterine Cervical Neoplasms – virology
- I. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans II. Series
- ISBN 978-92-832-1290-4 (NLM Classification: W1)
- ISSN 1017-1606
- PRINTED IN FRANCE
Cover Legend:
The cover shows the first page of a publication by Ciuffo (1907) who demonstrated — by autoinoculation — that a cell-free extract of common warts contains an infectious agent, later to be identified as human papillomavirus (see text below).
Superimposed on this text is a molecular structural model of the HPV 6 major capsid protein L1, with surface-exposed loops that contain highly antigenic epitopes (Oroczo et al., 2005; reproduced with permission; see also Section 1.2.1). Virus-like particles containing these epitopes have now been successfully used to develop prophylactic vaccines against several high-risk HPVs.
[cover design: Georges Mollon]
Innesto positivo con filtrato di verruca volgare
Dr Giuseppe Ciuffo
Con una serie di esperienze delle quali ho dato una notizia preventiva nel recente Congresso di Patologia (1) e che a suo tempo pubblichero in extenso, mi sto occupando di charire il problema della etiologia, patogenesi, contagiosita di quelle forme cutanee o delle mucose papillomatose, come la verruca volgare, il condiloma acuminato, che sono certamente infettive. Mio scopo principale e quello di poter trovare quale esso sia e quali caratteri abbia il germe specifico microscopico o il virus invisibile di queste forme, il meccanismo di trasmissibilita da uomo ad uomo o all’animale, di vedere infine se da un esame comparativo clinico, anatomico e batteriologico possa risultare una identita fra queste diverse forme su ricordate.
Per ora mi limitero a riportare una esperienza felicemente riuscita sulla verruca volgare ed importante, a mio modo di vedere, sia perche ci illumina sulla etiologia di questa forma clinica speciale, sia perche servi e serve di base e guida per le ulteriori mie ricerche sulla etiologia delle forme cliniche consimili.
(1) Atti del IV Congresso Italiano di Patologia, Paris, Ottobre 1906
Positive graft with a filtrate of common warts
Dr Giuseppe Ciuffo
With a series of experiments, the results of which I presented at the recent Pathology Congress (1) and shall publish shortly in extenso, I sought to clarify the problem of the etiology, pathogenicity and contagiousness of cutaneous or mucosal papillomatous forms, such as the common wart and condyloma acuminatum, which are assuredly infectious. My principal aim is to be able to find which is the specific microscopic germ or invisible virus that is responsible for these lesions and what are its characteristics, its mode of transmission from man to man or to animals and finally to determine whether a comparative clinical, anatomical and bacteriological examination could result in the identification of the responsible agent.
In this article, I am restricting myself to presenting an experiment on the common wart that was felicitously successful and important, the way I see it, not only because it sheds light on the etiology of the clinical form, but also because it has served and will serve as a basis and guide for my future investigations regarding the etiology of other clinically similar forms.
(1) Proceedings of the Fourth Italian Congress of Pathology, Paris, October 1906
- NLM CatalogRelated NLM Catalog Entries
- Human PapillomavirusesHuman Papillomaviruses
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