by Jennifer Loukissas, M.P.P., and Saloni Nayar, M.P.H.
In October, NCI's Office of Media Relations hosted a Science Writers' Seminar on human papillomavirus (HPV) and cervical cancer. NCI's leading experts on HPV-related cancers addressed journalists from across the nation about the natural history of HPV and new HPV-based technologies for prevention and screening of cervical cancer.
Douglas Lowy, M.D., NCI Deputy Director, provided an overview of the history of cervical cancer screening. He discussed the impact of identifying the role of HPV in cervical cancer etiology: "HPV has been linked as the major causative agent for virtually all cases of cervical cancer. We understand how this cancer comes about, perhaps more than any other tumor," he said.
Continuing the discussion, Mark Schiffman, M.D., M.P.H., a senior investigator in the Clinical Genetics Branch, presented the natural history of HPV. He clarified the relation of HPV infection to carcinogenesis and the mechanism involved. "Getting infected with HPV is extremely common, so common that it doesn't mean much. Persistence of that virus, not clearing it over the course of a couple of months—that is uncommon and is associated with subsequent cancer risk," he said.
Dr. Schiffman stressed the importance of monitoring the progression of HPV from initial infection to clearance or persistence and the development of precancerous lesions. "Infection has to persist in order to develop precancerous lesions, which then progress to invasive cancer," he explained. He also emphasized the importance of adapting cervical cancer prevention efforts in concordance with the age patterns and natural history of HPV.
Diane Solomon, M.D., Acting Chief of the Breast and Gynecologic Cancer Research Group, NCI Division of Cancer Prevention, described screening methods for cervical cancer. She outlined the techniques for evaluating cervical cytology with Papanicolaou (Pap) testing and discussed their drawbacks in triaging cytologic abnormalities. She described the strengths and limitations of HPV-based testing, including its reliability and capacity for risk discrimination of HPV infections, and closed her remarks with strategies for cervical cancer screening in the future.
Shifting the theme to prevention, Allan Hildesheim, Ph.D., Chief of the Infections and Immunoepidemiology Branch, addressed the role of HPV vaccines. He reviewed the development and licensure of the vaccines and current guidelines for their use. He then discussed post-vaccination immunity, including efficacy of the vaccine, duration of protection, and cross-protection against other HPV genotypes.
"These vaccines are very effective. The data show very high levels of antibodies following vaccination, much higher than we see after a natural infection," he said. Dr. Hildesheim also touched on use of the vaccines in populations not currently targeted for vaccination, such as males and older women, and issues related to efficacy and cost-effectiveness for vaccinating these people.
In further discussion, John Schiller, Ph.D., Head of the Neoplastic Disease Section, NCI Center for Cancer Research, presented data on topical microbicides that prevent infection with HPV and their potential for preventing HPV transmission. He discussed his research on chemical compounds that may act as potential HPV inhibitors, including carrageenan, an algae-based compound used in several household products.
The seminar ended with an opportunity for journalists to ask questions. Many of them commented that the seminar provided valuable background information that would assist in their reporting about HPV-related cervical cancer.
Archived recordings of the presentations are available at http://go.usa.gov/1wl.