Human papillomavirus (HPV) and cervical cancer.

Epidemiologic studies have consistently shown that the most important risk factor for cervical cancer relates to sexual activity and a sexually transmitted agent, probably a virus, is the principal causative agent. In recent years, much attention has been focused on the human papillomavirus (HPV) as the causative agent. The compelling epidemiologic evidence of the role of HPV in cervical cancer is complemented by equally strong data on the role of oncoproteins E6 and E7 of high-risk HPV strains in the molecular pathogenesis of cervical cancer. Incidence and mortality from cervical cancer have been decreasing steadily in most developed countries, but is the leading female cancer in developing countries. This variation in incidence is explicable in terms of differing levels of risk behaviour and population screening facilities and uptake. With better understanding of the aetiopathogenesis, vaccination against HPV is becoming a reality. This may be particularly useful in developing countries, where it is proving difficult to implement effective screening programmes.