The causal link between HPV and cervical cancer and its implications for prevention of cervical cancer.

This article reviews epidemiologic evidence linking human papillomavirus (HPV) to cervical cancer. The authors conclude that over 90% of all cervical cancers can be attributed to certain HPV types-HPV 16 accounting for the largest proportion (roughly 50%) followed by HPV 18 (12%), HPV 45 (8%), and HPV 31 (5%). Recognition of this circumstance has far-reaching implications for primary and secondary prevention of this malignancy. At present, prophylactic and therapeutic HPV vaccines are under development, and HPV typing is being integrated into pilot study screening programs in a few developed countries. In developing countries, well conducted conventional screening programs remain the best approach for the control of cervical cancer until a safe and efficient HPV vaccine can be developed for use by the general population.