Human papillomavirus and bladder cancer.

Human papillomavirus (HPV) deoxyribonucleic acid (DNA) has been originally detected in urothelial carcinomas of the bladder in immunocompromized patients. Studies from the general population showed a variable incidence of high risk HPV DNA which ranged from 2.5% to 81%, with HPV 16 DNA occurring more frequently. HPV DNA was detected in both papillary and invasive cancers, although in our experience the overall incidence was low. Most HPV positive cases were of high grade and stage with significant reduced survival or increased recurrence rate after transurethral resection. These results indicate an additional prognostic value of viral infection in bladder cancer. In addition, molecular studies suggest that the HPV related oncoproteins E6 and E7 play a role in bladder carcinogenesis via inactivation and/or degradation of p53 and pRb suppressor gene-associated proteins. The purpose of this review is to provide a brief summary of what is known about HPV and bladder cancer, and to address issues germane to the translation of this information to patient management.