Review article

Human Papillomavirus Infections and Cervical Carcinoma

Ante Ćorušić
Lana Škrgatić

Abstract

Cervical carcinoma is the second most frequent
carcinoma in women worldwide. The highest incidence is
recorded in developing countries of southwest Africa, South
America and Southeast Asia. In Europe, the highest incidence
is recorded in eastern European countries. In Croatia, its incidence
is lower than in many CEE countries. Cervical carcinoma
is the disease of young women. The major study conducted by
the International Agency for Research on Cancer (IARC) in 1995
revealed that 99.7% of all cervical carcinoma cases could be
attributed to human papillomavirus (HPV). Genital HPV strains
are divided into three groups: high oncogenic risk strains,
potentially carcinogenic strains, and low oncogenic risk strains.
Strains 16 and 18 are responsible for about 70% of cervical
epithelial cancers, and about 86% of cervical adenocarcinomas.
Nowadays the HPV infection is the most frequent sexually
transmitted disease. Remission can be spontaneous in 90-95%
of HPV cases. Pre-invasive cervical lesions (CIN - cervical intraepithelial neoplasia) and subsequent carcinoma develop after a
persistent infection with highly oncogenic HPV strains. The presumed
interval between a persistent HPV infection and invasive
cervical carcinoma is seven to ten years, which leaves suffi cient
time for prevention. Theoretically, no woman should develop
cervical carcinoma, or let alone die. However, the incidence of
cervical carcinoma is stable. The reason is opportunistic screening
in Croatia. These are mostly the same women who have
Pap smears, and it is on their own initiative. Therefore, there is
a need for organized screening program. Last year, HPV vaccine
was registered in many countries. National immunization
programs can be realized only in countries with well-organized
secondary prevention and fi nancial prerequisites.

Keywords

cervical cancer; HPV; etiopathogenesis; carcinogenesis; prevention

Hrčak ID:

18151

URI

https://hrcak.srce.hr/18151

Publication date:

29.12.2006.

Article data in other languages: croatian

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