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The Ludwig-McGill HPV Cohort is one of the world's largest longitudinal studies of the natural history of human papillomavirus (HPV) infection and cervical cancer risk. It was established in 1993 by Ludwig Cancer Research and McGill University in Montreal, Canada. [206]
Cervical cancer nearly always involves human papillomavirus (HPV) infection. [46] [47] HPV is a virus with numerous strains, several of which predispose to precancerous changes in the cervical epithelium, particularly in the transformation zone, which is the most common area for cervical cancer to start. [48]
Virtually all cervical cancer cases (99%) are linked to genital human papillomavirus infection (HPV); [14] [5] [6] most who have had HPV infections, however, do not develop cervical cancer. [3] [15] HPV 16 and 18 strains are responsible for approximately 70% of cervical cancer cases globally and nearly 50% of high grade cervical pre-cancers.
The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), [1] cervical smear (BE), cervical screening (BE), [2] or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix (opening of the uterus or womb) or, more rarely, anus (in both men and women). [3]
It resembles small-cell cancer of the lungs and accounts for less than 3% of all cervical cancers. Like small-cell cancer in the lungs, the lymph nodes play a major role in spreading the cancer throughout the body. SCC begins in the inner part of the cervix and is very hard to diagnose.
The cause of CIN is chronic infection of the cervix with HPV, especially infection with high-risk HPV types 16 or 18. It is thought that the high-risk HPV infections have the ability to inactivate tumor suppressor genes such as the p53 gene and the RB gene, thus allowing the infected cells to grow unchecked and accumulate successive mutations, eventually leading to cancer.
For example, individuals with cervical or anal infection with oncogenic, or cancer causing, strains of the human papilloma virus (HPV) are at higher risk for cervical and anal cancers, [9] as well as for cervical and anal dysplasia. [9]
ThinPrep pap smear with group of normal cervical cells on left and HPV-infected cells showing features typical of koilocytes: enlarged (x2 or x3) nuclei and hyperchromasia. A koilocyte is a squamous epithelial cell that has undergone a number of structural changes, which occur as a result of infection of the cell by human papillomavirus (HPV). [1]
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