The cause of invasive cervical cancer could be multifactorial

Cancer of the cervix is the third most common cancer among women worldwide. with incidence rates ranging from 3.8 per 100.000 women per year in Israel to 48.2 per 100.000 per year in Colombia. Epidemiologic and clinical data suggest that human papillomaviruses. especially HPV-16 and HPV-18, play the major role in the etiology of cervical cancer. However, many investigators acknowledge that HPV is neither necessary nor sufficient in the etiology o r cervical cancer and that a mulifactorial etiology is likely. HPV cannot b e found in every patient with the disease and other factor. such us herpes simplex virus type 2 infection. cigarette smoking, vaginal douching. nutrit ion, and use of oral contraceptives, have been associated with cervical can cer. In two different animal models. tumors can be produced following expos ure to DNA viruses and tars. Using those animal models as prototypes. we pr opose that the etiology of cervical cancer in humans could he an interactio n between DNA viruses. specifically papillomavirus and/or HSV-2 infection, and tar exposure through cigarette smoking and/or tar-based vaginal douchin g. (C) 2000 Editions scientifiques et medicales Elsevier SAS.