Recently, the Nobel Committee announced that it would award the Nobel Prize for Medicine/Physiology to German professor Harald zur Hausen, who discovered the Human Papillomavirus (HPV) was the cause of cervical cancer. According to the Committee, his discovery “went against current dogma,” when in the 70s and 80s he strove to prove that the papillomaviruses were the cause of cervical cancers. “He thus laid the foundations for better prevention and treatment of this form of cancer, which has become the third most common form to affect women,” says Professor Matthias Kleiner, President of the German Research Foundation.
“I am, of course, completely surprised and it is a great pleasure for me,” expressed zur Hausen in an interview with Adam Smith from nobelprize.org. He credits his dedication and personal conviction to his discovery, working in a direction thought to be completely wrong by many of his contemporaries. “I was an unwelcome and lonely voice,” notes zur Hausen.According to the Center for Disease Control (CDC), HPV is the most common sexually transmitted infection as 50% of sexually active men and women will contract an HPV infection at some point in their lives. Most infections of HPV are innocuous, will not cause any damage or symptoms, and are cleared by the immune system.
About 10% of women with high-risk HPV on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer. The American Cancer Society (ACS), estimates that 11 thousand cases of invasive cervical cancer will be diagnosed in the US. If caught in the early stages, cervical cancer has a 92% survival rate. Due to routine cervical cancer screening, the death rate of cervical cancer continues to decrease 4% a year. The National Cervical Cancer Coalition estimates that the yearly deaths from cervical cancer are approximately a quarter of a million deaths worldwide. Cervical cancer has no symptoms until significantly advanced.
Stemming from zur Hausen’s research are advances in both detection and prevention of HPV and resulting cervical cancer. Previously, HPV has been detected if it caused an abnormality in a Pap smear test. Although a Pap test can uncover abnormal or pre-cancerous changes in the cervix, it can easily miss abnormalities if the lesions were not swabbed. The results of the test are also vague, requiring interpretation from physicians. Pap tests were not specifically designed to test for HPV infections and therefore can miss a possible threat of cervical cancer. However, thanks to the research of zur Hausen, there have been significant developments in HPV tests. Qiagen, an assay and sample production company, has recently developed a HPV test, digene® HPV Test, which is designed to detect 13 high-risk strains of HP, as well as 5 low-risk types. It is the only FDA approved test specific to HPV.
Zur Hausen’s research has also paved the way for prevention of cervical cancer. Based on his identification of the virus and its structure, vaccines have been developed to help deter infection of high risk strains of HPV. In 2006, the FDA approved the vaccine Gardasil in the US. Gardasil has been shown to protect against two of the most prominent strains of highirisk HPV.
“Prof. zur Hausen’s seminal work spurred a new field of cancer research and, ultimately, a new generation of diagnostics and prevention techniques,” says Dr. Attila Lorincz, Professor of Molecular Epidemiology at the Wolfson Institute of Preventative Medicine. “With the combination of Pap and HPV testing for women age 30+ and the availability of a vaccine to immunize girls against certain strains of the virus, the promise of the global eradication of cervical cancer is near.”
Zur Hausen also believes that his discovery will shed light upon other viral causes of cancer. “Yes, we will see more links,” confirms zur Hausen. “One came up this year, the Merkel cell polyomavirus which has been found in Merkel cell carcinoma and every evidence at this stage points to the fact that it is etiologically involved. I hope indeed that this Nobel Prize will of course create more awareness for the role of infectious agents in human cancer.”
Not only does zur Hausen’s research provide us with ways in which to better prevent and detect cancer causing viruses like HPV, but also changes the way that physicians and scientists think about disease. Allowing us to broaden our minds and think critically about viruses and their role in disease formations in the body allow us to better prepare for other possible cancer-causing infections and to look for better viral causing cancer treatments, detection and prevention in the future.
Zur Hausen is a professor emeritus at the German Cancer Research Centre and remains an active spokesperson for the papillomavirus research community and for the role of infectious agents in causing human cancers.