HPV Infection and Its Link to Cancer

Anna R. Giuliano, PhD, director of the newly created Center for Infection Research in Cancer at Moffitt Cancer Center, is world renowned for her research on the human papillomavirus (HPV) and the variety of cancers linked to it that affect both men and women. She was recently appointed to lead this new center to expand Moffitts efforts to find other links between infections and cancer.

Our goals with the new center are to discover new infectious agents and their association with cancers and to translate those discoveries into clinical trials, new screening methods and cancer prevention, said Giuliano, an international leader in HPV research who was named Moffitts Researcher of the Year for 2011. We also want to deliver new standards of care based on infection status and find more effective treatment interventions.

Dr. Giuliano was voted as the Researcher of the Year by her peers at Moffitt in recognition of her incredible record of accomplishment, says Thomas Sellers, PhD, director of the Moffitt Research Institute. She has demonstrated herself as an outstanding leader of the Program in Cancer Epidemiology, but in this new position she can have much greater influence in bringing together multidisciplinary teams to advance the fight against cancers with an infection component. We are confident that this center will become pre-eminent in the world.

Giuliano is an internationally recognized speaker and consultant who has served on numerous committees and investigative task forces.

Since the links between sexually transmitted HPV infections and a variety of cancers were firmly established in 1995, research into the HPV cancer link has expanded greatly. Estimates are that HPV infection causes 5 percent of all new cancers, such as cervical cancer (noted by the World Health Organization to be the second biggest cause of female cancer mortality worldwide), vaginal, vulvar, anal, and a subset of cancers of the head and neck.

There are more than100 types of HPV, explained Giuliano. Forty of these pose varying risks for the development of cancer. HPV-16 and HPV-18 together account for about 70 percent of cervical cancers globally. Recently, its been found that oral HPV-16 infection is strongly linked to the development of throat cancer.

Giuliano, who has been at Moffitt since 2004, has also led increased research into vaccines aimed at preventing HPV infection and related cancers for both men and women.

In 2004, the National Institutes of Health awarded her $10 million to determine the natural history of HPV in men and transmission of the HPV viruses that causes cervical cancer in women. The grant was renewed in 2009, allowing Dr. Giuliano and colleagues to study the progression of these infections in men to disease. This ongoing, multinational study, The HPV Infection in Men (HIM), is funded through the Program Announcement for Cancer Cohort Studies that followed 4,000 men in the United States, Brazil and Mexico.

Men have as much HPV infection as women, but it hasnt been clear how HPV infections progress in men, explains Giuliano.

Recently, Giuliano and colleagues completed a phase III international clinical trial demonstrating that the 4 valent HPV vaccine significantly reduces both infection and disease in men.

Infections contribute to at least 18 percent of all cancers worldwide, Sellers says. With the demonstration of the efficacy of vaccines to prevent viral infections and the evidence that infection-associated cancers may need to be treated differently, we see this as something that is central to Moffitts focus on personalized medicine.