A strain of the human papilloma virus (HPV) that causes 20 percent to 30 percent of all cervical cancers doubles the mortality rate when compared with cervical cancers caused by the most common version of the virus, according to a paper in the April issue of Journal of Clinical Oncology (Vol 19; No 7: 1906- 15). The population-based study confirmed that mortality rates from cervical cancers caused by HPV-18, which is the second most common cause of the disease, could be four times as high as those caused by other HPV variants, including HPV-16, which causes the majority of cervical cancers.

"What is needed now is a trial to see if measuring the presence of HPV-18 in the tumors of cervical cancer patients makes a difference in clinical outcome in terms of ... treatment decisions," said Stephen Schwartz, PhD, primary author of the study and an associate member of the Fred Hutchinson Cancer Research Center in Seattle. "What we need to do now is figure out what we can do with this information to help women with cervical cancer live longer."

But cervical cancer experts said that the latest study should earmark those with HPV-18 for more intense treatment. The disease is now treated with varying combinations of surgery, radiation and chemotherapy, but not always all three. HPV type testing is not a standard of care and is primarily used as a research tool. The Food and Drug Administration has approved a test for HPV as an adjunct screen to the Pap smear, but a test that determines the type of HPV has not yet been approved. Such a test is expected to be most useful as a diagnostic and to determine treatment strategies for cervical cancer patients.

Researchers said the study would also aid the search for vaccines. There are nearly 100 varieties of HPV, but the most dangerous strains could be prioritized for vaccine development.

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