Cervical cancer etiology is better understood than the origins of most major malignancies. Within the Division of Cancer Epidemiology and Genetics, several groups continue to study the most interesting and important research topics. HPV Guanacaste Study and Nigeria Study. Remaining topics in natural history of the causal virus (human papillomavirus, HPV) are included in this project. In particular, the natural history of newly-appearing infections among women past the usual young age of acquisition is under study. The unusually high prevalence of HPV in sub Saharan Africa is another focus. The recently completed Portland study assessed the risk of cervical neoplasia in the 16 years following a single baseline HPV test and cytologic smear. Cervical Visualization Project. In most studies, HPV natural history is assessed visually (using a web-based open-source software system developed with the National Library of Medicine), microscopically (cytology and histology) and using a variety of molecular biomarkers. We have DNA, RNA, serologic, and other molecular tests. HPV Genome Project. Viral genomic studies are designed to determine why certain types of HPV, if persistent, are extremely powerful carcinogens (acquired genetic syndromes with high penetrance) while related HPV types are not. Viral methylation is also being considered. HPV Cervical Cancer Risk Prediction. This study involves translation of what we have learned about HPV and cervical carcinogenesis into clnical guidelines, particularly via risk prediction models. This research project is human population based and etiologic.

National Institute of Health (NIH)
National Cancer Institute (NCI)
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Clarke, Megan A; Fetterman, Barbara; Cheung, Li C et al. (2018) Epidemiologic Evidence That Excess Body Weight Increases Risk of Cervical Cancer by Decreased Detection of Precancer. J Clin Oncol 36:1184-1191
Silver, Michelle I; Gage, Julia C; Schiffman, Mark et al. (2018) Clinical Outcomes after Conservative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in Women Ages 21-39 Years. Cancer Prev Res (Phila) 11:165-170
Schiffman, Mark; Wentzensen, Nicolas (2017) Effective use of human papillomavirus testing for cervical cancer screening requires extended intervals to target persistent infections and precancerous lesions. Prev Med 105:378-380
Schiffman, Mark (2017) Cervical cancer screening: Epidemiology as the necessary but not sufficient basis of public health practice. Prev Med 98:3-4
Schiffman, Mark; Yu, Kai; Zuna, Rosemary et al. (2017) Proof-of-principle study of a novel cervical screening and triage strategy: Computer-analyzed cytology to decide which HPV-positive women are likely to have ?CIN2. Int J Cancer 140:718-725
Schiffman, Mark; Hyun, Noorie; Raine-Bennett, Tina R et al. (2016) A cohort study of cervical screening using partial HPV typing and cytology triage. Int J Cancer 139:2606-15
Silver, Michelle I; Schiffman, Mark; Fetterman, Barbara et al. (2016) The population impact of human papillomavirus/cytology cervical cotesting at 3-year intervals: Reduced cervical cancer risk and decreased yield of precancer per screen. Cancer 122:3682-3686
Schiffman, Mark; Wentzensen, Nicolas (2016) A Suggested Approach to Simplify and Improve Cervical Screening in the United States. J Low Genit Tract Dis 20:1-7
Gage, Julia C; Hunt, William C; Schiffman, Mark et al. (2016) Similar Risk Patterns After Cervical Screening in Two Large U.S. Populations: Implications for Clinical Guidelines. Obstet Gynecol 128:1248-1257
Zhao, Fang-Hui; Hu, Shang-Ying; Zhang, Qian et al. (2016) Risk assessment to guide cervical screening strategies in a large Chinese population. Int J Cancer 138:2639-47

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