Cervical cancer: from Hippocrates through Rigoni-Stern to zur Hausen.

On September 5, 2008, the Warren Alpert Foundation nnounced that Harald zur Hausen and Lutz Gissmann had won he Foundation’s 20th annual prize. In the 1980s, zur Hausen and issmann provided the first concrete evidence that specific Human apillomavirus (HPV) types were linked to cancer of the cervix 1,2]. That was the prelude to assignment of the Nobel Prize to the erman scientist. “Dr. zur Hausen went against current dogma by ostulating that the virus caused cervical cancer,” said the Karolinka Institute in Stockholm, in the statement explaining the reasons or the assignment of the prize. More than 2000 years have elapsed since the first description of ervical cancer by Hippocrates [3]. Aretaeus (‘A о ), one of the most celebrated of the ancient reek physicians, who probably practised in the first century after hrist, described uterine cancer as superficial and deep ulcers, hich later infiltrate the uterus. He also described another type f cancer, which does not present ulcers, but is rather a growth in he uterus [3]. Although in 1991 Griffiths [4] did not recognize the importance f Rigoni-Stern as a pioneer in the perception of the pathogenetic echanism of cervical cancer, Rigoni-Stern’s work is mentioned n almost 70 papers published from 2000 to 2008 [5]. In the litrature, Rigoni-Stern appears as an epidemiologist ahead of his ime. Indeed, the Royal Society of Epidemiology was founded in ondon in1850.A surgeon inPadua in themid-19th century, Rigonitern appears to have had an amateur interest in epidemiology, and bserved that cancer of the uterine cervix rarely occurred among elibate nuns [6]. Epidemiologists working in the early 20th century noted that: ervical cancer was common in female sexworkers [7], it wasmore ommon in women whose husbands had a high number of sexual artners or were regular customers of prostitutes [8], and it was are in Jewish women [9]. Other important milestones in the prevention of cervical cancer ere: the invention of the colposcope in 1925, the development of he Pap technique by Papanicolaou, the launch of Pap screening by apanicolaou and Traut [10] and the invention of a specific spatula o scrape the cervix by Ayre [11]. Another important achievement as the standardization of screening results by the Bethesda Sysem in 1988 [12]. However, in 1976 zur Hausen and Gissmann had lready found HPV DNA in cervical cancer and warts [13]. In 1983 zur Hausen, Gissmann and their co-workers identied HPV 16 in precursor lesions of genital cancer. In 1985 they emonstrated the presence of HPV DNA in cervical cancer cells [2]. he findings of the two scientists created the basis for subsequent tudies, which led to the development of two preventive vaccines: