Grant: Foundation Grant

<html> <body> <p>For the past 20 years, the program leaders (PL) have sustained a robust research program on the epidemiology and prevention of human papillomavirus (HPV) infection and associated cancers. Our research has provided essential knowledge towards (i) understanding acquisition of and susceptibility to HPV infection, (ii) how HPV infection triggers carcinogenesis, (iii) establishing that HPV is a necessary cause of cervical cancer, (iv) providing evidence that HPV testing improves cervical cancer screening efficacy, and (v) proving that HPV vaccination prevents precancerous lesions. Our research has strengthened the cooperation between McGill and Universit&eacute; de Montr&eacute;al and trained many leaders of cancer and STD control communities in Canada and abroad.<br> <br> We have recently begun a pragmatic phase of our research by focusing on opportunities for prevention using novel approaches with high translational potential. We launched two randomized controlled trials (RCT) of HPV prevention via a microbicidal gel (carrageenan), one for women (CATCH trial) and one for men who have sex with men (LIMIT-HPV trial). We began another RCT (TRAP-HPV study) to assess the value of HPV vaccination in reducing heterosexual HPV transmission. We plan to launch a new cervical self-sampling screening study (CASSIS trial) with the goal of validating a technique to increase cervical cancer screening coverage to remote areas (e.g., aboriginal populations or urban women who fail to attend screening). We are planning a study of artemisinin, a natural product and anti-malarial compound, for treating HPV-associated precancerous lesions in women and men.<br> <br> Our molecular epidemiological studies, some completed and some ongoing (e.g., HITCH cohort, BCCR case-control, McGill-Concordia cohort, Ludwig-McGill cohort, CCCaST RCT, HIPVIRG cohort) have accrued more than 40,000 cervical, anogenital, and serum specimens in a valuable biobank for translational studies and a wealth of data on risk factors and other variables. We began to investigate host and viral biomarkers for risk prediction, such as host and HPV DNA methylation, HLA polymorphisms, and HPV intratypic variation, viral load, and integration. For the CCCaST RCT, which includes more than 10,000 women, we plan to extend follow-up information and correlate that with HPV genotyping information at different points since enrolment. This would permit us to provide policymakers with evidence on the long-term safety of cervical cancer screening. Furthermore, using our biobank we hope to extend preliminary analyses on the value of testing for circulating HPV DNA as a correlate of disease progression and metastatic dissemination for cancers caused by HPV infection.<br> <br> Over the years we assembled a multidisciplinary team with expertise in epidemiology, microbiology, gynecology, pathology, dentistry, psychology, biostatistics, and immunology. This team will continue a tradition of mentoring many undergraduate and graduate students, and post-doctoral fellows via our two universities.<br> <br> HPV causes anogenital, upper aerodigestive tract, and non-melanoma skin cancers. In all, 10% of all cancers are likely caused by HPVs. Translational research is needed for sound cancer control and prevention policies involving HPV vaccination and HPV-based screening. Much remains to be learned concerning etiologic mechanisms, molecular targets, propensity for carcinogenesis, HPV acquisition and transmission, and the long-term impact of HPV-based technologies.</p> </body> </html>