Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2016; 22(33): 7415-7430
Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7415
Human papillomavirus and gastrointestinal cancer: A review
Dania Bucchi, Fabrizio Stracci, Nicola Buonora, Giuseppe Masanotti
Dania Bucchi, Department of Experimental Medicine, School of Specialization in Hygiene and Preventive Medicine, University of Perugia, 06126 Perugia, Umbria, Italy
Fabrizio Stracci, Nicola Buonora, Giuseppe Masanotti, Department of Experimental Medicine, Public Health Section, University of Perugia, 06126 Perugia, Umbria, Italy
Fabrizio Stracci, Nicola Buonora, Giuseppe Masanotti, Umbria Cancer Registry, 06126 Perugia, Umbria, Italy
Author contributions: All authors contributed to the conception and design of the study, literature review, analyses, drafts and critical revisions of the manuscript.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giuseppe Masanotti, MD, Professor, Department of Experimental Medicine, Public Health Section, University of Perugia, Via del Giochetto, n.6, 06126 Perugia, Umbria, Italy. giuseppe.masanotti@unipg.it
Telephone: +39-75-5857315 Fax: +39-75-5857317
Received: April 29, 2016
Peer-review started: May 2, 2016
First decision: June 20, 2016
Revised: June 29, 2016
Accepted: July 31, 2016
Article in press: July 31, 2016
Published online: September 7, 2016
Abstract

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Exposure to HPV is very common, and an estimated 65%-100% of sexually active adults are exposed to HPV in their lifetime. The majority of HPV infections are asymptomatic, but there is a 10% chance that individuals will develop a persistent infection and have an increased risk of developing a carcinoma. The International Agency for Research on Cancer has found that the following cancer sites have a strong causal relationship with HPV: cervix uteri, penis, vulva, vagina, anus and oropharynx, including the base of the tongue and the tonsils. However, studies of the aetiological role of HPV in colorectal and esophageal malignancies have conflicting results. The aim of this review was to organize recent evidence and issues about the association between HPV infection and gastrointestinal tumours with a focus on esophageal, colorectal and anal cancers. The ultimate goal was to highlight possible implications for prognosis and prevention.

Keywords: Human papillomavirus, Esophageal cancer, Colorectal cancer, Anal cancer, Oncogenesis, Prognosis, Prevention

Core tip: Human papillomavirus is one of the major causes of infection-related cancer worldwide. Studies on the aetiological role of human papillomavirus (HPV) in colorectal and esophageal malignancies have yielded conflicting results. HPV status has emerged as a possible predictor of treatment response and long-term oncological outcomes for cancer sites where HPV-related and non-related cancers co-exist. Human papillomavirus vaccination is the key to improving HPV-related disease control, and universal vaccination could achieve optimal health benefits.