GAIRDNER AWARDS
Doctor solved cervical cancer mystery
October 29, 2009
Megan Ogilvie
HEALTH REPORTER
Like most doctors, Nubia Muñoz entered the profession with a single goal: to help sick people get well.
But the Colombian physician soon realized she could help more people by uncovering the root causes of disease than by treating a patient's symptoms.
And so, after graduating from medical school in 1964, Muñoz swapped the stethoscope for a lab coat and embarked on a 40-year research career that has affected millions of women around the world.
Muñoz proved cervical cancer is caused by the human papillomavirus. Her rigorous work laid the foundation for the development of vaccines that prevent HPV infection and cervical cancer, one of the leading cancer killers of women in developing countries.
For this work, Muñoz will be presented with the Canada Gairdner Global Health Award Thursday night in Toronto.
She is the first to win the award, which recognizes scientists whose discoveries have made – or will one day make – a significant impact on health in the developing world.
"It's difficult to believe we have achieved so much," says Muñoz, professor emeritus at Colombia's National Cancer Institute. "This is like a dream for me to be the first to get this fantastic award."
Cervical cancer is the fifth most deadly cancer in women worldwide. Women in developing countries are much more likely to get the disease – 83 per cent of cases occur in these regions– and to die from it because of limited medical care, Muñoz says.
"It affects relatively young women between (the ages of) 40 and 50," she says. "And in these countries, in which there are no good screening programs, no good treatments, these women die relatively young, leaving a lot of children behind.
"So it's a tragedy, not only for women themselves, but ... for the family and the whole society."
After graduating from the medical school at Colombia's Universidad del Valle, Muñoz worked at the U.S. National Cancer Institute, studied epidemiology and cancer virology at Johns Hopkins University, then joined the World Health Organization's International Agency for Research on Cancer in Lyon, France.
"It was supposed to be one year, but it turned into 31 years," Muñoz says with a laugh. It was from this post that she began collecting the epidemiological data that would link HPV to cervical cancer.
In the mid-1980s, she collaborated with scientists in 22 countries to collect tumour biopsies and personal data from some 1,000 women with invasive cervical cancer. Muñoz says the results of that study, published in 1990, were the first to show the geographic distribution of the different types of human papillomavirus in cervical cancer.
In 1999, with the advent of sophisticated DNA technologies, Muñoz and her team were able to show that almost all cervical cancers are marked with DNA from HPV.
"We proposed for the first time that the virus was not only the main cause, but also the necessary cause of cervical cancer," she says. "That means if you don't have the infection, then you can't have the cancer."
Buoyed by the finding, Muñoz and her partner, Spanish epidemiologist Xavier Bosch, identified the main types of HPV – there are more than 100 types – that cause cervical cancer. The findings spurred pharmaceutical companies to develop HPV vaccines.
The Gairdner Foundation said Muñoz's work would go down in the annals of epidemiology as an example of how epidemiologists can unravel the cause of disease.
These days, Muñoz is slowing down – "my husband wants to spend time with me," she says – but still helps Bosch, her former partner, investigate whether HPV plays a role in other cancers.
"The main challenge now," she says, "is how to make these advances, these discoveries, reach the populations that need it most."
Toronto Star
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