Polio vaccines, Simian Virus 40, and human cancer: the epidemiologic evidence for a causal association

In 1960, it was discovered that Simian Virus 40 (SV40) contaminated up to 30% of the poliovirus vaccines in the US. This contamination arose because the vaccines were produced in monkey kidney cell cultures harboring SV40 between 1955 and 1963. During this period, approximately 90% of children and 60% of adults in the USA were inoculated for polio and possibly exposed to SV40. Many epidemiologic and molecular pathogenesis studies have been conducted in order to identify potential cancer risks since this 'natural' experiment began. Productive SV40 infection has the potential to initiate malignancy in a variety of target tissues. Epidemiological studies that investigated the relationship between SV40 infection and cancer risks have yielded mixed results. Studies can be grouped into three categories based on their exposure definition of SV40 infection: (1) use of vaccination or birth cohorts as proxy variables for infection, (2) follow-up of children of pregnant women who received polio vaccines, and (3) direct molecular detection of the virus or serologic detection of anti-SV40 antibody responses. A meta-analysis of five published studies did not support the hypothesis that SV40 exposure increases the overall risk of cancer incidence or cancer mortality. The analysis of specific cancer sites is largely inconclusive because of substantial problems that most studies have had in reliably defining exposure, defining latency effects, or dealing with confounding and other biases. A new generation of molecular epidemiologic studies is necessary to properly address these issues.