Epidemiologic studies of polyomaviruses and cancer: previous findings, methodologic challenges and future directions

Polyomavirus infection became the focus of epidemiologic studies of cancer several decades ago, soon after the discovery of simian virus 40 (SV40) in 1960 and its ability to induce tumors in experimentally infected animals in 1961. Between 1963 and 2003, eight case-control and eleven cohort studies investigated the possible associations between polyomavirus infection and multiple types of cancer, including lymphoma, brain tumors, and mesothelioma. Two of these studies included measures of infection with the human polyomaviruses, JC virus and BK virus. Overall, the results from these studies were mostly null, although limitations in study design and exposure assessment complicate their interpretation. This chapter includes a review of results from previous epidemiologic studies of polyomavirus infection and human cancer, discussion of the methodologic challenges in study design, and proposed future directions for epidemiologic research.