In recent years, much insight has been gained into the molecular pathogenesis of cervical cancer and its precursor lesions. Specific types of human papillomavirus (HPV) are the principle etiologic agents in cervical neoplasia. Interactions between HPV and cell-derived proteins result in deregulation of cell cycle progression an d appear to be critical for the development of cervical cancer. HPV DNA testing may have limited clinical utility as a primary screening tool in underdeveloped countries or underserved populations where access to repeated, reliable cytologic screening is severely limited or in which the prevalence of cervical cancer and precursor lesions is high. In areas where cervical cytologic screening is well established and the incidence of clinically significant pre-invasive disease is not excessive, HPV typing is of unproven benefit as a primary screening tool. In selected settings, triaging women with a minimally abnormal Papanicolaou smear with a combination of repeat cytology and HPV DNA testing appears to be a sensitive alternative to immediate colposcopic evaluation.
ASJC Scopus subject areas
- Obstetrics and Gynecology