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Human papillomaviruses. Applications, caveats and prevention
Christopher P Crum1, Ross S Berkowitz
1Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. cpcrum@rics.bwh.harvard.edu
The Journal of Reproductive Medicine
|August 13, 2002
Summary
Human papillomavirus (HPV) testing offers objective cervical neoplasia risk assessment. While effective for triage, awareness of limitations and patient concerns is crucial for appropriate use in screening programs.
Area of Science:
- Gynecology
- Oncology
- Infectious Diseases
Background:
- Cervical cytology lacks objective risk assessment for neoplasia.
- Human papillomavirus (HPV) is the primary cause of cervical cancer and its precursors.
- Current screening methods require improvement for risk stratification.
Purpose of the Study:
- To evaluate the role and implications of HPV testing in cervical cancer screening.
- To highlight the advantages and limitations of HPV testing for risk assessment.
- To discuss the impact of HPV vaccination on cervical cancer prevention.
Main Methods:
- Review of HPV testing technologies and their application in cervical cancer screening.
- Analysis of HPV test performance characteristics, including sensitivity and specificity.
- Discussion of clinical management strategies for HPV-positive and HPV-negative women.
Main Results:
- HPV testing provides objective risk assessment, enabling efficient triage of women.
- HPV-negative women can be safely followed up annually, while HPV-positive women require colposcopy.
- Highly sensitive tests may identify women with low immediate risk, necessitating careful interpretation and patient counseling.
Conclusions:
- HPV testing is a valuable tool for cervical cancer screening, improving risk stratification.
- Addressing patient concerns and understanding test limitations are essential for optimal implementation.
- Widespread HPV vaccination holds the potential to significantly reduce the incidence of cervical cancer and preinvasive disease.