Cervical cancer control in the era of HPV vaccination and novel biomarkers

Infections with human papillomaviruses (HPV) are a necessary, but not sufficient cause of cervical cancer. Cervical cancer develops over a long time through precursor lesions that can be detected by cytological screening. The majority of these lesions regress spontaneously without treatment. The challenge of cervical cancer screening is to detect the lesions that have a high risk of progression. Since the recently introduced vaccination against HPV cannot provide 100% protection, cervical cancer screening programs must continue. It is assumed that the reduction of precancers related to vaccination will have a negative impact on the efficiency of current screening programs. Therefore, participation rates need to be increased and current screening modalities should be improved. Several promising biomarkers have been described that might improve cervical cancer screening, but currently, high-quality studies on their efficiency are lacking.