Human Papillomavirus Screening: Design and Targeting of Human Papillomavirus Genotypes

In 2018, there were globally about 350,000 deaths from cervical cancer, despite the fact that the disease can be prevented by screening and in spite of the fact that highly effective human papillomavirus (HPV) tests became available some 25 years ago. WHO recommended HPV as the primary choice for cervical screening in 2014 (WHO 2014). In this chapter, I will outline the major evidence base behind HPV-based screening, discuss some of the major bottlenecks that has hampered the use of HPV-based screening for prevention of cervical cancer, and point out recent developments that may overcome these bottlenecks, in particular how targeting of screening to the most oncogenic HPV genotypes can be used to optimize sensitivity, specificity, and feasibility of HPV screening.