| Abstract: | Since the development of cytology-based cervical cancer screening using PAP test in the mid-20th century, the PAP test has been accepted as a method for secondary prevention of cervical cancer. Screening for cervical cancer precursors by cytology has been very successful in the countries with high-quality programs and good coverage of the population at risk. Low-grade abnormalities are the most common type of cytologic abnormalities. In several countries, it is currently recommended to follow up these women by performing PAP smear tests in 6-month intervals. If the low-grade abnormalities do not normalize, colposcopy should be done, which every now and then leads to several unnecessary referrals, associated anxiety and costs. Human papillomavirus (HPV) infection is very common in young women after the onset of sexual activity and, when it persists, it may result in cervical intraepithelial neoplasia (CIN). The recognition of the strong causal relationship between the persistent infection of the genital tract with high-risk HPV types and the occurrence of cervical cancer has resulted in the development of a number of HPV DNA and HPV RNA detection systems. The detection of high-risk HPV DNA is considered to be potentially useful in three applications: (1) as a triage test to select the women with minor cytologic lesions in their PAP smears who need a referral for colposcopic diagnosis and treatment, (2) as a follow-up test for the treated high-grade intraepithelial lesion, and (3.) as a primary screening test alone or in combination with PAP test to detect cervical cancer precursors. There are clear benefits of the use of HPV DNA testing in the triage of atypical squamous cells, mild dyscaryotic cells in older women, and in the post-treatment surveillance of women after treatment for CIN. There is an increasing need for more information and educational programs about HPV. |
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