The role of HPV DNA testing in the prevention of cervical cancer

Abstract

The well-established etiological association between cervical cancer development and the infection with high risk genotypes of Human papilloma viruses (hr-HPV) signify the role of HPV testing in both primary and secondary cervical cancer prevention. HPV testing methods are grouped into diagnostic and prognostic tests with the use of various techniques of molecular biology. Diagnostic tests enable detection the presence of HPV DNA (screening) and identification of HPV genotypes (genotyping). Prognostic or triage tests are used for the determination of HPV infected women who are at high risk for the development and/or progression to cervical cancer. hr-HPV testing in cervical cancer screening protocols can be implemented as primary testing or co-testing with cytology and as testing in a triage of women with high risk. The inclusion of hr-HPV testing as primary testing or co-testing is based on higher sensitivity and negative predictive value for the detection of CIN3 lesions compared to cytology alone. Several triaging tests are recommended for risk stratification such as genotyping for HPV 16 and 18, detection of E6/E7 mRNA and DNA methylation marker tests. For an efficient reduction of cervical cancer pervasiveness in Serbia, the implementation of cervical cancer organized population-based screening program that includes HPV testing is essential.