Clinical utility of HPV genotyping

In summary, cervical cancer screening is now entering a new era in which we will increasingly rely on measuring the causal viral infection, oncogenic HPV, rather than the pleomorphic cellular changes caused by the infection. As successive cohorts of women receive HPV vaccination, periodic screening with HPV tests will provide a useful means to monitor the duration of protection in the population. As we move from cytology-based screening to HPV-based screening, genotyping may prove useful in stratifying HPV+ women according to risk of prevalent or incipient precancer and cancer to determine the appropriate clinical management strategy. However, to achieve benefit to patients, the addition of HPV genotyping to cervical cancer screening must not be abused by excessive referrals to colposcopy and over-treatment, which can be exacerbated by the use of poorly validated tests.