Human papillomavirus testing in the prevention of cervical cancer

Mark Schiffman, Nicolas Wentzensen, Sholom Wacholder, Walter Kinney, Julia C. Gage, Philip E. Castle

Research output: Contribution to journalReview article

381 Citations (Scopus)

Abstract

Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening Methods: . New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test Results: predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment.

Original languageEnglish (US)
Pages (from-to)368-383
Number of pages16
JournalJournal of the National Cancer Institute
Volume103
Issue number5
DOIs
StatePublished - Mar 2 2011
Externally publishedYes

Fingerprint

Uterine Cervical Neoplasms
Papillomavirus Infections
Cervical Intraepithelial Neoplasia
Infection
Natural History
Early Detection of Cancer
Uncertainty
Cell Biology
Public Health
Costs and Cost Analysis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Human papillomavirus testing in the prevention of cervical cancer. / Schiffman, Mark; Wentzensen, Nicolas; Wacholder, Sholom; Kinney, Walter; Gage, Julia C.; Castle, Philip E.

In: Journal of the National Cancer Institute, Vol. 103, No. 5, 02.03.2011, p. 368-383.

Research output: Contribution to journalReview article

Schiffman, M, Wentzensen, N, Wacholder, S, Kinney, W, Gage, JC & Castle, PE 2011, 'Human papillomavirus testing in the prevention of cervical cancer', Journal of the National Cancer Institute, vol. 103, no. 5, pp. 368-383. https://doi.org/10.1093/jnci/djq562
Schiffman, Mark ; Wentzensen, Nicolas ; Wacholder, Sholom ; Kinney, Walter ; Gage, Julia C. ; Castle, Philip E. / Human papillomavirus testing in the prevention of cervical cancer. In: Journal of the National Cancer Institute. 2011 ; Vol. 103, No. 5. pp. 368-383.
@article{3eeeb00905f94e968178f02ba3442210,
title = "Human papillomavirus testing in the prevention of cervical cancer",
abstract = "Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening Methods: . New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test Results: predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment.",
author = "Mark Schiffman and Nicolas Wentzensen and Sholom Wacholder and Walter Kinney and Gage, {Julia C.} and Castle, {Philip E.}",
year = "2011",
month = "3",
day = "2",
doi = "10.1093/jnci/djq562",
language = "English (US)",
volume = "103",
pages = "368--383",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Human papillomavirus testing in the prevention of cervical cancer

AU - Schiffman, Mark

AU - Wentzensen, Nicolas

AU - Wacholder, Sholom

AU - Kinney, Walter

AU - Gage, Julia C.

AU - Castle, Philip E.

PY - 2011/3/2

Y1 - 2011/3/2

N2 - Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening Methods: . New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test Results: predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment.

AB - Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening Methods: . New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test Results: predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment.

UR - http://www.scopus.com/inward/record.url?scp=79952351033&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952351033&partnerID=8YFLogxK

U2 - 10.1093/jnci/djq562

DO - 10.1093/jnci/djq562

M3 - Review article

VL - 103

SP - 368

EP - 383

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 5

ER -