Invited commentary

Is monitoring of human papillomavirus infection for viral persistence ready for use in cervical cancer screening?

Research output: Contribution to journalComment/debate

26 Citations (Scopus)

Abstract

Persistent cervical infections by approximately 15 carcinogenic genotypes of human papillomavirus (HPV) cause virtually all cases of cervical cancer and its immediate precancerous precursor, cervical intraepithelial neoplasia grade 3 or carcinoma in situ. As is shown in a meta-analysis by Koshiol et al. (Am J Epidemiol 2008;168:123-137), detection of carcinogenic HPV viral persistence could be used to identify women at the greatest risk of cervical precancer. Specifically, women who have carcinogenic HPV infection that persists for at least 1 year versus those whose infections clear are at significantly elevated risk of having or developing cervical precancer. However, before detection of HPV persistence can be used in cervical cancer screening, several considerations need to be addressed: 1) validation and Food and Drug Administration approval of a reliable HPV genotyping test, 2) rational clinical algorithms based on risk of precancer and cancer for the clinical management of HPV persistence, 3) clinician and patient acceptability of monitoring of HPV infections (including not responding excessively to the first positive HPV test and waiting 1-2 years for infections to either persist or resolve), and 4) patient compliance with recommended follow-up. Investigators will need to address these and other key issues in order to realize the potential utility of HPV viral monitoring for improving the accuracy of cervical cancer screening.

Original languageEnglish (US)
Pages (from-to)138-144
Number of pages7
JournalAmerican Journal of Epidemiology
Volume168
Issue number2
DOIs
StatePublished - Jul 2008
Externally publishedYes

Fingerprint

Papillomavirus Infections
Early Detection of Cancer
Uterine Cervical Neoplasms
Infection
Drug Approval
Cervical Intraepithelial Neoplasia
Carcinoma in Situ
Physiologic Monitoring
United States Food and Drug Administration
Patient Compliance
Meta-Analysis
Genotype
Research Personnel

Keywords

  • Human papillomavirus 16
  • Human papillomavirus 18
  • Longitudinal studies
  • Papillomavirus infections
  • Uterine cervical neoplasms

ASJC Scopus subject areas

  • Epidemiology

Cite this

@article{8f001b13bded412dade5406ed589bd6c,
title = "Invited commentary: Is monitoring of human papillomavirus infection for viral persistence ready for use in cervical cancer screening?",
abstract = "Persistent cervical infections by approximately 15 carcinogenic genotypes of human papillomavirus (HPV) cause virtually all cases of cervical cancer and its immediate precancerous precursor, cervical intraepithelial neoplasia grade 3 or carcinoma in situ. As is shown in a meta-analysis by Koshiol et al. (Am J Epidemiol 2008;168:123-137), detection of carcinogenic HPV viral persistence could be used to identify women at the greatest risk of cervical precancer. Specifically, women who have carcinogenic HPV infection that persists for at least 1 year versus those whose infections clear are at significantly elevated risk of having or developing cervical precancer. However, before detection of HPV persistence can be used in cervical cancer screening, several considerations need to be addressed: 1) validation and Food and Drug Administration approval of a reliable HPV genotyping test, 2) rational clinical algorithms based on risk of precancer and cancer for the clinical management of HPV persistence, 3) clinician and patient acceptability of monitoring of HPV infections (including not responding excessively to the first positive HPV test and waiting 1-2 years for infections to either persist or resolve), and 4) patient compliance with recommended follow-up. Investigators will need to address these and other key issues in order to realize the potential utility of HPV viral monitoring for improving the accuracy of cervical cancer screening.",
keywords = "Human papillomavirus 16, Human papillomavirus 18, Longitudinal studies, Papillomavirus infections, Uterine cervical neoplasms",
author = "Castle, {Philip E.}",
year = "2008",
month = "7",
doi = "10.1093/aje/kwn037",
language = "English (US)",
volume = "168",
pages = "138--144",
journal = "American Journal of Epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Invited commentary

T2 - Is monitoring of human papillomavirus infection for viral persistence ready for use in cervical cancer screening?

AU - Castle, Philip E.

PY - 2008/7

Y1 - 2008/7

N2 - Persistent cervical infections by approximately 15 carcinogenic genotypes of human papillomavirus (HPV) cause virtually all cases of cervical cancer and its immediate precancerous precursor, cervical intraepithelial neoplasia grade 3 or carcinoma in situ. As is shown in a meta-analysis by Koshiol et al. (Am J Epidemiol 2008;168:123-137), detection of carcinogenic HPV viral persistence could be used to identify women at the greatest risk of cervical precancer. Specifically, women who have carcinogenic HPV infection that persists for at least 1 year versus those whose infections clear are at significantly elevated risk of having or developing cervical precancer. However, before detection of HPV persistence can be used in cervical cancer screening, several considerations need to be addressed: 1) validation and Food and Drug Administration approval of a reliable HPV genotyping test, 2) rational clinical algorithms based on risk of precancer and cancer for the clinical management of HPV persistence, 3) clinician and patient acceptability of monitoring of HPV infections (including not responding excessively to the first positive HPV test and waiting 1-2 years for infections to either persist or resolve), and 4) patient compliance with recommended follow-up. Investigators will need to address these and other key issues in order to realize the potential utility of HPV viral monitoring for improving the accuracy of cervical cancer screening.

AB - Persistent cervical infections by approximately 15 carcinogenic genotypes of human papillomavirus (HPV) cause virtually all cases of cervical cancer and its immediate precancerous precursor, cervical intraepithelial neoplasia grade 3 or carcinoma in situ. As is shown in a meta-analysis by Koshiol et al. (Am J Epidemiol 2008;168:123-137), detection of carcinogenic HPV viral persistence could be used to identify women at the greatest risk of cervical precancer. Specifically, women who have carcinogenic HPV infection that persists for at least 1 year versus those whose infections clear are at significantly elevated risk of having or developing cervical precancer. However, before detection of HPV persistence can be used in cervical cancer screening, several considerations need to be addressed: 1) validation and Food and Drug Administration approval of a reliable HPV genotyping test, 2) rational clinical algorithms based on risk of precancer and cancer for the clinical management of HPV persistence, 3) clinician and patient acceptability of monitoring of HPV infections (including not responding excessively to the first positive HPV test and waiting 1-2 years for infections to either persist or resolve), and 4) patient compliance with recommended follow-up. Investigators will need to address these and other key issues in order to realize the potential utility of HPV viral monitoring for improving the accuracy of cervical cancer screening.

KW - Human papillomavirus 16

KW - Human papillomavirus 18

KW - Longitudinal studies

KW - Papillomavirus infections

KW - Uterine cervical neoplasms

UR - http://www.scopus.com/inward/record.url?scp=46749089215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46749089215&partnerID=8YFLogxK

U2 - 10.1093/aje/kwn037

DO - 10.1093/aje/kwn037

M3 - Comment/debate

VL - 168

SP - 138

EP - 144

JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

SN - 0002-9262

IS - 2

ER -