Molecular tests potentially improving HPV screening and genotyping for cervical cancer prevention

Ana Gradíssimo, Robert D. Burk

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

Introduction: Human papillomavirus (HPV)-related cancers can be averted by type-specific vaccination (primary prevention) and/or through detection and ablation of precancerous cervical lesions (secondary prevention). This review presents current challenges to cervical cancer screening programs, focusing on recent molecular advances in HPV testing and potential improvements on risk stratification. Areas covered: High-risk (HR)-HPV DNA detection has been progressively incorporated into cervix cancer prevention programs based on its increased sensitivity. Advances in next-generation sequencing (NGS) are being rapidly applied to HPV typing. However, current HPV DNA tests lack specificity for identification of cervical precancer (CIN3). HPV typing methods were reviewed based on published literature, with a focus on these applications for screening and risk stratification in the emerging complex clinical scenario post-vaccine introduction. In addition, the potential for NGS technologies to increase specificity is discussed in regards to reflex testing of specimens for emerging biomarkers for cervix precancer/cancer. Expert commentary: Integrative multi-disciplinary molecular tests accurately triaging exfoliated cervical specimens will improve cervical cancer prevention programs while simplifying healthcare procedures in HPV-infected women. Hence, the concept of a ‘liquid-biopsy’ (i.e., ‘molecular’ Pap test) highly specific for early identification of cervical precancerous lesions is of critical importance in the years to come.

Original languageEnglish (US)
Pages (from-to)379-391
Number of pages13
JournalExpert Review of Molecular Diagnostics
Volume17
Issue number4
DOIs
StatePublished - Apr 3 2017

Fingerprint

Uterine Cervical Neoplasms
Human Papillomavirus DNA Tests
Papanicolaou Test
Primary Prevention
Secondary Prevention
Early Detection of Cancer
Reflex
Vaccination
Vaccines
Biomarkers
Technology
Delivery of Health Care
Biopsy
DNA
Neoplasms

Keywords

  • Cervical cancer
  • human papillomavirus
  • molecular testing
  • NGS
  • screening
  • triage

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Medicine
  • Molecular Biology
  • Genetics

Cite this

Molecular tests potentially improving HPV screening and genotyping for cervical cancer prevention. / Gradíssimo, Ana; Burk, Robert D.

In: Expert Review of Molecular Diagnostics, Vol. 17, No. 4, 03.04.2017, p. 379-391.

Research output: Contribution to journalReview article

@article{85e263e2bec0478489921a0f4f4daae1,
title = "Molecular tests potentially improving HPV screening and genotyping for cervical cancer prevention",
abstract = "Introduction: Human papillomavirus (HPV)-related cancers can be averted by type-specific vaccination (primary prevention) and/or through detection and ablation of precancerous cervical lesions (secondary prevention). This review presents current challenges to cervical cancer screening programs, focusing on recent molecular advances in HPV testing and potential improvements on risk stratification. Areas covered: High-risk (HR)-HPV DNA detection has been progressively incorporated into cervix cancer prevention programs based on its increased sensitivity. Advances in next-generation sequencing (NGS) are being rapidly applied to HPV typing. However, current HPV DNA tests lack specificity for identification of cervical precancer (CIN3). HPV typing methods were reviewed based on published literature, with a focus on these applications for screening and risk stratification in the emerging complex clinical scenario post-vaccine introduction. In addition, the potential for NGS technologies to increase specificity is discussed in regards to reflex testing of specimens for emerging biomarkers for cervix precancer/cancer. Expert commentary: Integrative multi-disciplinary molecular tests accurately triaging exfoliated cervical specimens will improve cervical cancer prevention programs while simplifying healthcare procedures in HPV-infected women. Hence, the concept of a ‘liquid-biopsy’ (i.e., ‘molecular’ Pap test) highly specific for early identification of cervical precancerous lesions is of critical importance in the years to come.",
keywords = "Cervical cancer, human papillomavirus, molecular testing, NGS, screening, triage",
author = "Ana Grad{\'i}ssimo and Burk, {Robert D.}",
year = "2017",
month = "4",
day = "3",
doi = "10.1080/14737159.2017.1293525",
language = "English (US)",
volume = "17",
pages = "379--391",
journal = "Expert Review of Molecular Diagnostics",
issn = "1473-7159",
publisher = "Expert Reviews Ltd.",
number = "4",

}

TY - JOUR

T1 - Molecular tests potentially improving HPV screening and genotyping for cervical cancer prevention

AU - Gradíssimo, Ana

AU - Burk, Robert D.

PY - 2017/4/3

Y1 - 2017/4/3

N2 - Introduction: Human papillomavirus (HPV)-related cancers can be averted by type-specific vaccination (primary prevention) and/or through detection and ablation of precancerous cervical lesions (secondary prevention). This review presents current challenges to cervical cancer screening programs, focusing on recent molecular advances in HPV testing and potential improvements on risk stratification. Areas covered: High-risk (HR)-HPV DNA detection has been progressively incorporated into cervix cancer prevention programs based on its increased sensitivity. Advances in next-generation sequencing (NGS) are being rapidly applied to HPV typing. However, current HPV DNA tests lack specificity for identification of cervical precancer (CIN3). HPV typing methods were reviewed based on published literature, with a focus on these applications for screening and risk stratification in the emerging complex clinical scenario post-vaccine introduction. In addition, the potential for NGS technologies to increase specificity is discussed in regards to reflex testing of specimens for emerging biomarkers for cervix precancer/cancer. Expert commentary: Integrative multi-disciplinary molecular tests accurately triaging exfoliated cervical specimens will improve cervical cancer prevention programs while simplifying healthcare procedures in HPV-infected women. Hence, the concept of a ‘liquid-biopsy’ (i.e., ‘molecular’ Pap test) highly specific for early identification of cervical precancerous lesions is of critical importance in the years to come.

AB - Introduction: Human papillomavirus (HPV)-related cancers can be averted by type-specific vaccination (primary prevention) and/or through detection and ablation of precancerous cervical lesions (secondary prevention). This review presents current challenges to cervical cancer screening programs, focusing on recent molecular advances in HPV testing and potential improvements on risk stratification. Areas covered: High-risk (HR)-HPV DNA detection has been progressively incorporated into cervix cancer prevention programs based on its increased sensitivity. Advances in next-generation sequencing (NGS) are being rapidly applied to HPV typing. However, current HPV DNA tests lack specificity for identification of cervical precancer (CIN3). HPV typing methods were reviewed based on published literature, with a focus on these applications for screening and risk stratification in the emerging complex clinical scenario post-vaccine introduction. In addition, the potential for NGS technologies to increase specificity is discussed in regards to reflex testing of specimens for emerging biomarkers for cervix precancer/cancer. Expert commentary: Integrative multi-disciplinary molecular tests accurately triaging exfoliated cervical specimens will improve cervical cancer prevention programs while simplifying healthcare procedures in HPV-infected women. Hence, the concept of a ‘liquid-biopsy’ (i.e., ‘molecular’ Pap test) highly specific for early identification of cervical precancerous lesions is of critical importance in the years to come.

KW - Cervical cancer

KW - human papillomavirus

KW - molecular testing

KW - NGS

KW - screening

KW - triage

UR - http://www.scopus.com/inward/record.url?scp=85015732726&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015732726&partnerID=8YFLogxK

U2 - 10.1080/14737159.2017.1293525

DO - 10.1080/14737159.2017.1293525

M3 - Review article

VL - 17

SP - 379

EP - 391

JO - Expert Review of Molecular Diagnostics

JF - Expert Review of Molecular Diagnostics

SN - 1473-7159

IS - 4

ER -