Clinical value of HPV testing in cervical cancer

Worldwide, cervical cancer is among the most common cancers in women. Human papillomavirus (HPV) has a strong association with cervical cancer. Since HPV plays an important etiological role in cervical cancer, it is logical to use HPV as a marker for early detection of cervical cancer and precancer. Recent advances in technology enable the development of high-throughput HPV assays of different formats, including DNA-based, mRNA-based, high-risk group-specific and type-specific methods. These assays are to improve the accuracy and cost-effectiveness of cervical cancer screening programs. While conventional Pap smear or liquid-based cytology is still the standard for care in many parts of the world, the intrinsic drawbacks of cytology-based screening call for replacement by HPV testing or the addition of adjunct markers. However, HPV test results are bound to have a low positive predictive value that may subject women to unnecessary follow-up investigations. A fine balance has to be established between the sensitivity and specificity of the HPV test to achieve a clinically useful predictive value, thus maximizing the efficacy of screening.