Human Papillomavirus Detection Is Not Yet Predictive of Cervical Cancer

In a recent study, researchers at the University of Nijmegen Medical Center in the Netherlands examined the relationship between genital human papillomavirus (HPV) and cervical cancer. "Cervical cancer is a major cause of death, and the second most frequent cancer in women worldwide," explained R.L.M. Bekkers and colleagues. "High-risk HPV genotypes have been detected in almost 100 percent of all cervical cancers, and the process of HPV-mediated carcinogenesis has been partly clarified."

"The concept that HPV is a obligatory cause in cervical cancer development has led to extensive research regarding the incorporation of HPV detection in (1) cervical cancer prevention programs, (2) triage of women with abnormal cervical scrapes in the screening program, and (3) follow-up of patients treated for cervical intraepithelial neoplasia (CIN)," said the authors.

According to epidemiological studies, 50 percent of women becoming sexually active will contract a genital HPV infection within 2 years. Though the lifetime risk of a genital HPV infection is estimated to be 80 percent, very few of these women will develop cervical cancer, the researchers pointed out.

"Several studies have shown that the persistence of genital HPV infections is especially related to the development of cervical cancer. As a result, HPV detection at a single moment was shown to be of limited clinical value in the triage of patients with abnormal cervical scrapes, or during follow-up after treatment for CIN," added the researchers. "Furthermore, major variations in the sensitivity of different HPV detection methods, as well as differences in HPV detection related to the menstrual cycle, have shown that many facts regarding HPV transmission, replication and detection need to be clarified, before HPV detection can be of clinical value," the researchers concluded.

The study, "Epidemiological and Clinical Aspects of Human Papillomavirus Detection in Prevention of Cervical Cancer," was published in Reviews in Medical Virology (2004;14(2):95-105).

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