Current Obstetrics and Gynecology Reports

, Volume 3, Issue 2, pp 107–115

Detection and Clinical Management of Cervical Pathology in the Era of HPV

Management of HPV and Associated Cervical Lesions (C-H Lai, Section Editor)

DOI: 10.1007/s13669-014-0081-z

Cite this article as:
Deftereos, G. & Kiviat, N.B. Curr Obstet Gynecol Rep (2014) 3: 107. doi:10.1007/s13669-014-0081-z

Abstract

While infection with high-risk (HR) human papillomavirus (HPV) is central to cervical carcinogenesis, natural history studies show that both low- and high-grade cervical intraepithelial neoplasia (CIN) lesions are very early manifestations of HR-HPV infection. Most high- and low-grade lesions are self limited, and only those HR-HPV infections capable of persisting for decades are at risk of progression. Our new understanding of the natural history of HPV associated lesions has dramatically changed cervical cancer screening, classification and management of cervical lesions. As an increasing proportion of women are vaccinated against those oncogenic-HPVs responsible for most cervical cancers, the positive predictive value of cytology and HPV testing for identification of women at risk for cancer will decrease. New biomarkers, capable of identifying those high-grade lesions which are truly at risk of progression and need treatment, will need to be developed to serve as adjuncts to morphology and patient management.

Keywords

Human papillomavirusHPVCervical cancerNatural historyCervical intraepithelial neoplasiaCINManagementClearancePersistenceTransmissionImmune response

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineAllegheny General HospitalPittsburghUSA
  2. 2.Department of Pathology, Harborview Medical CenterUniversity of WashingtonSeattleUSA