WOMEN'S HEALTH
Human Papillomavirus—Lessons From History and Challenges for the Future

https://doi.org/10.1016/S1701-2163(16)32997-8Get rights and content

Abstract

Human papillomavirus (HPV) is the most common sexually transmitted infection, and HPV-associated cervical cancer is a significant cause of morbidity and mortality worldwide. Recent advances in molecular biology have facilitated testing for HPV infection. Over the last decade, national and international cervical cancer screening programs have added HPV testing to their guidelines. The use of HPV prophylactic and therapeutic immunization may expand the need for systematic HPV testing to help define eligible subgroups for intervention. Given the worldwide variation in HPV subtype prevalence, basic Pap testing will continue to play an important role in cervical cancer screening, and methods to improve Pap smear sensitivity may help to improve screening in the future. This review focuses on the genetics and cellular biology of HPV infection, the natural history and prevalence of HPV infections, cervical cancer screening around the world and in Canada in particular, and evolving research to improve screening methods.

Résumé

Le virus du papillome humain (VPH) constitue l’infection transmissible sexuellement la plus courante et le cancer du col utérin associé au VPH constitue une cause importante de morbidité et de mortalité de par le monde. Des percées récentes en biologie moléculaire ont facilité le dépistage de l’infection au VPH. Au cours de la dernière décennie, certains programmes nationaux et internationaux de dépistage du cancer du col utérin ont ajouté le dépistage du VPH à leurs directives cliniques. L’utilisation de l’immunisation prophylactique et thérapeutique anti-VPH pourrait amplifier la nécessité du recours à un dépistage systématique du VPH en vue de contribuer à l’identification des sous-groupes admissibles à l’intervention. Compte tenu des variations mondiales en matière de prévalence des sous-types du VPH, le test de Pap de base continuera de jouer un rôle important dans le dépistage du cancer du col utérin; les méthodes permettant d’améliorer la sensibilité des frottis de Pap pourraient contribuer à l’amélioration du dépistage à l’avenir. Cette analyse est axée sur la génétique et la biologie cellulaire de l’infection au VPH, l’histoire naturelle et la prévalence des infections au VPH, le dépistage du cancer du col utérin de par le monde et au Canada en particulier, et l’évolution de la recherche visant l’amélioration des méthodes de dépistage.

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    Competing Interests: None declared.

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