Cervical Dysplasia and Human Papillomavirus

Abstract

Human papillomavirus (HPV) affects the majority of sexually active individuals and accounts for approximately 5% of human cancers and nearly 100% of cervical cancer cases. The progression from persistent HPV infection to invasive cervical cancer takes at least 10 years and is preceded by epithelial dysplastic changes. Cytologic screening programs, which rely on disease detection during this precancerous interval, have successfully decreased the incidence of cervical cancer. The HPV vaccine, approved since 2006, effectively decreases cervical disease but remains underused in the United States and abroad, with the incidence of HPV-related cancers still on the rise. In this review, we discuss the epidemiology and molecular pathogenesis of HPV infections and cervical cancer development, cervical cancer screening and screening terminology, management of abnormal screening results, and HPV vaccination. This review contains 4 figures, 8 tables and 49 references Key words: atypical squamous cells of undetermined significance, cervical cancer, cervical intraepithelial neoplasia, colposcopy, high-grade cervical dysplasia, human papillomavirus, human papillomavirus vaccine, low-grade cervical dysplasia, Papanicolaou test, papillomaviruses