High-risk HPV test in cervical cancer prevention – present and future
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Student’s Scientific Association, Oncological Surgery Department, Medical University, Lublin, Poland
Oncological Surgery Department, Independent Public Teaching Hospital No.,1 in Lublin; Medical University, Lublin, Poland
Natalia Zarankiewicz   

Student's Scientific Association, Oncological Surgery Department, Medical University of Lublin, Lublin, Poland
J Pre Clin Clin Res. 2020;14(3):80–84
Cervical cancer is the fourth most common cancer among women. It is related to persistent HPV infection. In order to improve diagnostic methods, a lot of research has been focused on detecting HPV DNA. A test known as a high-risk HPV test or HPV primary screening provides very encouraging results.

The aim of this review is to present the actual knowledge about the possibilities of cervical cancer screening methods. Particular attention is paid to the question concerning the effectiveness of detecting viral DNA as a screening programme, compared to pap smear.

State of knowledge:
The HPV primary screening has higher sensitivity than the cervical smear test and it is able to detect lower-stage lesions, which are considered clinically irrelevant. Nonetheless, many HPV infections recede naturally. Therefore, relying only on the results of this test may expose women to unnecessary colposcopies and stress. Due to this fact, women under 30 years should not be screened with the hrHPV test. In view of its limitations, the HPV primary screening strategy is still tested worldwide as a pilot project. In Poland in 2019, a pilot project with the hrHPV test started at the National Institute of Oncology.

Detecting viral DNA has its advantages and disadvantages. Further research is still required, but the hrHPV test has a great opportunity to become one of the main screening programmes worldwide, or at least, a valuable addition to cervical smear test.

HPV – human papillomavirus; DNA – Deoxyribonucleic acid; hrHPV test- high-risk HPV test; WHO – World Health Organization; CIN3 – cervical intraepithelial neoplasia, grade 3; USPSTF – The US Preventive Services Task Force; CIN2 – cervical intraepithelial neoplasia, grade 2; CIN2+ – cervical intraepithelial neoplasia, grade 2 or worse, including CIN3; LBC – liquid-based cytology; CIN3+ – CIN3 or worse, including invasive cervical cancer; FDA – Food and Drug Administration; ATHENA – Addressing the Need for Advanced HPV Diagnostics; ASC-US – Atypical Squamous Cells of Undetermined Significance; NILM – Negative for Intraepithelial Lesion or Malignancy
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