The new era of primary HPV screening for prevention of invasive cervical cancer

We now know that persistent cervical infections by certain types of human papillomavirus (HPV) designated as high-risk, carcinogenic or cancer-associated, cause virtually all invasive cervical cancer. The discovery of oncogenic HPV as the necessary cause of invasive cervical cancer has led to revolutionary advances in prevention, including the development of sensitive molecular HPV testing for cervical cancer screening. Using high-risk HPV testing for the primary screen shifts the use of the Pap test from the general population to those women at risk of cervical cancer, high-risk HPV positives. In high-resource settings, using high risk HPV testing as the primary cervical cancer screening test could increase the efficiency of current screening programs, more effectively identify women at risk for adenocarcinoma, and combined with self-collection, reach medically unserved populations that experience a disproportionate burden of invasive cervical cancer.