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Human Papillomavirus Detection: Testing Methodologies and Their Clinical Utility in Cervical Cancer Screening

Laudadio, Jennifer MD

Advances in Anatomic Pathology: May 2013 - Volume 20 - Issue 3 - p 158–167
doi: 10.1097/PAP.0b013e31828d1893
Review Articles

Human papillomavirus (HPV) is a well-studied etiologic agent for cervical cancer dysplasia and neoplasia. HPV E6 and E7 viral proteins drive oncogenesis by blocking the activity of pRB and p53, respectively. Consensus screening guidelines focus on appropriate use of both cervical cytology and HPV testing to reduce the morbidity and mortality associated with cervical cancer. HPV testing is indicated for women aged 21 to 64 years with atypical squamous cells of undetermined significance (ASC-US) on cytology. In women aged 30 to 64, testing is also indicated for routine screening in conjunction with cervical cytology. Various methods are available for HPV detection and several Food and Drug Administration-approved assays are on the market using either signal or target amplification methodologies. Most of the approved tests target DNA, but tests for mRNA detection are also available. Recently, assays for type specific detection of HPV types 16 and 18 have been Food and Drug Administration approved, and the use of genotyping has been incorporated into management algorithms. HPV testing can be performed on liquid-based cytology samples and options for automation are available making the introduction of HPV testing into many pathology laboratories possible.

Department of Pathology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC

All figures can be viewed online in color at http://

The author has no funding or conflicts of interest to disclose.

Reprints: Jennifer Laudadio, MD, Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 517, Little Rock, AR 72205 (e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.