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Special issue of Preventive Medicine argues the case for HPV testing to prevent cervical cancer

, by DCEG Staff

Perhaps one of the greatest success stories in cancer prevention is cervical cancer screening. Generations of women, particularly in high-income countries, have benefited from cytology-based annual testing, also known as Pap tests. In the last 10 years, screening guidelines have shifted to include testing for human papillomavirus (HPV), the cause of cervical cancer.

In February 2017, DCEG experts and colleagues from around the world presented the evidence in favor of phasing out cytology-based screening in favor of the more sensitive HPV testing. A collection of articles published in a special issue of the journal Preventive Medicine lays out their reasoning, as well as the challenges to implementation around the world.

Several DCEG investigators contributed to the special issue: Nicolas Wentzensen, M.D., Ph.D., Julia Gage, Ph.D., M.P.H., Joseph Tota, Ph.D., and Mark Schiffman, M.D., M.P.H., who also served as guest editor.

Read Dr. Schiffman's introduction to the special issue.

Read about how DCEG research on the natural history of cervical cancer has influenced screening guidelines.

Learn about past and ongoing HPV studies at DCEG.


Reference: "Emerging Paradigms in Cervical Cancer Screening” (Special Issue), guest editor: Mark Schiffman, MD, MPH. Individual articles have been published in advance of Preventive Medicine, Volume 98 (May 2017), Elsevier.


The natural history, risk factors and opportunities for prevention of cervical cancer (HPV: Human Papillomavirus; HR-HPV: high oncogenic risk HPV). The blue boxes depict the natural history of cervical cancer carcinogenesis, from exposure to HPV, to acquisition and persistence of the infection, to pre-invasive lesions that may progress to invasive cervical cancer (ICC). For each step leading to ICC, only a fraction of cases progresses to the next step, whereas the majority will regress. The salmon boxes highlight some of the major risk factors for the initial contact with HPV and for the progression to subsequent steps. The green boxes indicate where opportunities for prevention lie. Reproduced with permission from Tota et al., Prev Med 53: S12-S21, 2011.

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