Cervical infections by approximately 15 cancer-associated
(carcinogenic or high-risk) human papillomavirus (HPV)
genotypes cause virtually all cervical cancer and its immediate
precursors worldwide.3 A new paradigm of cervical
carcinogenesis replaces an older pathology model of stepwise
progression from low-grade to high-grade morphologic
changes and can now be summarized as 4 reliable
measured stages: 1) HPV acquisition, 2) HPV persistence
(vs clearance), 3) progression of a persisting infection to
cervical precancer, and 4) invasion.6
Globally, HPV is the most common sexually transmitted
infection. The majority of HPV infections, including
carcinogenic HPV genotypes, are typically transient
and resolve within 6 to 12 months, occasionally causing
mild morphologic changes. In general, it can be said that
carcinogenic HPV is the necessary but infrequent cause of
cervical cancer. That cervical cancer is the second most
common cancer worldwide is to a great extent a result of
the nearly ubiquitous exposure to HPV after sexual debut.
Women with persistent carcinogenic HPV infections are
at risk of developing precancer,6 although not all persistent
infections progress to precancer. If precancer is not
detected and treated in a timely manner, a significant proportion
can invade.