Abstract
Cervical cytological pathology is not uncommon. Prevention of cervical cancer by detection of the disease in an early and pre-malignant stage is practised globally either through population-based screening programmes or more optimistically non-organised ones. High-grade cervical intraepithelial neoplasia (CIN) detected by cervical cytological screening are extensively visualised by colposcopy and successively treated by, for instance, large loop electro-surgical excision of the transformation zone (LLETZ). Persistent infections with certain high-risk human papillomavirus (hr-HPV) genotypes play a significant, but not determinative, role in cervical cancer carcinogenesis. The HPV-induced oncogenesis is suggested to be a multi-step process in which the integration of viral DNA in the human genome is the established key-event. Therefore, detection and genotyping of HPV infections in cervical smears also suggested to become highly established tools in assessing the risk of progression of cervical abnormalities. Moreover, accurate genotyping of (HPV) is important in order to i) monitor the efficacy of multivalent vaccines and surgical treatment, ii) study the epidemiology of HPV infections worldwide, and iii) assess the oncogenic potential of high-risk HPV genotypes. Also the assessment of biomarkers indicative for cell-proliferation and parameters related to aberration of chromosome aberration might play an important role in future cervical cancer prevention screening. Patients are however not always willing to undergo cervical assessment by a doctor, leading to unnecessarily high cancer incidence. The cooperation of the patient is essential in cancer screening, a less 'invasive' form of sampling, i.e. cervicovaginal selfsampling, might increase the participation rates and lower cervical cancer incidence.
