Cervical cancer and human papillomavirus : South African guidelines for screening and testing

Abstract

Cervical carcinoma is still the most common cancer of women on the African continent. Mortality remains high – worldwide at 50% – mainly because of late presentation, advanced stage of disease and absence of a functioning screening process. The aetiological link between human papillomavirus (HPV) infection and cervical cancer has been well established and a number of high-risk HPV genotypes have been identified. HPV infection is the most common sexually transmitted infection (STI) in the world today – up to 80% of sexually active females will harbour HPV at some point in their lives. The majority of women will experience natural elimination of HPV infection because of an intact immune system. Persistent infection with a high risk type HPV puts women at high risk to develop precursors of cervical cancer or carcinoma itself. As part of a public health response to this serious problem, several HPV vaccines are under development. Use of vaccines still poses unanswered questions in many respects.