Future trends in cervical cancer

Abstract

The identification of the close association of certain types of human papillomavirus with the development of cervical cancer should lead to an extensive revision of appropriate health policies. Having taken into account the drawbacks inherent in the existing data (stemming from the use of varying nomenclature, diagnostic methods and reliability, registration and screening practices) it is possible to conclude that the incidence of HPV infections, all premalignant and malignant stages of cervical cancer are, or will soon be, increasing in several countries. This rate of increase is fastest for the younger age groups and is despite the introduction of various forms of screening. These trends therefore indicate an urgent need to adopt policies to avert an unnecessary increase in fatalities due to cervical cancer. It is therefore recommended to: (1) establish a routine diagnostic method which can identify either the type of HPV present or the lesions which are progressing; (2) determine the incidence of HPV infections in the general population; (3) disseminate to medical personnel, teachers, and other members of society existing knowledge concerning the dangers associated with this virus and relevant to preventing its further spread; (4) introduce an effective population screening campaign for all sexually active women, preferably involving a yearly examination at a colposcopy clinic; (5) intensify basic and applied HPV research, especially that which could lead to a deeper understanding of viral transmission and infection, identification of cofactors which promote cervical lesion progression, or to the production of a vaccine.