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Role of routine human papillomavirus subtyping in cervical screening

Human papillomavirus testing has been evaluated as an adjunct to cervical cytologic screening. There is a well-established association between high-risk malignant subtypes of human papillomavirus infection and the development of neoplastic change. Although human papillomavirus infection is a necessary condition for malignant transformation, it is not a sufficient condition. Multiple cofactors are necessary for progression to dysplasia and then to invasive cervical cancer. Because of the multifactorial nature of malignant transformation, current methods of human papillomavirus testing do not add sufficient predictive and diagnostic information over that obtained by cytology and colposcopic biopsy to warrant routine clinical use.