HPV-BASED SCREENING AND MOLECULAR DIAGNOSTICS IN THE PREVENTION OF CERVICAL CANCER: CLINICAL PERFORMANCE, REAL-WORLD EVIDENCE, AND IMPLEMENTATION PRIORITIES

Abstract

Persistent infection with carcinogenic human papillomavirus (HPV) is a  necessary causal factor in most cervical cancers, but a positive molecular assay is not  equivalent  to  precancer  or  invasive  disease.  The  transition  from  cytology-centred  prevention  to  validated  high-risk  HPV  testing  has  changed  the  evidentiary  basis  of  screening,  triage,  surveillance  and  programme  evaluation.  Objective:  To  critically  integrate evidence on HPV DNA and mRNA testing, partial and extended genotyping,  p16/Ki-67  dual  staining,  host  and  viral  methylation,  self-collection,  artificial  intelligence and longitudinal real-world data, with particular consideration of feasible  implementation in Uzbekistan.