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BioMed Research International

Volume 2015, Article ID 250917, 2 pages
http://dx.doi.org/10.1155/2015/250917

Editorial
Cervical Cancer Prevention: New Frontiers of
Diagnostic Strategies

Massimo Origoni,1 Walter Prendiville,2 and Evangelos Paraskevaidis3

1
Department of Obstetrics & Gynecology, School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
2
UPMC Beacon Hospital, Dublin, Ireland
3
Division of Obstetrics & Gynecology, School of Medicine, University of Ioannina, Epiros, Greece

Correspondence should be addressed to Massimo Origoni; massimo.origoni@hsr.it

Received 18 May 2015; Accepted 18 May 2015

Copyright © 2015 Massimo Origoni et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.

Invasive cervical cancer still represents one of the major issues stratification for cervical cancer is the final result of a
of preventive oncology either in developed countries or in cultural revolution in the field of cervical cancer natural
developing countries, accounting for the fourth leading cause history knowledge and isolation of progression risk factors.
of cancer related deaths in women worldwide and the second Molecular techniques are better than cervical cytology with
leading cause of deaths in women in developing countries respect to diagnostic sensitivity and reproducibility to detect
[1]. It is the greatest cause of cancer death in women in cervical intraepithelial neoplasia grade 2 (CIN2) or cervical
sub saharan Africa, even outstripping breast cancer. Since intraepithelial neoplasia grade 3 (CIN3)—the high-grade
the introduction of population-based organized cytological lesion precursors of invasive cervical cancer. According to
screening programs, a dramatic decrease of incidence of data from four European randomized trials comparing HPV-
cervical cancer has been obtained in many western countries; based cervical cancer screening with cytology-based cervical
despite this reassuring result, the overall performance of cancer screening, HPV-based screening resulted in a 60–70%
cervical cytological screening, the Pap test, is still far from reduction in invasive cervical cancer incidence compared
being optimal [2]. Because Human Papillomavirus (HPV) with cytology-based screening. The decrease in incidence of
is the recognized necessary cause for the development of invasive cervical cancer with HPV testing was not signifi-
cervical cancer, the present research is aimed at the inves- cant within 2.5 years of enrolment, but the effect became
tigation of new approaches towards its prevention and is decisive with longer follow-up [4]. Besides these results that
particularly focused upon several biomolecular patterns and have significantly contributed to the shift to a molecular
detection tools of the virological contamination of the lower screening strategy, a large amount of research works has been
female genital tract. The identification of high-risk viral performed and is still ongoing in the field of identifying
strains DNA (HPV 16 and 18) is now worldwide recognized additional and novel aspects of the HPV causal effect of
as more effective than cervical cytology in several settings: determining the neoplastic transformation of cervical tissues:
primary screening, triage of atypical cytology, and follow-up genotyping, E6/E7 oncoproteins overexpression, high-risk
after treatment [3]. In this model, the traditional approach HPV mRNA determination, novel progression biomarkers
of looking for the early stages of the cervical neoplastic such as p16INK4a and Ki67, DNA methylation markers, and,
disease has nowadays shifted to the biological interpretation last but not least, the future role of colposcopy in the
of the effects of HPV persistent infection on cervical epithelia biomolecular era. In this special issue, readers will find
and thus to the identification of “at-risk” individuals or articles that focus on these promising aspects of investigation,
groups rather than affected patients. The concept of risk providing interesting results that could potentially open new
2 BioMed Research International

windows of knowledge and new options of interventions in

the still unfinished battle towards cervical cancer that started
with Papanicolaou.
Massimo Origoni
Walter Prendiville
Evangelos Paraskevaidis

References
[1] L. A. Torre, F. Bray, R. L. Siegel, J. Ferlay, J. Lortet-Tieulent, and
A. Jemal, “Global cancer statistics, 2012,” CA: A Cancer Journal
for Clinicians, vol. 65, no. 2, pp. 87–108, 2015.
[2] L. G. Koss, “The Papanicolaou test for cervical cancer detection.
A triumph and a tragedy,” Journal of the American Medical
Association, vol. 261, no. 5, pp. 737–743, 1989.
[3] M. G. Dijkstra, P. J. Snijders, M. Arbyn, D. C. Rijkaart, J.
Berkhof, and C. J. Meijer, “Cervical cancer screening: on the way
to a shift from cytology to full molecular screening,” Annals of
Oncology, vol. 25, no. 5, pp. 927–935, 2014.
[4] G. Ronco, J. Dillner, K. M. Elfström et al., “Efficacy of HPV-
based screening for prevention of invasive cervical cancer:
follow-up of four European randomised controlled trials,” The
Lancet, vol. 383, no. 9916, pp. 524–532, 2014.
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