Cervical cancer is the second most common cancer in women worldwide and is caused primarily by certain strains of the human papillomavirus (HPV). HPV is very common and spreads through sexual contact. While most HPV infections cause no symptoms and go away on their own, persistent infections with high-risk HPV types can cause normal cervical cells to become precancerous and develop into cancer over time if not treated. Screening for HPV and abnormal cervical cells through Pap tests and HPV tests is important for early detection and prevention of cervical cancer.

1. BY DR.RICHA SHARMA
Moderator: Prof. A.N. Srivastava

2. CARCINOMA CERVIX
 Malignant tumor of uterine cervix.
 Second most common cancer worldwide and the commonest
cancer among Indian women

3. Early stage Late stage
Micro -invasive cancer
cervix normal,shallow
ulcer or reddened area
stage IA to IIA cervical
carcinoma
Symptoms:
Asymptomatic
 diagnosis with abnormal
Pap
Appear as polyps, grow
into cervix
 hardened, barrel-shaped
cervix.
stage IV cervical carcinoma
 bleeding or discharge P/V
dyspareunia
 lower abdomen pain

5. HPV(Human Papilloma Virus)
HPV is known as the"common cold" of the sexually
transmitted infection world.
 It is very common and affects roughly 80 % of all sexually
active people, whether they have symptoms or not.
 The most important risk factor in the development of
cervical cancer is infection with a high-risk strain of HPV.
In 1976 Harald zur Hausen published the hypothesis that
HPV plays an important role in the cause of cervical
cancer.
 In 1983 and 1984 zur Hausen and his collaborators
identified HPV16 and HPV18 in cervical cancer.

6. More than 150 types of
HPV are acknowledged
to exist (some sources
indicate more than 200
subtypes).
Types 16and 18 are
generally acknowledged
to cause about 70% of
cervical cancer cases.
Together with type 31,
they are the prime risk
factors for cervical
cancer

7. HPV Infection
HPV is spread through genital skin contact during sex.
The virus passes through tiny breaks in the skin. HPV is
not spread through blood or other body fluid.
Condoms offer limited protection as they do not cover all
of the genital skin.
 Warts on any other parts of the body rarely spread to the
genital area.
 Blood- debatable
After it enters the body, HPV behaves in one of two ways:
• it can stay dormant (inside the body’s cells)
• it can become active.

8. Human papillomavirus (HPV) is a ds DNA virus from the
papillomavirus family that is capable of infecting humans.
HPVs establish productive infections only in keratinocytes
of the skin or mucous membranes.
HPV infection is limited to the basal cells of stratified
epithelium, the only tissue in which they replicate.
The infectious process is slow, taking 12–24 hours for
initiation of transcription.
HPV infections have not been shown to be cytolytic;
rather, viral particles are released as a result of
degeneration of desquamating cells.

14. The HPV TestIn March 2003, the U.S. FDA approved a test
manufactured by Qiagen/Digene, which is a "hybrid-
capture" test as an adjunct to Pap testing.
The test may be performed during a routine Pap smear.
 It can detect the DNA of 18 "high-risk" HPV types that
most commonly affect the cervix, but it cannot determine
the specific HPV types.

15. TYPES OF HPV TEST
I. Signal amplification assays
II. DNA Target amplification assays
III. Isothermal nucleic acid amplification methods (typically
for mRNA)
IV. Read-out assays for target amplification methods
V. Real time readout assays with type-specific probes

16. Signal amplification assays

17. DNA Target amplification assays

18. Isothermal nucleic acid amplification
methods

19. The HPV Test
The HPV test checks directly for the presence of the high-
risk HPV DNA. HPV testing is FDA-approved for use with
a Pap test in routine cervical cancer screening for women
age 30 and older and for women of all ages as a follow-up
to inconclusive Pap test results, known as ASC-US
(atypical squamous cells of undetermined significance).
Research shows that the two tests together are more
accurate than the Pap test alone at identifying women
with cervical cancer or its early signs.
Like the Pap test, the HPV test uses a small, soft brush to
collect cervical cells. Women who receive the HPV test
along with their Pap test will not notice any difference in
their exam.

27. PEARLS
 Cervical cancer is largely preventable – regular screening, changing or
avoiding certain risk factors, and vaccinations are essential.
 Cervical cancer is caused by a common virus – the human papillomavirus.
 Cervical cancer screenings include the traditional Pap tests, liquid-based Pap
test and HPV testing.
 Cervical cancer and HPV do not usually have symptoms.
 From 50 percent to 80 percent of all people will have HPV at some point in
their lifetime.
 The FDA has approved HPV vaccines for females aged 9 to 26 years.