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2008). Indeed better screening is necessary due to the number of false-negatives from women with precancerous lesions among the most frequent reasons of medical malpractice in the United States (Steben, M. et al. 2007).
In the case of having a tissue sample to be tested, early stage cervical cancer can be differentiated from healthy cervical tissue by gene expression profile due to comparisons done with healthy and lymph node metastatic tissues which found certain genes upregulated and down regulated (Biewenga, P. et al. 2008). Early stage cervical cancers can be cured by radical surgery or radiotherapy with similar effectiveness (Biewenga, P. et al. 2008). Overall the treatment options for cervical cancer are based on whatever the outcome of clinical staging is and include surgery, radiotherapy, chemotherapy, and/or chemoradiotherapy (Ellenson, L.H. & Wu, T.C. 2004). More sophisticated methods such as the use of MR imaging before, during and after radiation therapy is providing accuracy in the main evaluation of prognostic factors and staging (Engin, G. 2006).
Currently there is an HPV vaccine for women that have been shown to be 100% effective against HPV types 16 and 18, preventing subsequent development of CIN (Steller, M.A. 2003). This vaccine is the direct result of over two decades of research and ongoing trials to find a male equivalent vaccine are underway utilizing a number of species. Papillomavirus infections, however, are species restricted and do not infect of induce changes in the morphology of animal tissues, thus requiring the use of species specific HPV which is hard to equate to humans due to no cervico-vaginal challenge or natural sexual transmission (Schiller, J.T., & Lowy, D.R. 2006). Because of these issues it is difficult to evaluate potential benefits or efficacy.
Ultimately, cervical cancer requires HPV infection but once infection occurs the virus requires other factors such as its host's genetics, immunity, as well as environmental factors such as nutrition, hormonal supplementation like birth control, or cigarette smoking which causes vasoconstriction and overall inflammation. If given the right external factors to its own viral integration into the host's DNA than continuous HPV infection may lead to precancerous lesions and cervical cancer itself. With a number of genetic, molecular, and protein markers being elucidated, tailoring both the treatment and screening processes can bring down overall cervical cancer mortality worldwide.
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