Development of cervical cancer is preceded by well-defined premalignant lesions. These lesions are classified as cervical intraepithelial neoplasia (CIN) and are detectable by cervical cytology, resulting in nationwide cervical cancer screening programs. Although these programs have led to a substantial reduction in mortality and morbidity of cervical cancer, there are many drawbacks including limited accuracy of cytology, unnecessary screening rounds, and over-treatment. A persistent infection with high risk Human Papillomavirus (hrHPV) is necessary for development, maintenance and progression of CIN lesions. HPV testing, as an adjunct to cytology, can lead to a better selection of women at risk for development of cervical cancer and consequently to more efficient cervical cancer screening strategies. The use of HPV testing can reduce the risk of detection failure in cervical screening, the studies described in this thesis confirm this in clinically validated settings. New guidelines and recommendations are formulated.

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Abbott, Bayer BV, GlaxoSmith-Kline, Greiner Bio-One and Wergroep Cervix Uteri, Helmerhorst, Prof. Dr. T.H.J.M. (promotor), Memidis Pharma, Pantarhei Devices BV, Rovers Medical Devices BV, Sanofi Pasteur MSD, Serono Benelux BV an affi liate of Merck Serono SA, Stichting Bevolkingsonderzoek Baarmoederhalskanker regio West, The Dutch Prevention Fund/Zorg Onderzoek Nederland and Doelmatigheidsonderzoek Erasmus University Rotterdam
hdl.handle.net/1765/10489
Erasmus MC: University Medical Center Rotterdam

Bais, A. (2007, September 12). Risk reduction by HPV-Testing in Women with Premalignant Cervical Lesions: Studies of clinical management and observations on the immunological background. Retrieved from http://hdl.handle.net/1765/10489