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About the Authors:
Neide T. Boldrini
Affiliation: Post-Graduate Program in Infectious Diseases, Federal University of Espirito Santo (Universidade Federal do Espírito Santo – UFES), Vitória-Espírito Santo (ES), Brazil
Luciana B. Freitas
Affiliation: Post-Graduate Program in Infectious Diseases, Federal University of Espirito Santo (Universidade Federal do Espírito Santo – UFES), Vitória-Espírito Santo (ES), Brazil
Amanda R. Coutinho
Affiliation: Post-Graduate Program in Infectious Diseases, Federal University of Espirito Santo (Universidade Federal do Espírito Santo – UFES), Vitória-Espírito Santo (ES), Brazil
Flavia Z. Loureiro
Affiliation: Post-Graduate Program in Infectious Diseases, Federal University of Espirito Santo (Universidade Federal do Espírito Santo – UFES), Vitória-Espírito Santo (ES), Brazil
Liliana C. Spano
Affiliation: Post-Graduate Program in Infectious Diseases, Federal University of Espirito Santo (Universidade Federal do Espírito Santo – UFES), Vitória-Espírito Santo (ES), Brazil
Angélica E. Miranda
* E-mail:[email protected]
Affiliation: Post-Graduate Program in Infectious Diseases, Federal University of Espirito Santo (Universidade Federal do Espírito Santo – UFES), Vitória-Espírito Santo (ES), Brazil
Introduction
Although screening for cervical cancer, with varying age ranges and periodicity of testing, is recommended for women in most countries, the incidence of cervical cancer and its related mortality is far greater in developing countries [1] [2]. The use of cytological screening to detect and remove precursor lesions has had a huge impact on both the incidence and mortality of cervical cancer [1] [3]. However, despite the general decline in the incidence of squamous cell carcinoma (SCC) in some countries where organized or opportunistic cytology screening has been implemented [1] [2] [4] [5], cervical cancer still occurs [6]. This may be due to methodological limitations of screening and/or screening coverage [3] [7] [8].
Persistent human papillomavirus (HPV) infection with specific high-risk (HR) HPV is an indicator of high-grade squamous intraepithelial lesions (HSIL) [9]. HPV genotyping assays may be used in cytology negative, and in HPV positive women over 30 years old in the same manner as HPV triage testing is currently employed in women with atypical squamous cells of unknown significance (ASC-US) or borderline and mild dysplasia (BMD) cytology [10]. The aim of type-specific detection of HPV is to further stratify women with normal cytology who are HPV positive into different risk categories [11]. The identification of infection with HR-HPV among these women justifies immediate colposcopy [11]; also women...