Use of the polymerase chain reaction to study the relationship between human papillomavirus infections and cervical cancer.

Although it is now evident that human papillomaviruses (HPV) are strongly associated with cervical cancer, their etiological role in the oncogenesis of this disease is still unknown. However, HPV screening may identify women at risk of acquiring this disease. With the recent development of the polymerase chain reaction (PCR), it has become possible to detect small numbers of human papillomavirus genomes in clinical samples. The sensitivity and specificity of this technique, together with the possibility of performing the test on crude cervical scrapes, makes PCR the method of choice for screening. In this paper, data on the detection of human papillomavirus by PCR are presented and the applicability of this technique for the screening of human papillomavirus genotypes is evaluated. The question arises whether screening for diagnostic purposes must include all the human papillomavirus types associated with infections of the genital tract or only those which are strongly associated with cervical cancer (HPV 16 and HPV 18). It is proposed that an international council must be created that is responsible for standardised epidemiological screening strategies and follow-up programmes.