Future molecular aspects of cervical cytology

Cervical cancer, a potentially preventable disease, remains the second most common malignancy in women worldwide. Current screening protocols rely on the Pap smear test, which has a reported false-negative rate of 15–50%. Advances in automation of cervical cytology have resulted in improved cell preservation techniques and overall high-quality cellular material that is suitable for molecular analysis. The current focus is primarily on the use of molecular biomarkers as adjuncts to existing screening procedures. These biomarkers include human papillomavirus (HPV) and the host cell regulatory molecules, minichromosome maintenance proteins, Cdc6 (a cell division cycle protein) and p16(INK4A) tumour suppressor protein. Developments in micro-array technology and its application to the study of cervical cancer have greatly expanded the list of differentially regulated genes known to be involved in cervical cancer. This will help to unravel the pathogenesis of HPV infection and dysplastic progression, and ultimately improve treatment of cervical intra-epithelial neoplasia and cervical cancer.