Human papillomavirus testing: the challenges of picking the right tools for the job

Establishing human papillomavirus (HPV) as the necessary cause of cervical cancer has paved the way for disease management strategies that focus on the virus through primary prevention (immunization) and HPV testing. There has been an almost exponential increase in the available tests for HPV infection in the last few years, resulting in a huge variety of both commercial and in-house assays to choose from that vary in their performance and technical characteristics. However, the complex natural history of the disease and the high prevalence of asymptomatic infection (which frequently clears) means that the challenges associated with HPV testing do not simply reside in the development of a technically robust test, but in the application of such to generate meaningful results.