Cervical cancer is the third most common female cancer in the world. Globally, nearly 500,000 women are diagnosed with cervical cancer each year; its mortality rate is as high as 50%, occurring mainly in Asia. Almost all cases of cervical cancer (99%) are caused by human papillomavirus (HPV) infection. Most HPV infections are asymptomatic and can be cleared by the body’s natural immune system. However, by the time symptoms appear, the cancer is usually in a more advanced stage and difficult to treat, making early diagnosis necessary. The FDA’s 2015 clinical guideline recommends high-risk HPV testing as the first choice for cervical cancer screening to detect precancerous lesions early and kill cervical cancer in its “cradle”. Why test for HPV? Four out of five women will be infected with HPV at some point in their lives, and there are more than 100 different types of HPV known, most of which are considered “low risk” and not associated with cervical cancer. Persistent infection with 13 genotypes of oncogenic human papillomavirus (HPV) (HPV16, HPV18, HPV31, HPV33, hpv35, hpv39, HPV45, hpv51, HPV52, hpv56, HPV58, hpv59, and hpv68) can cause cervical cancer. However, the risk of progression to cervical cancer and precancerous lesions varies according to the oncogenic genotype of the individual. It is estimated that 90% of cervical cancer cases worldwide are infected with HPV in the eight oncogenic HPV genotypes (HPV16, HPV18, HPV31, HPV33, HPV35, HPV45, HPV52, and HPV58), with HPV16 and HPV18 being the two most common genotypes associated with cervical cancer, at up to 70%. To date, genotyping, including two types (HPV16/18) and eight types (2 + HPV31/33/35/45/52/58) has been included in clinical guidelines for cervical cancer prevention. Compared to women without HPV infection, women carrying these two strains are 35 times more likely to develop cervical precancerous lesions even if they have normal cytology results. Interpretation of HPV test results 70-80% of women are infected with HPV during their lifetime, and the majority of women clear it by themselves within 6-12 months after infection, while only a minority of women will continue to be infected and eventually develop cervical cancer. Through active treatment and strengthening of immunity, the virus can be cleared; however, persistent infection with high-risk HPV, especially the single type, is the most important risk factor for the malignant transformation of cervical epithelium, and theoretically, it takes about 10-15 years from high-risk HPV infection to cervical cancer. About HPV Vaccine There is no HPV vaccination in China yet, so many women go to Hong Kong and other places to get the vaccine. HPV vaccine is the first human attempt to eradicate a cancer through a vaccine. There are two types of HPV vaccines currently used worldwide. GlaxoSmithKline’s Cervarix (Huoyancon) is a bivalent vaccine, targeting HPV types 16 and 18. Merck’s Gardasil is a quadrivalent vaccine, targeting HPV types 16, 18A, 11 and 6. Gardasil also provides additional protection against genital warts such as condyloma acuminatum. Although the current vaccine does not cover all HPV virus subtypes, 70% of all cervical cancer occurrences are associated with HPV types 16 and 18, while HPV types 6 and 11 may be closely related to the occurrence of warts such as condyloma acuminata, meaning that the HPV vaccine may prevent 70% of cervical cancers. One of the differences between these two vaccines is that Gardasil is used for the prevention of genital warts in men in addition to women. When should I get the HPV vaccine? The age at which the HPV vaccine is appropriate varies from country to country, ranging from 9-45 years old globally, to 9-26 years old for FDA approval. The last injection is given 6 months later. HPV vaccination is not effective at ages younger than 9 years because the immune system is not fully established, and people who are allergic to yeast should not receive the vaccine. Although no adverse effects of HPV vaccine on the fetus have been found, there is still insufficient data to support this and therefore HPV vaccination is not recommended for pregnant women. In addition, pregnancy can occur immediately after HPV vaccination and does not require additional time to “digest” the vaccine. Therefore, as mentioned above, HPV infection is a necessary condition for the development of cervical cancer, and annual monitoring of HPV infection is essential, and screening is currently the main tool for prevention and early diagnosis of cervical cancer. HPV infection can be transmitted not only directly through sexual contact, but also indirectly through environmental pollutants in public places, baths, public toilets, bath tubs, swimming pools, and through vertical transmission to newborns. There is a long process from HPV infection to cervical cancer. Early detection, diagnosis and treatment is an important method to prevent cervical cancer, and the role played by routine HPV testing plays an important role in it.