Molecular markers in cervical screening – a promise for the future

Cervical cancer is one of the leading cancers in women worldwide. The detection and diagnosis of cervical carcinoma and its precursor lesions, called cervical intraepithelial lesions (CIN), represents the main goal in order to decrease the morbidity and mortality of this disease. In the majority of cases CIN resolve spontaneously. Only a minor part of the lesions develop to high-grade lesions and eventually invasive cancer and it is important to detect those CIN with potential to progress to cervical cancer. For clinical management it is important to distinguish the cervical dysplasia with regression potential in order to avoid unnecessary treatments. Many potential biomarkers have been analyzed for the characterization of cervical cancer and pre-cancer. So far, detection of HPV has been the most promising clinical application. Several new markers have been evaluated intensively and might be used in some clinical settings, mainly p16, MCM5/CDC6 and HPV RNA, integration of HPV DNA into the host genome, chromosomal imbalances. In this article, representative examples of these markers are presented in the context of improved cervical disease detection and progression.