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Widespread adoption of population-based screening has been associated with marked decreases in cervical cancer incidence and mortality in the United States over the last few decades. Despite these gains, an estimated 13 240 US women were diagnosed with cervical cancer in 2018, and 4170 died from the disease.1
A large body of consistent evidence implicates infection with high-risk types of human papillomavirus (hrHPV) as the causative agent in cervical cancer. These infections are common, occurring in the majority of sexually active women over their lifetime.2 While most infections resolve without clinical consequence over a period of several years, persistent infections can lead to high-grade precancerous cervical lesions (such as cervical intraepithelial neoplasia [CIN] grades 2 and 3) that can progress to cervical cancer. Approximately 30% of CIN grade 3 lesions progress to invasive cancer over a 30-year period.2 This slow progression allows many opportunities for these lesions to be detected and treated, thereby disrupting the trajectory to cancer.
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Corresponding Author: George F. Sawaya, MD, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 550 16th St, Seventh Floor, San Francisco, CA 94143 (email@example.com).
Conflict of Interest Disclosures: Dr Sawaya reported receipt of grants from the National Cancer Institute (NCI) during the conduct of the study. Dr Smith-McCune reported receipt of grants from the National Institutes of Health (NIH) during the conduct of the study. Dr Kuppermann reported grants from NIH/NCI during the conduct of the study.
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