Toward a reduction of the global burden of cervical cancer.

Of the 190,000 deaths from cervical cancer that occur annually worldwide, the majority take place in developing countries. Recent advances in our understanding of the causes and natural history of cervical neoplasia and, in particular, the establishment of the central role of human papilloma virus (HPV) infection have created opportunities for the primary and secondary prevention of cervical cancer. In the future, prevention efforts will include the incorporation of HPV testing as an adjunct to or replacement for cytology-based screening programs and the use of recombinant DNA technologies for the development of prophylactic vaccines.