Screening and prevention: cervical cancer.

Cervical cancer is the leading cause of cancer death in women in developing countries and significant disparities in cervical cancer mortality rates persist in the United States. Improved recognition of the role of human papilloma virus (HPV) in cervical cancer pathogenesis has recently revolutionized screening and prevention strategies. Improved understanding and implementation of these advances will allow primary care physicians to significantly impact the cervical cancer mortality burden. This article reviews the basic physiology of the transformation zone, current understanding of cervical cancer pathogenesis, the history and evolution of cervical cancer screening in general and in specific populations of women, and an overview of the development and current use of the HPV vaccine.