In the United States (US), approximately 13,170 patients are diagnosed with cervical cancer each year, and over 4200 will die from it. It is the second leading cause of cancer death in patients with a uterus aged 20 to 39 years.

Cervical cancer incidence and mortality disproportionately affect Black, Hispanic/Latino patients, and American Indian and Alaskan Native patients, who have rates almost twice as high as White patients.

Approximately 50% of patients diagnosed with cervical cancer in the US have not had adequate screening. Lack of follow-up after screening contributes to the disparity in cervical cancer incidence and mortality.

Persistent infection with the oncogenic (high-risk) human papillomavirus (HPV) types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 is required but not sufficient to develop cervical cancer and its precursor lesions. HPV 16 is the most common carcinogenic genotype, followed by HPV 18. Together, they are responsible for 70% of HPV-related cervical cancers. Although approximately 80% of patients with a uterus will be infected through sexual intercourse by an HPV type at some point in their lives, 90% of these infections are transient and will be cleared immunologically within 1 to 2 years.

Risks for persistent infection include tobacco exposure and immune compromise, including coinfection with human immunodeficiency virus (HIV) and conditions such as autoimmune disease. HPV infection in patients older than 30 years is more likely to indicate a persistent infection than detectable HPV in younger patients. Cervical cancer is thought to occur after a median of 20 to 25 years following the initiation of a persistent HPV infection.

The conventional cervical cytology smear or the liquid-based cytology (both referred to as Pap smear) is used as a screening test to identify the presence of visually abnormal cervical epithelial cells. Either technique is acceptable, but liquid-based cytologic specimens perform better in the presence of blood or mucous and offer the ability to perform reflex or concurrent HPV testing.

Annually, 4.8 million patients have an abnormal Pap smear in the US. Cytologic abnormalities are categorized using the Bethesda system.