ABSTRACT
This chapter follows the emergence of molecular HPV testing technologies and their application to cervical cancer screening in the USA. When HPV testing was first commercialised in the late 1980s, screening for cervical cancer had been a routine part of preventive healthcare for at least two decades, with testing conducted by cervical cytologists using the Pap smear test, a technology first developed in the 1910s. Many now predict that molecular HPV tests will eventually replace cervical cytology, bringing fundamental changes to the clinical infrastructure of screening in the process. However, at present these technologies not only co-exist but augment each other. This process of technological accretion has involved not only an accommodation with molecular technologies, but also the widespread adoption of novel cytology technologies: liquid-based cytology (LBC) and automated slide readers. This chapter explores the institutional factors that have shaped this contingent outcome. We begin by setting out the clinical context of cervical cancer screening.
