# Circulating Tumor DNA in Cervical Cancer: Clinical Utility and Medico-Legal Perspectives

## TL;DR

This paper reviews the use of circulating tumor DNA in cervical cancer for prognosis and explores its clinical and legal implications.

## Contribution

The paper provides a comprehensive review of ctHPV DNA detection methods and their medico-legal implications in cervical cancer.

## Key findings

- ctHPV DNA detection is promising for prognosis and recurrence assessment in cervical cancer.
- PCR, ddPCR, and NGS are commonly used for ctHPV DNA detection.
- The paper highlights medico-legal issues like diagnostic errors and data protection compliance.

## Abstract

Cervical cancer related to human papillomavirus (HPV) is a leading cause of cancer-related mortality among women worldwide. Cancer cells release fragments of their DNA, known as circulating tumor DNA (ctDNA), which can be detected in bodily fluids. A PubMed search using the terms “ctHPV” or “circulating tumor DNA” and “cervical cancer”, limited to the past ten years, identified 104 articles, complemented by hand-searching for literature addressing medico-legal implications. Studies were evaluated for relevance and methodological quality. Detection and characterization of circulating tumor HPV DNA (ctHPV DNA) have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer. Detection techniques include polymerase chain reaction (PCR), digital droplet PCR (ddPCR), and next-generation sequencing (NGS). This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications, including management of discordant results, diagnostic errors, liability, and data protection compliance.