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

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.