Schematic representation of progressive changes of HPV tumorigenesis from HPV infection, to viral integration into host genome, to transcription of viral E6/E7 mRNA, to translation into viral oncoproteins, to altered expression of cellular proteins including overexpression of the p16 tumor suppressor gene product. Advances in detection assays now permits visualization of these sequential steps using DNA in situ hybridization, RNA in situ hybridization, and p16 immunohistochemistry.