Cervical cancer secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]

Overview

Secondary prevention strategies following cervical cancer are mainly include pap test, HPV DNA test and colposcopy.

Screening

  • The widespread introduction of the Papanicolaou test, or pap smear for cervical cancer screening has been reduced the incidence and mortality of cervical cancer in developed countries. [1]
  • The major advantage of pap smear is its cost effectiveness, also it is easy to perform but the result relies on the quality of sample provided and that is a disadvantage for screening by pap smear.
  • The pap smear suggests the presence of cervical intraepithelial neoplasia (premalignant changes in the cervix) before a cancer developes, allowing for further workup.[2]
  • New method has been developed to increase the sensitivity of Pap smear and it is called liquid based cytology(LBC), it is less time consuming and reduce the amount of unsatisfactory sample collection from cervix but it is mostly available in high income countries.
  • HPV DNA test can be used as an adjunct to cytology, it distinguishes high-risk HPV types from low-risk HPV types. [3]
  • HPV DNA test is more sensitive in detecting high grade cervical lesion, CIN2 and higher. It is also useful for treatment follow up of women with high grade neoplasia and when the result of cytology is equivocal ( atypical squamous cells of undetermined significance). [4]
  • Colposcopy is another method for screening of target poulation and it provides better view of cervix and vagina and helps in accurate grading. Its main disadvantage are need of experienced personnel and its high cost.[5]


References

  1. Ogilvie, Gina; Nakisige, Carolyn; Huh, Warner K.; Mehrotra, Ravi; Franco, Eduardo L.; Jeronimo, Jose (2017). "Optimizing secondary prevention of cervical cancer: Recent advances and future challenges". International Journal of Gynecology & Obstetrics. 138: 15–19. doi:10.1002/ijgo.12187. ISSN 0020-7292.
  2. Kose, Faruk M.; Naki, Murat M. (2014). "Cervical premalignant lesions and their management". Journal of the Turkish German Gynecological Association. 15 (2): 109–121. doi:10.5152/jtgga.2014.29795. ISSN 1309-0399.
  3. Burd EM (January 2003). "Human papillomavirus and cervical cancer". Clin. Microbiol. Rev. 16 (1): 1–17. PMC 145302. PMID 12525422.
  4. Grce, Magdalena (2014). "Primary and secondary prevention of cervical cancer". Expert Review of Molecular Diagnostics. 9 (8): 851–857. doi:10.1586/erm.09.64. ISSN 1473-7159.
  5. Aggarwal, Pakhee (2014). "Cervical cancer: Can it be prevented?". World Journal of Clinical Oncology. 5 (4): 775. doi:10.5306/wjco.v5.i4.775. ISSN 2218-4333.

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