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{{Cervical cancer}}
{{Cervical cancer}}
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==Overview==
==Overview==
Secondary prevention strategies following cervical cancer include [[pap test]], HPV test, and colposcopy .
Secondary prevention strategies following cervical cancer are mainly include [[pap test]], [[HPV]] [[DNA]] test and [[colposcopy]].  
===Screening===
===Screening===
The widespread introduction of the [[pap smear|Papanicolaou test]], or ''pap smear'' for cervical cancer screening has been credited with dramatically reducing the incidence and mortality of cervical cancer in developed countries.<ref>[http://www.aafp.org/afp/20000301/1369.html]</ref> The pap smear suggests the presence of [[cervical intraepithelial neoplasia]] (premalignant changes in the cervix) before a cancer has developed, allowing for further workup. Recommendations for how often a Pap smear should be done vary from once a year to once every five years. The [[American Cancer Society]] recommends that cervical cancer screening should begin approximately three years after the onset of vaginal intercourse and/or no later than twenty-one years of age.<ref>{{cite journal |author=Saslow D, Runowicz CD, Solomon D, ''et al'' |title=American Cancer Society guideline for the early detection of cervical neoplasia and cancer |journal=CA: a cancer journal for clinicians |volume=52 |issue=6 |pages=342-62 |year=2002 |pmid=12469763 |doi=}}</ref> If premalignant disease or cervical cancer is detected early, it can be treated relatively noninvasively, and without impairing fertility.
* The widespread introduction of the [[pap smear|Papanicolaou test]], or ''pap smear'' for cervical cancer screening has been reduced the incidence and mortality of cervical cancer in developed countries. <ref name="OgilvieNakisige2017">{{cite journal|last1=Ogilvie|first1=Gina|last2=Nakisige|first2=Carolyn|last3=Huh|first3=Warner K.|last4=Mehrotra|first4=Ravi|last5=Franco|first5=Eduardo L.|last6=Jeronimo|first6=Jose|title=Optimizing secondary prevention of cervical cancer: Recent advances and future challenges|journal=International Journal of Gynecology & Obstetrics|volume=138|year=2017|pages=15–19|issn=00207292|doi=10.1002/ijgo.12187}}</ref>  
* 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.<ref name="KoseNaki2014">{{cite journal|last1=Kose|first1=Faruk M.|last2=Naki|first2=Murat M.|title=Cervical premalignant lesions and their management|journal=Journal of the Turkish German Gynecological Association|volume=15|issue=2|year=2014|pages=109–121|issn=13090399|doi=10.5152/jtgga.2014.29795}}</ref>
* 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. <ref name="pmid12525422">{{cite journal |vauthors=Burd EM |title=Human papillomavirus and cervical cancer |journal=Clin. Microbiol. Rev. |volume=16 |issue=1 |pages=1–17 |date=January 2003 |pmid=12525422 |pmc=145302 |doi= |url=}}</ref>
* [[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). <ref name="Grce2014">{{cite journal|last1=Grce|first1=Magdalena|title=Primary and secondary prevention of cervical cancer|journal=Expert Review of Molecular Diagnostics|volume=9|issue=8|year=2014|pages=851–857|issn=1473-7159|doi=10.1586/erm.09.64}}</ref>
* [[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.<ref name="Aggarwal2014">{{cite journal|last1=Aggarwal|first1=Pakhee|title=Cervical cancer: Can it be prevented?|journal=World Journal of Clinical Oncology|volume=5|issue=4|year=2014|pages=775|issn=2218-4333|doi=10.5306/wjco.v5.i4.775}}</ref> 


The [[HPV test]] is a newer technique for cervical cancer screening which detects the presence of [[human papillomavirus]] infection in the cervix. It is more [[sensitivity (tests)|sensitive]] than the pap smear (less likely to produce false negative results), but less specific (more likely to produce false positive results) and its role in routine screening is still evolving. Since more than 99% of invasive cervical cancers worldwide contain HPV, some researchers recommend that HPV testing be done together with routine cervical screening (Walboomers ''et al'', 1999). But, given the prevalence of HPV (around 80% infection history among the sexually active population) others suggest that routine HPV testing would cause undue alarm to carriers.
 
   
*see also [[cervical cancer screening]]
*see also [[cervical cancer screening]]
*see also [[pap smear]]
*see also [[pap smear]]
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==References==
==References==
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{{reflist|2}}
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[[Category:Gynecology]]
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[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:primary care]]
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Latest revision as of 20:51, 29 July 2020

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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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