The purpose of cervical screening is to prevent the appearance of invasive disease by the detection and appropriate treatment of pre-cancerous abnormalities.
There is compelling evidence that carcinoma of the cervix is associated with the human papilloma virus (HPV), which is transmitted during sexual intercourse. There are many strains of HPV. Types 16 and 18 are the two most commonly found in association with pre-malignancy and malignancy. When both partners enter marriage as virgins and remain faithful to each other, carcinoma of the cervix is rare. This explains why the disease is uncommon in religious communities that adhere to these principles. The sheath provides protection against sexually transmitted disease.
Cells have the potential to become malignant. This probably happens fairly frequently but the immune system usually destroy the abnormal ones (Q32.1).
The principles of screening are discussed in screening tests. Carcinoma of the cervix is a ‘surface’ disease. With a vaginal speculum the cervix can be readily visualised and cells sampled. There can be little doubt that screening has reduced the incidence of carcinoma of the cervix. Studies suggest that since the introduction of screening there has been a reduction of about 70%. Despite screening with cytology there remains a 30% incidence of malignancy. There is, therefore, a need for further improvement.
Liquid-based cytology involves placing sampling with a brush rather that a spatula and the brush is shaken into a liquid rather than producing a slide. This may prove to be more accurate than conventional smears.
Recently, there has been the development of a vaccine for immunisation against pre-malignancy and malignancy of the cervix - Gardasil - Sanofi Pasteur MSD. It has been suggested that vaccination will reduce the risk of cervical cancer by 70%.0605HPV Types 16 and 18 cause 70% of cervical cancer cases, and HPV Types 6 and 11 cause 90% of genital warts cases.
Gardasil may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings. Anyone who is allergic to the ingredients of GARDASIL should not receive the vaccine. GARDASIL is not for women who are pregnant. GARDASIL will not treat these diseases and will not protect against diseases caused by other types of HPV. GARDASIL is given as 3 injections over 6 months and can cause pain, swelling, itching, and redness at the injection site, fever, nausea, and dizziness. Only a doctor or healthcare professional can decide if GARDASIL is right for you or your daughter.
The recent literature on adolescent knowledge about HPV and attitudes about HPV vaccines supports the importance of designing developmentally appropriate educational materials for adolescents about HPV and HPV vaccines, and provides guidance for the development of key educational messages.0801
Related Medical Abstracts - Click on the paper title:-
- Education about human papillomavirus and human papillomavirus vaccines in adolescents.(2008-01)
- Prophylactic HPV Vaccines. (2007-01)
- Review of current knowledge on HPV vaccination: An Appendix to the European Guidelines for Quality Assurance in Cervical Cancer Screening. (2007-02)
- Strategies for the introduction of human papillomavirus vaccination: modelling the optimum age- and sex-specific pattern of vaccination in Finland. (2007-03)
- Ensuring access to HPV vaccines through integrated services: a reproductive health perspective. (2007-04)
- Seroprevalence of human papillomavirus types 16 and 18 in the general population in Taiwan: Implication for optimal age of human papillomavirus vaccination. (2007-05)
- How will HPV vaccines affect cervical cancer? (2006-01)
- Improved endocervical sampling and HPV viral load detection by Cervex-Brush Combi. (2006-02)
- Prospects for cervical cancer prevention by human papillomavirus vaccination. (2006-03)
- HPV vaccination with Gardasil: a breakthrough in women's health. (2006-04)
- Using the new HPV vaccines in clinical practice. (2006-05)
- The human papillomavirus vaccines. (2006-06)A study of women's knowledge regarding human papillomavirus infection, cervical cancer and human papillomavirus vaccines. (2006-06)
- A study of women's knowledge regarding human papillomavirus infection, cervical cancer and human papillomavirus vaccines. (2006-07)
- Assessment of knowledge and attitudes of young uninsured women toward human papillomavirus vaccination and clinical trials. (2006-08)
- Pediatricians' intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. (2005-01)
- Human papillomavirus vaccine as a new way of preventing cervical cancer: a dream or the future? (2004-01)
- Human papillomavirus vaccine as a new way of preventing cervical cancer: a dream or the future? (2004-02)Primary screening for cervical cancer precursors by the combined use of liquid-based cytology, computer-assisted cytology and HPV DNA testing. (2002-01)
- Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. (2001-01)Utility of liquid-based cytology for cervical carcinoma screening: results of a population-based study conducted in a region of Costa Rica with a high incidence of cervical carcinoma. (1999-01)International incidence rates of invasive cervical cancer after introduction of cytological screening (1997)
- Treatment of pre-invasive conditions during opportunistic screening and its effectiveness on cervical cancer incidence in one Norwegian county (1997)Cervical specimens collected in liquid buffer are suitable for both cytologic screening and ancillary human papillomavirus testing. (1997-03)
Please click on the required question.
- 1 What is the cervix?
- 2 What is a cervical polyp?
- 3 What is meant by cervical erosion (ectopy) and cervicitis?
- 4 What is the transformation zone?
- 5 What is a 'Paptest' (PAP test (cervical smear) test)
- 6 My PAP smear test (cervical smear) shows inflammation. Should I be worried?
- 7 What are cells and what is an abnormal (pre- malignant) cell?
- 8 My PAP smear test (cervical smear) shows abnormal cells. Does this mean that I have cancer?
- 9 What is meant by the terms pre-malignant cells, dyskaryosis, dysplasia and CIN?
- 10 What are the symptoms of pre-malignancy of the cervix?
- 11 What are benign and malignant tumours?
- 12 Why have I developed a pre-malignant condition of my cervix?
- 13 What is colposcopy?
- 14 What treatments are available for pre-malignant conditions of the cervix?
- 15 Can pre-malignant conditions of the cervix be cured?
- 16 How can I be re-assured that the pre-malignant changes will not recur?
- 17 How can we prevent carcinoma of the cervix?
- 18 Is there a reason to screen for HPV?
- 19 Support Groups.
- 20 Are there any support groups?
The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.
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This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided. If you still have unanswered questions, please consider entering them into one of our forums and I will try to assist you.
The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.David Viniker retired from active clinical practice in 2012.
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