Prospects for controlling cervical cancer at the turn of the century
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| Formato: | Artículo científico |
| Lenguaje: | en |
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Instituto Nacional de Salud Pública
2003
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| _version_ | 1876423182978646016 |
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| author | Eduardo L. Franco |
| author_facet | Eduardo L. Franco |
| contents | Prospects for controlling cervical cancer at the turn of the century Eduardo L. Franco Eliane Duarte Alex Ferenczy Salud human screening Pap cytology papillomavirus cervical neoplasms Cervical cancer morbidity and mortality have decreasedsubstantially during the last 50 years mostly due to successfulorganized or opportunistic screening with Pap cytologyin high and middle income countries. In many low incomecountries Pap cytology screening is yet to be effectivelyimplemented or has failed to reduce cervical cancer ratesto an appreciable extent. The fact that infection with certainhuman papillomavirus (HPV) types is now recognizedas a necessary cause of this disease has led to new researchfronts on prevention of cervical cancer. Testing for HPV DNAhas shown great promise as a screening tool with bettersensitivity but somewhat lower specificity than Pap cytology.In combination with the latter, HPV testing has the potentialto improve the negative predictive value of cytology,thus allowing for increased testing intervals, which wouldlower program costs with acceptable safety. Advances incytology processing and automation have also led to newscreening approaches that are increasingly gaining acceptancein high and middle income countries. For low incomecountries, visual inspection with acetic acid has proven tobe an effective alternative to conventional Pap cytology, especiallyin settings where no screening programs have beenimplemented. Concerning primary prevention of cervicalcancer, recent research on the safety and efficacy of candidateprophylactic vaccines against HPV have shown verypromising results with nearly 100% efficacy in preventingpersistent infections and development of cervical cancerprecursors. However, policy makers are strongly cautioned pretoavoid deferring decisions concerning the implementationof cervical cancer screening under the expectation thata successful vaccine could obviate the need for secondaryprevention strategies. This paper is available too at: http://www.insp.mx/salud/index.html 2003 artículo científico 0036-3634 https://www.redalyc.org/articulo.oa?id=10609711 en http://www.redalyc.org/revista.oa?id=106 Salud Pública de México application/pdf Instituto Nacional de Salud Pública Salud Pública de México (México) Num.3 Vol.45 |
| format | Artículo científico |
| id | redalyc_10609711 |
| institution | Redalyc |
| language | en |
| publishDate | 2003 |
| publisher | Instituto Nacional de Salud Pública |
| spellingShingle | Prospects for controlling cervical cancer at the turn of the century Eduardo L. Franco Salud human screening Pap cytology papillomavirus cervical neoplasms Prospects for controlling cervical cancer at the turn of the century Eduardo L. Franco Eliane Duarte Alex Ferenczy Salud human screening Pap cytology papillomavirus cervical neoplasms Cervical cancer morbidity and mortality have decreasedsubstantially during the last 50 years mostly due to successfulorganized or opportunistic screening with Pap cytologyin high and middle income countries. In many low incomecountries Pap cytology screening is yet to be effectivelyimplemented or has failed to reduce cervical cancer ratesto an appreciable extent. The fact that infection with certainhuman papillomavirus (HPV) types is now recognizedas a necessary cause of this disease has led to new researchfronts on prevention of cervical cancer. Testing for HPV DNAhas shown great promise as a screening tool with bettersensitivity but somewhat lower specificity than Pap cytology.In combination with the latter, HPV testing has the potentialto improve the negative predictive value of cytology,thus allowing for increased testing intervals, which wouldlower program costs with acceptable safety. Advances incytology processing and automation have also led to newscreening approaches that are increasingly gaining acceptancein high and middle income countries. For low incomecountries, visual inspection with acetic acid has proven tobe an effective alternative to conventional Pap cytology, especiallyin settings where no screening programs have beenimplemented. Concerning primary prevention of cervicalcancer, recent research on the safety and efficacy of candidateprophylactic vaccines against HPV have shown verypromising results with nearly 100% efficacy in preventingpersistent infections and development of cervical cancerprecursors. However, policy makers are strongly cautioned pretoavoid deferring decisions concerning the implementationof cervical cancer screening under the expectation thata successful vaccine could obviate the need for secondaryprevention strategies. This paper is available too at: http://www.insp.mx/salud/index.html 2003 artículo científico 0036-3634 https://www.redalyc.org/articulo.oa?id=10609711 en http://www.redalyc.org/revista.oa?id=106 Salud Pública de México application/pdf Instituto Nacional de Salud Pública Salud Pública de México (México) Num.3 Vol.45 |
| title | Prospects for controlling cervical cancer at the turn of the century |
| topic | Salud human screening Pap cytology papillomavirus cervical neoplasms |
| url | https://www.redalyc.org/articulo.oa?id=10609711 |