[Screening and vaccination in prevention of cervical cancer]

ABSTRACT

Cancer of cervix is the second most common cancer among women worldwide, with a frequency of more than 500000 cases every year. The mean age for cervical cancer is 51/4 years and the most common type is squamous cell carcinoma. HPV can be found in a growing proportion of patients with cervical cancer,approaching 100%. HPV 16 is the most prevalent in cervical cancer, followed by HPV 18 and 33. As half of cervical cancer cases are diagnosed as an advanced at the time of stage and with the techniques available, remain untreatable. During the past 20 years, vast research has been focused to unveil definite diagnostic techniques production of vaccines and new management modalities. Cultural status, habits and social behavior of women have an important bearing in the occurence and morbidity and mortality due to this disease. Minority class and woman with low income and women with low income undergo less screening. In America and Northern Europe, the Major cause for a reduction in the morbidity and mortality of cervical cancer has been the execution of screening at a large scale resulting in a 70% reduction in morbidity and mortality due to cervical cancer. On the other hand, in Iran according to the available statistics, the leading cause of a delayed diagnosis of cervical cancer has been the absence of the performance of Pap smear test. A high rate of false negative smears and atypical squamous cells [ASC] diagnoses have led to the development of new diagnostic techniques. More recently, the use of liquid-based technologies such as Thin Prep and AutoCyte Prep have gained popularity; It has been held till today that pap smear might increase the sensitivity of detecting cervical dysplasia. In reviewing the published literature about the efficacy of this technique and the endorsement of the results of screening, information is lacking HPVDNA typing can be used concurrently with pap smear in cases where pap smear is abnormal. A negative combination test [Pap smear HPVDA typing] in contrast three-repeated Pap smear tests shall provide more reliability as regards the absence of neoplasia in future. In the year 2003, FDA approved the use of Hybrid capture 2 Assay for HPVDVA typing along with Pap smear in women above 30 years of age, so that high risk in faction in these woman is subjected to screening