Role of obstetricians and gynecologists in cervical cancer screening / 中华预防医学杂志

ABSTRACT

Cervical cancer is the second leading cause of death due to gynecological malignancy in female patients. If obstetrician and gynecologists could master the mechanisms involved in the development of cell mutation and new tissue, the effectiveness of cervical cancer screening could be greatly increased. In the process of cervical cancer screening, if cervical tissue hyperplasia accompanied by bleeding could be identified by visual inspection and also in line with the conditions of abnormal cells and vascular proliferation, the cervical cancer would be highly suspicious at this time. Taking the tissue of the abnormal part of the cervix should be immediately conducted when conditions are available. If not, the colposcopy and following biopsy should be immediately performed. After these actions, if no cervical abnormalities are found, the visual inspection of cervix should be performed using cervical cytology (Pap smear test) or a human papillomavirus (HPV) test, or a combination of two tests. When the risk of cervical precancerous lesions predicted by screening results is greater than 5%, colposcopy should be required which is unconditional on the screening methods used before. In the area of abnormal cell proliferation and angiogenesis, 5% acetic acid should be applied to observe whether there is acetowhite epithelium. If yes, the cervical precancerous lesions is highly suspicious in the area of acetowhite epithelium and biopsy should be performed. Even if there is no acetowhite epithelium in the blood vessel-rich area, cervical precancerous lesion could not be excluded and the cervical detachment cell diagnosis results could be used. If the results prompt abnormalities, biopsy could be taken continuously in the red area, including the endocervical curettage in the red area of endocervical tissue. Following the above three-step process of cervical cancer screening, obstetricians and gynecologists could easily, accurately and quickly detect the cervical cancer and cervical precancerous lesions, and complete the goal of cervical cancer screening.