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Current limits of cervical cancer prevention in the Czech republic


Authors: J. Sláma
Authors‘ workplace: Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
Published in: Ceska Gynekol 2017; 82(6): 482-486

Overview

Objective:
Cervical cancer represents disease with an unique possibilities of prevention. Despite this fact, it´s still detected excessive number of new cases and deaths annualy in our country. The aim of this work was to identify major limits of cervical cancer prevention in the Czech republic.

Design:
Review article.

Setting:
Department of Obstetrics and Gynecology, General University Hospital and 1st Medical Faculty, Charles University, Prague.

Materials and methods:
The main limit of primary and secondary prevention of cervical cancer is low participation rate of target population. Limits of screening include also inadequate age stratification of examination visits and usage of tests with a limited sensitivity.

Results:
Combination of prophylactic vaccination in HPV-naive population with screening based on HPV DNA testing with selective genotyping are the strategies showing high efficacy, sensitivity and long-term negative predictive value. Essential requirement is as high as possible participation of young girls in national vaccination program and adult women in screening program.

Conclusions:
It cannot be expected further improvement of current results if primary and secondary prevention programs remain unchanged. Necessary steps comprise rising of public education about advantages of vaccination and legislative changes in screening program.

Keywords:
HPV test, cervical cancer, screening, vaccination


Sources

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4. Khan, MJ., Castle, PE., Lorincz, AT., et al. The elevated 10-years risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst, 2005, 20, 97(14), p. 1072–1079.

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8. Whitlock, EP., Vesco, KK., Eder, M., et al. Liquid-based cytology and human papillomavirus testing to screen for cervical cancer: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med, 2011, 15, 155(10), p. 687–697, W214-5.

9. Wright, TC. Jr, Behrens, CM., Ranger-Moore, J., et al. Triaging HPV-positive women with p16/Ki-67 dual-stained cytology: Results from a sub-study nested into the ATHENA trial. Gynecol Oncol, 2017, 144(1), p. 51–56.

10. Wright, TC., Stoler, MH., Behrens, CM., et al. Primary cervical cancer screening with human papillomavirus: end of study results from the ATHENA study using HPV as the first-line screening test. Gynecol Oncol, 2015, 136(2), p. 189–197.

11. www.svod.cz

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 6

2017 Issue 6

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