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Cervical Cancer

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Cervical Cancer

NIH - Medical Encyclopedia Cervical Cancer

"Cervical cancer is cancer that starts in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina. … Worldwide, cervical cancer is the third most common type of cancer in women. … Cervical cancers start in the cells on the surface of the cervix. There are two types of cells on the cervix's surface: squamous and columnar. The majority of cervical cancers are from squamous cells. The development of cervical cancer is very slow. It starts as a pre-cancerous condition called dysplasia. This pre-cancerous condition can be detected by a Pap smear and is 100% treatable. That is why it is so important for women to get regular Pap smears … Undetected, pre-cancerous changes can develop into cervical cancer and spread to the bladder, intestines, lungs, and liver. … Almost all cervical cancers are caused by HPV (human papillomavirus). … Other risk factors for cervical cancer include: • Having sex at an early age • Multiple sexual partners • Sexual partners who have multiple partners or who participate in high-risk sexual activities • Women whose mothers took the drug DES (diethylstilbestrol) during pregnancy in the early 1970s to prevent miscarriage • Long-term use of birth control pills (more than 5 years) • Weakened immune system • Infections with genital herpes or chronic chlamydia infections • Poor economic status (may not be able to afford regular Pap smears)."

Highlighted Articles

[Clearance, persistence and recurrence of HPV infection.] (Gynecol Obstet Fertil. 2008) “The longitudinal studies show that "recurrent" HPV infections offer no evidence that the recurrent episode is correlated with reemergence of the same strain or another strain of the same genotype (wild or variant), but the sequential detection of other HPV type is common. The studies offer no evidence of competition between HPV types but frequently show an increased risk of acquisition of new HPV types in patients already infected compared with those who are HPV-negative.”

Prevalence of HPV Infection Among Females in the United States (JAMA. 2007) "Results The overall HPV prevalence was 26.8% … among US females aged 14 to 59 years … HPV prevalence was 24.5% (19.6%-30.5%) among females aged 14 to 19 years, 44.8% (36.3%-55.3%) among women aged 20 to 24 years, 27.4% (21.9%-34.2%) among women aged 25 to 29 years, 27.5% (20.8%-36.4%) among women aged 30 to 39 years, 25.2% (19.7%-32.2%) among women aged 40 to 49 years, and 19.6% (14.3%-26.8%) among women aged 50 to 59 years. There was a statistically significant trend for increasing HPV prevalence with each year of age from 14 to 24 years … followed by a gradual decline in prevalence through 59 years … HPV is common among females in the United States. Our data indicate that the burden of prevalent HPV infection among females was greater than previous estimates and was highest among those aged 20 to 24 years."

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Cervical Cancer

Diagnosis, Imaging, and Screening

NEWS:

Failure To Be Screened At Recommended Intervals Is Major Risk Factor For Cervical Cancer

Unnecessary Treatment Of Some Cervical Cancer Patients Can Be Prevented By MRI And PET/CT

Watchful Waiting May Be Appropriate for Some Women With HPV “Cervical HPV infection is not a disease per se but is a marker for potential future cervical cancer, but the risk for cancer after a single-time HPV infection is low, especially in young women, whereas persistent infections with types of carcinogenic HPV are more likely to increase the risk for cervical cancer. … • One-time detection of infection with carcinogenic HPV is associated with a high rate of clearance of 67% by 12 months. • Persistence of carcinogenic HPV infection, in particular HPV-16, is associated with a higher risk for progression to CIN2+, especially in women younger than 30 years. “

ARTICLES:

Imaging of lymph node metastases in cervical cancer.

Liquid Pap No More Sensitive Than Conventional Pap in Cervical Cancer Screening and Prevention

Results of Pap Smears and Human Papillomavirus Tests during Cervical Cancer Screening “Twenty-three percent of the women tested positive for HPV. Younger women were more likely than older women to be positive for HPV. Over half of women younger than 30 years with abnormal cells on their Pap smear that were not clearly cancerous had HPV infection. About 9% of women 30 years and older had HPV infection despite having normal Pap smears.”

JOURNAL ARTICLES:

Cost-effectiveness of cervical cancer screening with human papillomavirus DNA testing and HPV-16,18 vaccination. (J Natl Cancer Inst. 2008)

Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis. (CMAJ. 2008) “INTERPRETATION: Sentinel node biopsy has greater accuracy in determining lymph node status among women with primary cervical cancer than current commonly used imaging methods.”

Human papillomavirus testing for primary cervical cancer screening. (Expert Rev Mol Diagn. 2008)

[Prevalence of genital HPV infection among women screened for cervical cancer.] (Rev Saude Publica. 2008) “CONCLUSIONS: High-risk HPV prevalence was high in the sample studied. The highest prevalence of HPV infection was seen in women under 25 years old and then a new increase was seen over the age of 55 and the highest rates were found among those with many sexual partners during their lifetime.”

The performance of human papillomavirus high-risk DNA testing in the screening and diagnostic settings. (Cancer Epidemiol Biomarkers Prev. 2008)





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