[Cervical screening: toward a new paradigm?]. / Un nouveau paradigme pour le dépistage du cancer du col utérin?
J Gynecol Obstet Biol Reprod (Paris)
; 39(2): 102-15, 2010 Apr.
Article
in Fr
| MEDLINE
| ID: mdl-20106606
ABSTRACT
OBJECTIVES:
Analysis of the trials which compare the virologic testing (HPV testing) and the cytology in the cervical screening. MATERIAL ANDMETHODS:
The MedLine database was consulted using the Keywords "cervical screening", "pap smear", "liquid based cytology", "HPV testing", "adults", "adolescents", "cervical intraepithelial neoplasia (CIN)", "uterine cervix cancer". Articles were selected according their concern about the debate of the uterine cervix cancer screening in France.RESULTS:
The HPV testing seems interesting allowing a decreasing delay in the diagnosis of CIN (more diagnosis of CIN2+ in the first round and less during the second one). But, when the two rounds are added, the number of CIN2+ are identical in the two arms (cytology and HPV testing) in all the trials (except the Italian NTCC trial). A negative HPV testing protects the women much longer than cytology can do a delay of five years between two rounds seems ideal. The HPV testing alone increases the detection rate of cervical lesions, which could regress spontaneously and may induce an overtreatment, especially in the youngest population a triage is necessary and the cytology appears to be the best way to select the candidates for colposcopy in case of positive HPV testing and cytology. The HPV infection presents some particularities in adolescent females for this reason, the HPV testing should not be used in this special population. In vaccinated women, a consensus for the screening is necessary.CONCLUSION:
The health care providers in France have to understand the characteristics of the HPV testing its advantages compared to the cytologic screening are only evident in case of an organization of the screening in France and even in Europe.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Papillomaviridae
/
Vaginal Smears
/
Uterine Cervical Neoplasms
/
Mass Screening
/
Papanicolaou Test
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
Country/Region as subject:
Europa
Language:
Fr
Journal:
J Gynecol Obstet Biol Reprod (Paris)
Year:
2010
Document type:
Article
Affiliation country: