Widdice Lea E, Moscicki Anna-Barbara
Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
J Adolesc Health. 2008 Oct;43(4 Suppl):S41-51. doi: 10.1016/j.jadohealth.2008.04.007. Epub 2008 Jul 23.
Worldwide, cervical cancer is a major health concern for women of all ages; however the epidemiology and biology of human papillomavirus (HPV) infection differs in female adolescents and adults. In the United States, 50% of adolescent and young women acquire HPV within 3 years after initiating sexual intercourse, resulting in relatively high prevalence rates. Most infections, however, are transient and clear within several months. Consequently HPV infections detected in adolescents are likely to reflect benign disease, whereas infections detected in older women are likely to reflect persistent infections and a higher risk of advanced cervical intraepithelial lesions that can lead to invasive cervical cancer. This article reviews the most recently published guidelines for the prevention of cervical cancer through screening and management of abnormal cervical cytologic and histologic findings, which have been updated to reflect the differences in HPV infections and cervical abnormalities in female adolescents and adults.
在全球范围内,宫颈癌是所有年龄段女性主要的健康问题;然而,人乳头瘤病毒(HPV)感染在女性青少年和成年人中的流行病学及生物学特征有所不同。在美国,50%的青少年及年轻女性在开始性行为后的3年内感染HPV,导致患病率相对较高。然而,大多数感染是短暂的,会在几个月内清除。因此,在青少年中检测到的HPV感染可能反映的是良性疾病,而在老年女性中检测到的感染可能反映的是持续性感染以及发生高级别宫颈上皮内病变的更高风险,这些病变可能会发展为浸润性宫颈癌。本文回顾了最近发布的通过筛查和处理异常宫颈细胞学及组织学检查结果来预防宫颈癌的指南,这些指南已更新,以反映女性青少年和成年人中HPV感染及宫颈异常情况的差异。