Moscicki Anna-Barbara
Division of Adolescent Medicine, University of California San Francisco, 3333 California Street, San Francisco, CA 94118, USA.
Adolesc Med State Art Rev. 2010 Aug;21(2):347-63, x-xi.
Review of the most recent evidence indicates that screening for cervical cancer in females younger than 21 years of age likely leads to more harm than good. In addition, screening during adolescence has not lead to decreased cervical cancers in this age group. The rate of cervical cancer remains extremely low in adolescents. In contrast, abnormal cytology is extremely common, of which most is benign. Hence, referral to colposcopy is unnecessary and costly. New guidelines recommend cervical cancer screening to start at the age of 21 years and to not be based on sexual behavior. The exception is for immunocompromised girls, who should be screened once intercourse is initiated, since they are at increased risk for cervical cancer. Recently, we have also broadened our understanding about human papillomavirus-associated disease in men. In this chapter, we cover the advances in science that have led to new screening recommendation for cervical cancer and the advances in prevention: vaccines for both adolescent women and men.
对最新证据的审查表明，对21岁以下女性进行宫颈癌筛查可能弊大于利。此外，青春期筛查并未使该年龄组的宫颈癌发病率降低。青少年宫颈癌发病率仍然极低。相比之下，细胞学异常极为常见，其中大多数是良性的。因此，转诊至阴道镜检查既无必要又成本高昂。新指南建议宫颈癌筛查从21岁开始，且不基于性行为。免疫功能低下的女孩是例外，一旦开始性行为就应进行筛查，因为她们患宫颈癌的风险增加。最近，我们对男性人乳头瘤病毒相关疾病也有了更广泛的认识。在本章中，我们将介绍促成宫颈癌新筛查建议的科学进展以及预防方面的进展：针对青春期女性和男性的疫苗。
