Nahar K N, Nessa A, Shamim S, Nasrin B, Hossain F, Begum N
Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jul;20(3):528-35.
Cervical cancer is one of the few highly preventable cancers. The early detection and removal of precancerous cervical lesions effectively abolish the development of invasive cervical cancer. The Pap test has been the standard screening test in the Western world for the last five decades. Visual inspection of cervix with acetic acid (VIA) is currently more popular method of cervical cancer of screening test in low resource countries. Cervical cancer incidence and mortality have been reduced dramatically as a result of successful screening in many countries. Cancer cervix can be prevented through both primary prevention using human papilloma virus (HPV) vaccine and early detection using screening techniques. Several screening modalities are now available for early detection of cervical cancer and its precursor lesions. They all differ with regard to their test characteristics, feasibility and economic considerations. This review has different aspects of these screening modalities and provides different options considering mass application. In developed countries, Pap smear cytology is used for cervical cancer screening. But in low-resource country, like Bangladesh, it is too expensive and is not feasible. VIA, a non-cytological test is a simple and inexpensive test which can be provided by trained paramedical personnel with a short training. So VIA can be done in low-resource countries for screening of cervical cancer as an alternative to Pap smear cytology.
宫颈癌是少数几种高度可预防的癌症之一。早期发现并切除宫颈癌前病变可有效避免浸润性宫颈癌的发生。巴氏试验在过去五十年一直是西方世界的标准筛查试验。在资源匮乏的国家，用醋酸目视检查宫颈（VIA）是目前更常用的宫颈癌筛查方法。由于许多国家成功开展了筛查，宫颈癌的发病率和死亡率已大幅降低。宫颈癌既可以通过使用人乳头瘤病毒（HPV）疫苗进行一级预防，也可以通过筛查技术进行早期检测来预防。目前有几种筛查方式可用于早期检测宫颈癌及其前驱病变。它们在检测特性、可行性和经济考量方面各有不同。本综述探讨了这些筛查方式的不同方面，并考虑大规模应用提供了不同的选择。在发达国家，巴氏涂片细胞学检查用于宫颈癌筛查。但在资源匮乏的国家，如孟加拉国，这过于昂贵且不可行。VIA作为一种非细胞学检查，是一种简单且廉价的检测方法，经过短期培训的辅助医务人员即可操作。因此，在资源匮乏的国家，VIA可作为巴氏涂片细胞学检查的替代方法用于宫颈癌筛查。
