AUSL Reggio Emilia, Epidemiology Unit, Reggio Emilia, via Amendola 2, 42122, Reggio Emilia, Italy.
Curr Pharm Des. 2013;19(8):1490-7.
The identification of HPV as the cause of cervical cancer has changed the information required for surveillance. HPV prevalence and screening uptake worldwide are now necessary to describe the epidemiology of this cancer. In low-income countries cervical cancer incidence varies from low to very high levels and is strongly influenced by virus prevalence. In high-income countries, instead, incidence is low and little influenced by the virus prevalence, thanks to screening. The European Guidelines currently recommend Pap test every 3-5 years starting at age 22-30 and stopping at age 60-65. HPV testing is now limited to triage of borderline lesions? and to post-CIN follow up. Pilot studies evaluating HPV testing as primary test are recommended. Future governmental agency Guidelines in Europe will probably include HPV testing as viable for primary screening, with cytology triage for HPV-positive women (those positive to cytology will be directly referred to colposcopy, those negative will repeat HPV at one year. Persistence of HPV positivity will refer to colposcopy directly, clearance to regular screening). The interval after an HPV-negative test should be at least 5 years and starting age should be age 30/35. Pap test is still recommended for women under 30.
HPV 的鉴定改变了宫颈癌监测所需的信息。HPV 流行率和筛查参与率是描述这种癌症的流行病学的必要条件。在低收入国家，宫颈癌发病率从低到很高，并且受病毒流行率的强烈影响。在高收入国家，由于筛查，发病率较低，受病毒流行率影响较小。目前，欧洲指南建议从 22-30 岁开始，每 3-5 年进行一次巴氏涂片检查，直到 60-65 岁。HPV 检测现在仅限于对边界病变的分流？以及 CIN 后的随访。建议进行评估 HPV 检测作为初筛的试点研究。未来欧洲政府机构的指南可能将 HPV 检测纳入初筛，对 HPV 阳性女性进行细胞学分流（细胞学阳性者将直接转诊行阴道镜检查，细胞学阴性者将在一年后再次进行 HPV 检测。HPV 持续阳性者直接转诊行阴道镜检查，HPV 阴性者恢复常规筛查）。HPV 阴性检测后的间隔应至少为 5 年，起始年龄应为 30/35 岁。巴氏涂片检查仍推荐用于 30 岁以下的女性。
