Morris Elise, Roett Michelle A
Georgetown University-Providence Hospital Family Medicine Residency, 4000 Reservoir Road NW, Washington, DC 20007.
Fort Lincoln Family Medicine Center, 4151 Bladensburg Road, Colmar Manor, MD 20722.
FP Essent. 2015 Nov;438:18-23.
In 2015 in the United States, it is estimated there will be approximately 12,900 new patients with cervical cancer and 4,100 will die of the disease. If diagnosed at a localized stage, the 5-year survival rate exceeds 90%. Human papillomavirus (HPV) infection is the main risk factor for cervical cancer. Current recommendations for cervical cancer screening include Papanicolaou (Pap) testing every 3 years for women ages 21 to 29 years. For women ages 30 to 65 years, an alternative is screening with Pap and HPV testing every 5 years. If screening results are abnormal, further evaluation can be guided by an algorithm. For a diagnosis of carcinoma in situ or grade 3 cervical intraepithelial neoplasia (CIN), treatment typically involves ablation or excision. Women with CIN 1 or CIN 2 that persists typically are treated with the same methods. For women diagnosed with early-stage invasive cancer, standard treatment is radical hysterectomy. More advanced cancers also are treated with surgery, but chemotherapy and/or radiation also may be used depending on cancer stage. Because most cervical cancer is caused by HPV, it is potentially preventable with HPV vaccination, which is recommended for females and males, ideally beginning at age 11 or 12 years.
2015年在美国，据估计将有大约12900例宫颈癌新发病例，其中4100例将死于该疾病。如果在局部阶段被诊断出来，5年生存率超过90%。人乳头瘤病毒（HPV）感染是宫颈癌的主要危险因素。目前宫颈癌筛查的建议包括：21至29岁的女性每3年进行一次巴氏试验。对于30至65岁的女性，另一种选择是每5年进行一次巴氏试验和HPV检测。如果筛查结果异常，可以通过一种算法来指导进一步评估。对于原位癌或3级宫颈上皮内瘤变（CIN）的诊断，治疗通常包括消融或切除。持续存在CIN 1或CIN 2的女性通常采用相同的方法治疗。对于被诊断为早期浸润癌的女性，标准治疗是根治性子宫切除术。更晚期的癌症也采用手术治疗，但根据癌症分期，也可能使用化疗和/或放疗。由于大多数宫颈癌是由HPV引起的，通过HPV疫苗接种有可能预防，建议女性和男性接种，理想情况下从11或12岁开始。
