Cervical Cancer prevention by Screening

CERVICAL CANCER SCREENING

You can prevent cervical cancer with screening. Screening is the search for diseases, such as cancer, in people without symptoms. Screening has saved thousands of lives. You should get screened for cervical cancer on a regular basis. Cervical cancer can be prevented!

AVAILABLE SCREENING, TESTS FOR CERVICAL CANCER

  • Conventional cytology (Pap) smear
  • Liquid based cytology
  • Automated cervical screening techniques
  • HPV testing
  • Visual inspection of cervix after applying Lugol’s iodine(VILI) or acetic acid (VIA).
  • Speculoscopy

Liquid based cytology (LBC)

Cell sample is collected from the cervix in the same way as for a Pap smear.

Sampled cells are then transferred into a vial of collection fluid .

Sample is sent to a laboratory to be processed and transferred onto a slide .

Several commercial systems can be used for preparing LBC smears, e.g.

ThinPrep (Hologic, Bedford, MA, USA)

BD SurePath system (BD, Franklin Lakes, NJ, USA)

HPV-DNA TESTING

New screening procedures based on the detection of high-risk HPV DNA in vaginal or cervical smears.

A sample of cells is collected from the cervix or vagina using a swab or small brush, and placed in a small container with a preservative solution.

The high cost, and the need for both a molecular laboratory and reliable methods of transport, present major challenges, so not yet feasible in low-resource settings.

A new, faster, highly sensitive and less costly test for HPV is under development but is not yet available.

LOW COST SCREENING STRATEGIES FOR CERVICAL CANCER

Currently, cervical cytology is widely regarded as the gold standard for cervical cancer screening in all developed countries. It is however not feasible to implement a systematic cytology based screening programme in a developing country like Nigeria. This is mainly due to severe restrictions on the availability of infrastructure, human & other resources, and funding. Low-cost, easy methods have been developed.

Visual inspection of the cervix with acetic acid (VIA)

Involves using naked eyes to view the cervix 1-2 mins after application of 3-5% acetic acid (vinegar) or logul’s iodine – CIN and early-stage cervical cancers turn aceto-white.

Objective of VIA is to detect this aceto-white lesions (VIA positive) leading to the early diagnosis of pre malignant lesions and early preclinical, asymptomatic invasive cancer.

CHALLENGES

  • Lack of radiotherapy facilities
  • Increasing the capacity human resource
  • Awareness to cervical screening
  • Awareness to vaccination

CONCLUSIONS

The global burden of cervical disease and cancer is substantial.

100% of cervical cancer cases are caused by HPV.

HPV infections are very common and women remain at risk from HPV infection throughout their sexually active lives.

Most HPV-related lesions resolve naturally; progression to cervical cancer is a relatively rare event.

A key factor in allowing disease to progress is the ability of HPV to evade the immune system and establish a persistent infection.

Prophylactic HPV vaccines have been developed to induce HPV-specific immune responses that prevent infection.

Before the advent of vaccines, cervical screening was the principal means of preventing cervical cancer.

Even with effective screening, deaths from cervical cancer still occur.

Vaccination plus screening is the most effective approach to reduce the incidence of cervical cancer

Both vaccines have good efficacy, immunogenicity and safety profiles.

ADVICE: SCREEN FOR CERVICAL CANCER

VACCINATE YOURSELF AND YOUR DAUGHTER AGAINST HPV TELL YOUR
FRIENDS,SISTERS,WIVES,MOTHERS,COLLEAGUES,NEIGHBOURS, AND EVERY WOMAN IN YOUR LIFE



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