Cervical cancer screening needs to take into account a partially vaccinated population and new technologies
A national, well funded and organised program of screening using the conventional Pap smear has significantly reduced the incidence of and mortality from cervical cancer in Australia.1 While the program has been in place, there has been a great increase in knowledge of the pathogenesis of cervical cancer, with certain oncogenic subtypes of human papillomavirus (HPV) shown to be a necessary cause for development of this disease.2 In addition, a national program of vaccination against two of the 15 oncogenic viruses began in April 2007, and tests to detect HPV are now available. Furthermore, research showing that new technologies for screening cervical samples are superior to conventional cytology has also been published.3,4
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- 5. Pharmaceutical Benefits Advisory Committee. Public summary document: Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) recombinant vaccine injection, 0.5ml Gardasil®. Canberra: PBAC, 2006. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/F671233BC33FB47FCA25728E001C5974/$File/gardasil.pdf (accessed Jun 2008).
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- 7. Burchell AN, Winer RL, de Sanjosé S, Franco EL. Epidemiology and transmission dynamics of genital HPV infection. Vaccine 2006; 24 Suppl 3: S52-S61.
- 8. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. College statement: guidelines for HPV vaccine. Melbourne: RANZCOG, 2007. http://www.ranzcog.edu.au/publications/statements/C-gyn18-Guidelines-for-HPV-Vaccine.pdf (accessed Mar 2008).
- 9. Castle PE, Sideri M, Jeronimo J, et al. Risk assessment to guide the prevention of cervical cancer. Am J Obstet Gynecol 2007; 197: 356.e1-356.e6.
- 10. Davey E, Barratt A, Irwig L, et al. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. Lancet 2006; 367: 122-132.
I have received travel assistance to attend meetings from Cytyc, the manufacturer of the ThinPrep Imaging System.