Cervical cancer – problem solved?


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Peter Sasieni1
1Wolfson Institute of Preventive Medicine, Queen Mary University, London, London, UK

Abstract

There have been a number of real breakthroughs in cervical cancer prevention over the last century, but as Mark Twain might have said, "Reports of the eradication of cervical cancer have been greatly exaggerated".

I will review advantages and limitations of conventional cervical screening (Pap tests), human papillomavirus (HPV) testing, and HPV vaccination in the control of cervical cancer.

As technologies improve, we need to consider how best to minimise the harms and costs of intervention as well as trying to prevent this cancer. This talk will touch on a number of issues including:

  • The effectiveness of conventional cervical screening and why cervical cancer is still the number one female cancer in many countries.
  • The potential for improving cervical screening using HPV testing.
  • The benefits and harms of starting cervical screening at 20 rather than 25.
  • The appropriate upper age for cervical screening.
  • The association between treatment for screen-detected disease and subsequent pre-term deliveries in pregnancy.

Finally I will consider how cervical cancer prevention might look 20 years from now.