Published online Oct 10, 2014. doi: 10.5306/wjco.v5.i4.744
Revised: April 11, 2014
Accepted: May 13, 2014
Published online: October 10, 2014
Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical cancer development and its precursors is the human papillomavirus (HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methods for cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals.
Core tip: Screening is the best method to prevent cervical cancer. Screening strategies should weigh the benefits and risks of screening to avoid discovery and needless treatment of transient human papillomavirus (HPV) infections. Current United States guidelines recommend Pap smear screening with conventional or liquid-based method no frequent than every 3 years, or every 5 years in women greater than age of 30 if done in conjunction with HPV testing. Screening is not recommend in females younger than 21 years, regardless of age at initiation of sex. In this population, options for prevention include HPV vaccination and decreasing other risk factors associated with HPV infection.