| Revista: | Salud pública de México |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000213455 |
| ISSN: | 0036-3634 |
| Autores: | Franco, Eduardo L1 Duarte Franco, Eliane Ferenczy, Alex2 |
| Instituciones: | 1McGill University, Department of Oncology, Montreal, Quebec. Canadá 2McGill University, Department of Pathology, Montreal, Quebec. Canadá |
| Año: | 2003 |
| Volumen: | 45 |
| Paginación: | 367-375 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico |
| Resumen en español | Referente a la prevención primaria del cáncer cervical, investigaciones recientes sobre seguridad y eficacia de la vacuna profiláctica contra el virus del papiloma humano han mostrado resultados muy prometedores con una eficacia cercana a 100% en prevención de infecciones persistentes y desarrollo de lesiones precursoras de este cáncer. Sin embargo, las políticas generadas son fuertemente cautelosas para evitar decisiones aplazadas, concernientes a la implantación del tamizaje del cáncer cervical bajo la expectativa de que la vacuna podría obviar la necesidad de estrategias de prevención secundaria. Este artículo también está disponible en: http://www.insp.mx/salud/index.html |
| Resumen en inglés | Cervical cancer morbidity and mortality have decreased substantially during the last 50 years mostly due to success-ful organized or opportunistic screening with Pap cytology in high and middle income countries. In many low income countries Pap cytology screening is yet to be effectively implemented or has failed to reduce cervical cancer rates to an appreciable extent. The fact that infection with certain human papillomavirus (HPV) types is now recognized as a necessary cause of this disease has led to new research fronts on prevention of cervical cancer. Testing for HPV DNA has shown great promise as a screening tool with better sensitivity but somewhat lower specificity than Pap cytology. In combination with the latter, HPV testing has the potential to improve the negative predictive value of cytology, thus allowing for increased testing intervals, which would lower program costs with acceptable safety. Advances in cytology processing and automation have also led to new screening approaches that are increasingly gaining acceptance in high and middle income countries. For low income countries, visual inspection with acetic acid has proven to be an effective alternative to conventional Pap cytology, especially in settings where no screening programs have been implemented. Concerning primary prevention of cervical cancer, recent research on the safety and efficacy of candidate prophylactic vaccines against HPV have shown very promising results with nearly 100% efficacy in preventing persistent infections and development of cervical cancer precursors. However, policy makers are strongly cautioned to avoid deferring decisions concerning the implementation of cervical cancer screening under the expectation that a successful vaccine could obviate the need for secondary prevention strategies. This paper is available too at: http://www.insp.mx/salud/index.html |
| Disciplinas: | Medicina |
| Palabras clave: | Diagnóstico, Oncología, Salud pública, Cáncer, Cérvix, Citología, Prevención, Vacunas, Tamizaje |
| Keyword: | Medicine, Diagnosis, Oncology, Public health, Cancer, Cervix, Cytology, Prevention, Vaccines, Screening |
| Texto completo: | Texto completo (Ver PDF) |
