[Epidemiology and diagnosis of cervical intraepithelial neoplasia--is the present concept of screening and diagnosis still current?].
Infection with human papillomavirus (HPV) is the major factor in the genesis of cervical intraepithelial (CIN) and invasive neoplasia. However, screening is still based upon cytology and further diagnostic investigation relies on colposcopy with punch biopsy. In this review, recent studies are evaluated with regard to consequences for optimal screening and management strategies of CIN. In summary, exfoliative cytology is still widely considered as the method of choice for population screening. Primary HPV DNA screening proves equivalent or superior to cytology only in populations with a low prevalence of HPV infections. Preliminary data from serological HPV tests are less promising. Cytological diagnosis of HPV infection may be verified by HPV testing. Recognizing high oncogenic risk viruses in CIN 1 may help to reduce the control period from 24 to 12 months and may lead to immediate therapy for CIN 2 lesions. However, further prospective studies evaluating the cost-effectiveness of HPV DNA tests in German-speaking countries are necessary.
Hillemanns
P
P
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, Deutschland. peter.hillemanns@t-online.de
Thaler
C
C
Kimmig
R
R
D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology; D015344:DNA Probes, HPV; D005260:Female; D006801:Humans; D008403:Mass Screening; D009367:Neoplasm Staging; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology
D015344:DNA Probes, HPV
Epidemiologie und Diagnostik der zervikalen intraepithelialen Neoplasie--Ist das derzeitige Konzept von Screening und Diagnostik noch aktuell?