Cervical cancer control, priorities and new directions.
Cervical cancer is caused by infection with a range of high risk "oncogenic" human papillomavirus (HPV) types, and it is now accepted that >99% of cervical cancer is initiated by HPV infection. The estimated lifetime risk of cervical cancer is nevertheless relatively low (less than 1 in 20 for most community based studies). Although sensitivity and specificity of the available diagnostic techniques are suboptimal, screening for persistent HPV infection is effective in reducing the incidence of cervical cancer. Infection can be detected by molecular techniques or by cytological examination of exfoliated cervical cells. Persistent infection is the single best predictor of risk of cervical cancer. The latest findings of HPV and cervical cancer research need to be widely disseminated to the scientific and medical societies that are updating screening and management protocols, public health professionals, and to women and clinicians. This report reviews current evidence, clinical implications and directions for further research in the prevention, control and management of cervical cancer. We report the conclusions of the Experts' Meeting at the EUROGIN 2003 conference.
Monsonego
Joseph
J
EUROGIN, Paris, France. jm@eurogin.com
Bosch
F Xavier
FX
Coursaget
Pierre
P
Cox
John Thomas
JT
Franco
Eduardo
E
Frazer
Ian
I
Sankaranarayanan
Rengaswamy
R
Schiller
John
J
Singer
Albert
A
Wright
Thomas C
TC
Kinney
Walter
W
Meijer
Chris J L M
CJ
Linder
James
J
McGoogan
Euphemia
E
Meijer
Chris
C
Wright
Tom
T
D005260:Female; D006292:Health Priorities; D006801:Humans; D008403:Mass Screening; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology