Prevention of cervical cancer.
This article reviews the burden of cervical cancer in South Africa and shows that it remains the most common cancer among South African women, particularly women with least access to cervical cancer screening. It explains the rationale behind the South African cervical cancer screening policy, which is to offer all asymptomatic women three free cervical smears in a lifetime, beginning at age 30, 10 years apart. Further, it illustrates that cervical cancer screening offers unique opportunities for prevention at both the primary and secondary levels. The causal association of human papillomavirus infection of the cervix and the possibility for vaccination against the virus is discussed. The history of screening in South Africa and why it has failed to make a major impact to date on the morbidity and mortality of cervical cancer is also discussed. Finally, possible alternative approaches to cervical cytology for the prevention of cervical cancer are briefly reviewed.
Denny
Lynette
L
Department of Obstetrics & Gynaecology, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa. lynette.denny@uct.ac.za
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D011322:Primary Prevention / Q000379:methods; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods / Q000458:organization & administration; D013019:South Africa / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D014626:Vaginal Smears; D055815:Young Adult
D053918:Papillomavirus Vaccines