[Updated cervical cancer screening; human papilloma virus and Papanicolaou tests].
Cervical cancer screening using Papanicolaou test (Pap) previously reduced the incidence of and mortality from cervical cancer in Japan. However, this reduction stopped from 1990, and the incidence increased in 2001. Furthermore, the age of women developing cervical cancer has decreased, and the mortality rate in women aged from 25-54 years increased from 1994 to 2003. We conducted research regarding women aged from 20 to 59 years, demonstrating that the coverage of cervical cancer screening within the last three years in Japan is 33%. This is less than half of that in many developed countries. Many recent studies have revealed that the sensitivity of the Pap test for screening has been over-estimated. Our preliminary study in Japan also revealed that more than 29% of CIN2 or more advanced lesions were missed in one screening, although this rate differed depending on the experience or ability of each cyto-screener. To compensate for this limitation in Pap test, the HPV-DNA test has been introduced in cervical cancer screening in both developed and developing countries. Both Pap test and the HPV test are used as primary screening tools in women older than 30 years in the U.S.A. The interval of this screening can extend to three years if both tests are negative. A primary HPV screening program is due to start in the U.K. and Holland. The increasing incidence of cervical cancer in Japan prompts us to make efforts to increase the coverage of cervical cancer screening, and the HPV test should also be incorporated into screening programs.
Kanazawa Medical University, Kanazawa 920-0293, Japan. tsasa@kanazawa-med.ac.jp
Toshiyuki
T
Sasagawa
D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D055815:Young Adult
D004279:DNA, Viral