Anticipating the Impact of Human Papillomavirus Vaccination on US Cervical Cancer Prevention Strategies

被引：2

作者：

Massad, L. Stewart ^{[1
]}

机构：

[1] Washington Univ, Sch Med, Box 8064, St Louis, MO 63110 USA

来源：

JOURNAL OF LOWER GENITAL TRACT DISEASE | 2018年 / 22卷 / 02期

关键词：

cervical cancer prevention; cytology; colposcopy; HPV testing; INTRAEPITHELIAL NEOPLASIA; MANAGEMENT GUIDELINES; RISK; LESIONS; HPV; PREVALENCE; COLPOSCOPY; INTERVALS; RATES;

D O I：

10.1097/LGT.0000000000000385

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Cervical cancer prevention guidelines are benchmarked to risk of cervical precancer. In younger age cohorts, vaccination against high-risk types of human papillomavirus (HPV) has reduced HPV 16/18 prevalence and cervical intraepithelial neoplasia. Lower prevalence of precancer will impair the sensitivity of cytology and colposcopy, but negative predictive value will rise. Training and skills maintenance will become more difficult as abnormalities become less common. Primary screening with HPV assays will become more attractive but will require HPV genotyping as most positive HPV tests will reflect non-16/18 infections with lower oncogenicity. Screening will begin later and will occur at longer intervals. Colposcopy and treatment thresholds will become more stringent. Historical data sets will become inappropriate for guidelines development. As women immunized using nonavalent vaccine reach screening age, these trends will become still more pronounced.

引用

页码：123 / 125

页数：3

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