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Chapter 33 - Pre-invasive Cervical Disease and Colposcopy

from Section 7 - Cervix

Published online by Cambridge University Press:  24 November 2021

Tahir Mahmood
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
University of Malta, Malta
Ioannis Messinis
University of Thessaly, Greece
Sambit Mukhopadhyay
Norfolk & Norwich University Hospital, UK
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Cervical cancer remains the major cause of death from cancer in women worldwide. While well-established screening programmes and treatment of pre-invasive disease are available in economically developed countries, screening remains opportunistic to non -existent in low-income countries. Cervical cancer and its precursors are caused by persistent infections with high-risk HPV. Early-onset sexual intercourse is an important factor for HPV infection. Excisional treatment for pre-invasive disease is preferred to ablative treatment. A simple hysterectomy is adequate for most microinvasive cancers of the cervix. Virus like particles (VLPs) assembled from recombinant HPV coat proteins are used to constitute HPV vaccine. It has the advantage of being non-infectious, as they contain no viral genetic material. The vaccines prevent HPV-related cancers and ideally are given before sexual debut. Guidelines vary between countries, but vaccination is usually initiated between 9–12 years for both sexes. Preventive HPV vaccination for both sexes remains a cornerstone of preventing HPV related cancers globally.

Publisher: Cambridge University Press
Print publication year: 2021

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