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2 results

  • Chapter 33 - Pre-invasive Cervical Disease and Colposcopy
  • from Section 7 - Cervix
  • Edited by Tahir Mahmood, Charles Savona-Ventura, Ioannis Messinis, Sambit Mukhopadhyay
  • Book: The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
  • Published online: 24 November 2021
  • Print publication: 02 December 2021, pp 275-283
  • View extract

    Summary

    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.