HPV HANDBOOK - Zervita

More documents

Recommendations

Info

CERVICAL CYTOLOGY AS A SCREENING TESTIncidencePortugalDenmarkGermanyUKFranceItalyBelgiumSwedenIrelandGreeceSpainThe NetherlandsFinland0 2 4 6 8 10 12 14 16 18 20Rate per 100 000 women (Europe)MortalityPortugalDenmarkGermanyUKFranceItalyBelgiumSwedenIrelandGreeceSpainThe NetherlandsFinland0 1 2 3 4 5 6 7 8 9 10Rate per 100 000 women (Europe)Figure 1 Incidence and mortality rates of cervical cancer in European countries in1995; data adjusted for age to the European standard population andcountries ordered by incidence rate. (Modified from Bray et al. 2002)17
3: <strong>HPV</strong> AND CERVICAL CANCER: PUBLIC HEALTH PERSPECTIVESThe effect of population-based organized cervical cancer screeninghas been well demonstrated in Nordic countries. 5,6 In Finland(population 5 million), organized screening for cervical cancer wasinitiated in the early 1970s and was accompanied by progressivedecreases of 80% in both the age-adjusted disease-incidence andmortality rates for cervical cancer, by the early 1990s. 7 Similardecreases in disease incidence and mortality were evident in Icelandfollowing the introduction of organized screening. In contrast, duringthe same period in Norway – where cervical cancer screening operatedon an opportunistic basis – the incidence and mortality rates showedsmaller decreases of about 30%. Similarly, in Sweden and Denmark,where regional coverage of organized programmes is incomplete,decreases in cervical cancer incidence rates of 52–56% have beenreported. 24In the UK, cervical cancer screening became more widespread in theearly 1960s, 30 but there was no associated clear decrease in cervicalcancer incidence between 1960 and 1986, from an analysis of data forall ages combined. 31 However, there was a decline in the registereddisease-incidence and mortality rates among the target population of35–54-year-old women. After 1988, following the introduction of acomputerized call–recall system, new quality standards and newguidelines for the follow-up of women with abnormal smears,coverage increased rapidly to approximately 80% of the targetpopulation (women 20–69 years old). The incidence of invasivecervical cancer decreased by 35% during 1991–1993, compared withthe expected incidence based on the age- and district-specific trendsin the period from 1971 to 1990, 32 and the age-standardized mortalityfrom cervical cancer decreased by 39% between 1987 and 1997. 33There was even a larger decrease in mortality among women
Page 4 and 5: THE HEALTH PROFESSIONAL’SHPV HAND
Page 6: ContentsList of contributors 7Intro
Page 10: Introduction to the HPV Handbook se
Page 13 and 14: 3: HPV AND CERVICAL CANCER: PUBLIC
Page 17: 3: HPV AND CERVICAL CANCER: PUBLIC
Page 26 and 27: 2. HPV testing as a screeningtest:
Page 28 and 29: HPV TESTING AS A SCREENING TEST: TH
Page 36 and 37: 3. HPV testing as a screeningtest:
Page 44: HPV TESTING AS A SCREENING TEST: TH
Page 66 and 67: THE POTENTIAL PUBLIC HEALTH IMPACT
Page 68 and 69:
THE POTENTIAL PUBLIC HEALTH IMPACT
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Indexadenocarcinoma,detection by HP
Page 82 and 83:
INDEXuse in ASCUS 53use to confirm
show all

HPV HANDBOOK - Zervita

Create successful ePaper yourself

Delete template?

Save as template?