Screening for cancer of the cervix uteri: how, from which age onwards and up to which age
DOI:
https://doi.org/10.18597/rcog.559Keywords:
cervix, cancer, screening, screening programmes, evaluationAbstract
Objective: evaluating the available evidence regarding screening cancer of the cervix uteri related to topics such as screening tests, when to initiate screening, screening interval, when to suspend it and screening women undergoing hysterectomy as a result of benign pathology.
Methodology: literature published in MEDLINE and PROQUEST between January 1999 and December 2003 was reviewed as well as journals which usually publish articles referring to the topic, such as the British Medical Journal, The Lancet and JAMA.
Results: organized screening programmes, educational campaigns aimed at teaching skills and competence and invitations by letter were the strategies leading to the best results. In spite of conventional cytology’s limitations, there is not sufficient evidence for recommending routine use of new technologies such as liquid-based cytology, human papilloma virus (HPV) or visual inspection with acetic acid (VIA) test. What is important is that 80% coverage should be achieved with this and adequate follow-up. Screening must be begun within the three years following a woman engaging in sexual relations for the first time, with a one-year interval for women at high risk while low-risk women can be screened each 2 or 3 years, suspending this at age 65 or 70 in women who have had regular screening and three or more negative cytologies during the last ten years. The management of women who have undergone hysterectomy due to benign pathology must be individualized; the vagina of women having risk factors must be subjected to periodic cytological evaluation.
Conclusions: cervical-uterine cytology continues being the mainstay for cancer of the cervix uteri screening programmes.
Author Biographies
Jairo Amaya
Sonia Restrepo
References
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