Cervical cancer screening: A never-ending developing program

摘要: With the term "oncological screening", we define overall performances made to detect early onset of tumors. These tests are conducted on a population that does not have any signs or symptoms related neoplasm. The whole above certain age, only one sex, subjects with high risk developing cancer due genetic, professional, discretionary reasons may be involved. Screening campaigns should associated, when factors can avoided known, for prevention by means suitable behavior. goal screening cannot however limited diagnosis greater number neoplasms. will useful if it leads reduction in mortality at least tumor. then allow disease stage there is possibility healing, instead difficult diagnosed appearance symptoms. This reason why all same effectiveness. In Italy, every year about 150000 deaths cancer. Some these tumors cured very percentage success time. Cervical non-invasive tests. test used over world Papanicolaou (Pap) test. carried out entire healthy potentially exposed contracting Public health has begun hope saving many approximately 270000 new cases reported each year. done following protocols guarantee quality national level: subject change time reflect realities correct errors system. A simplified sketch possible route as follows: (1) after selecting target population, example women between 25 and 64 years (in case monitoring cervical cancer), an invitation letter date appointment, planned according acceptance capacity hospital, sent individuals; (2) examination, which depending individual type monitored, example, Pap smear, performed patient go home; (3) once available results examinations, negative, they shall communicated person concerned notified mail recalled second few distance, non-negativity, instead, contacted telephone informed need carry further examinations: said "phase two" pathway; (4) phase two, reached small portion interested parties (usually less than 3%-5%), more in-depth out, which, cancer, be: cytological colposcopic removal fragment tissue (biopsy) subsequent histological additional such ultrasound, radiography, others computerized tomography, magnetic resonance imaging, positron emission etc., negativity, called control proposed oncologic therapeutic plan and/or surgery treat tumor; (5) treatment completed, enters follow-up protocol, monitored see tumor been completely removed still developing. undoubtedly most successful campaign. Paradoxically, its effectiveness strongest criticize usefulness vaccination against human papillomavirus (HPV) countries where service organized efficient manner. directed sexually active aged 25-64 years: provide examining under microscope staining specific "thin prep" material taken from cervix spatula brush. It recommended repeat two three years. important emphasize vaccinated HPV must continue Although some programs (e.g., smears) had remarkable reducing kind free inherent limitations. methods fact applied large parts apparently population. particular, limits cancers obvious prohibit introduction program. Potential limitations screenings basically types: organizational medical. relate ability program recruit well organized, hardly able exceed coverage 70%-80% current often much smaller. medical represented mortality, using