The establishment of Human Papillomavirus (HPV) infection as a necessary risk factor for about 95% of cervical cancers has over the past few years raised the question of how this knowledge should best be used for optimization of cervical cancer screening programs.
Key features of the epidemiology of HPV infection are now known.
The incidence and prevalence are very high in the ages after the beginning of sexual activity, with the prevalence peaking at about 22-25 years of age.
Thereafter, the prevalence declines and in women older than 35 years the population-based prevalence of oncogenic HPV infection has in the Western world varied between 1-5%. There is a very high rate of spontaneous clearance of HPV infection (about 70% in I year).
Women who develop cancer or cervical intraepithelial neoplasia (CIN) are, however, persistently HPV-positive before disease.
Modeling studies have indicated that organized screening strategies combining cytological screening with HPV testing in older age groups could be more effective and more cost-efficient than present-day screening programs.
A randomized trial evaluating a strategy with organized population-based primary screening for HPV infection at 35 years of age is ongoing in Sweden.
Study design considerations and possible implications of primary HPV screening trials are discussed.
Mots-clés Pascal : Tumeur maligne, Col utérus, Facteur risque, Virose, Infection, Papillomavirus humain, Papillomavirus, Papovaviridae, Virus, Epidémiologie, Dépistage, Programme sanitaire, Suède, Europe, Article synthèse, Homme, Appareil génital femelle pathologie, Col utérus pathologie
Mots-clés Pascal anglais : Malignant tumor, Uterine cervix, Risk factor, Viral disease, Infection, Human papillomavirus, Papillomavirus, Papovaviridae, Virus, Epidemiology, Medical screening, Sanitary program, Sweden, Europe, Review, Human, Female genital diseases, Uterine cervix diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0043453
Code Inist : 002B20C02. Création : 31/05/1999.