2. Our method
• Breast cancer
• Cervical
cancer
Screening
• Vaccination
• Imaging
Prevention
• Hormonal
• Barrier
Family
planning
3. Cervical cancer
• in 2020, WHO launched the Global Strategy to
Accelerate the Elimination of Cervical Cancer. The goals
of the strategy are, by 2030:
• to vaccinate 90% of eligible girls against HPV;
• to screen 70% of eligible women at least twice in their
lifetimes;
• to effectively treat 90% of those with a positive
screening test or a cervical lesion, including with
palliative care when needed.
4. Pap smear HPV DNA
Method collecting cells from
cervix to detect early cancer
cells.
- To identify patient with
precancerous/ cancerous
Collecting cells from cervix to
detect presence of HPV infection.
- Detect patient at risk ( high risk)
to develop cervical cancer in
future.
Sensitivity and
specificity
Sensitivity: 87%
Specificity: 96.8%
Sensitivity: 94.6%
Specificity:94.1 %
Indication All women age >21 years old General population: starts at 30
years old
High risk group: starts at 25 yrs old
Follow up Every 3 years General population: every 5-10
years.
High risk group: every 3-5years
Strength -Higher specificity
- cheaper
-High sensitive, good sensitvity.
-More accurate in post
menopausal woman.
Referral -Refer diagram Type 16 and 18 refer for
colposcopy
Other type refer for cytology
5. Pap smear + HPV DNA testing: accuracy can be
up to almost 100%
6.
7.
8. WHEN TO STOP SCREENING
• Age > 65 years with consistent negative result
for the past 15 years.
• If no testing done before. Test once before
allowed to exit screening.
11. GARDASIL 9
FEMALE MALE
INDICATION 9-45 YEARS 9-45 years
DOSE Given IM:
0,2,6 months
Given IM:
0,2,6 months
BENEFIT 1. Prevention of cervical,
vaginal, anal and vulvar
cancer.
2. Prevention of Genital
warts (condyloma
acuminata) caused by
HPV types 6 and 11.
3. precancerous or
dysplastic lesions
1. Prevention of anal and
external genital
precancer and cancer.
2. Prevention of genital
warts caused by HPV.
Editor's Notes
Women who are 21 to 29 should have a Pap test alone every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
Women who are 30 to 65 have three options for testing. They can have a Pap test and an HPV test (co-testing) every 5 years. They can have a Pap test alone every 3 years. Or they can have HPV testing alone every 5 years.
High risk group :
istory of cervical cancer, are infected with HIV, have a weakened immune system, or who were exposed to diethylstilbestrol (DES) before birth may require more frequent screening and should not follow these routine guidelines.
