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A new study comparing human papillomavirus (HPV) screening tests to traditional cervical smear for cervical cancer in the uterine (cervical Ca) was recently published in the Journal of the American Medical Association. Finding the best test has been a goal for years. This study recruited about 19,000 women, who had one test or the other. The results seemed to favor the HPV test as being more accurate and lacking fewer "positives". (Is being positive for this test medically rather negative?)
Like any study on large numbers, this has generated opinions on both sides.For a while, a single sample is often taken to be used for both exams, called "co-test Cervical Ca has been recognized as a very desperate cancer for centuries Cervical is the Latin word for the neck, cervix of the uterus. Many parts of us are labeled as a cervix, like the stem of your torso that holds your head. In a uterus, the narrow lower part, which is the channel that Leroy or Lois glide on the way to the outside world, is the cervix of the uterus.
Unfortunately, this sinister and silent Ca in a non-visible place most often shows no symptoms or signs in the early stages. In later stages (too late), it can produce badl bleeding, pelvic pain, or pain during intercourse. Five-year survival rates in the United States are 68%. It is the fourth most common cancer and the fourth leading cause of cancer death among women. It is expected that there will be 13,240 new American cases this year with 4,200 deaths. Today, it is thought that the cause in almost all cases is due to chronic infections by HPV or bad warts with certain onco (cancer) gene types (generators). There may be 200 known HPV strains. Oncogenic types in 70% of cases are types 16 and 18. There are approximately 12 types of cancer. If HPV vaccines can reduce the incidence of future cervical Ca should be seen and hoped for. These same types of HPV cause most cancers of the anus, many cancers of the bad, vulva and penis, as well as some cancers of the oropharynx.
Hippocrates writes in 400 BC this cervical Ca was incurable. The ideas of cause have been wide and wild over time. In the early 1900s, population studies showed that it was a badually transmitted disease. Because it was rare in Jewish women, the smegma, a collection of dead cells, oil and "stuff", of uncircumcised males was postulated as the cause. In the 1960s, herpes simplex persists in cervical cells and becomes the presumed culprit. Tsk-tsk
In 1976, HPV DNA was discovered in the cervix and bad warts by zur Hausen, which earned him a Nobel Prize. With more studies, he has been able to be inoculated into laboratory animals to induce the cervix. Papanicoulaou, a pathologist of Greek origin, developed his technique to examine cells taken from the cervix in 1928. His presentation, like many new ones, was scanned, and unrecognized until 39; in 1941, when he and a gynecologist, Traut, published a tome on
The main difference between a Pap test and an HPV test is that the first one badyzes the cells microscopically for abnormal gradations of change from mild to malignant , now mainly through the Bethesda system established in 1988. It is still done by humans who judge. from what is seen. HPV tests badyze tissues in a very complicated way according to the particular methodology used for submicroscopic DNA. The first is subject to sampling and human error. The second is subject to technical / laboratory errors. The objective of the study is well taken, but the co-test is based on the same sample for both tests. A New York gynecologist, who comments on the slightly larger findings of the HPV diagnosis, said that he still does not answer the crucial question if the HPV test alone is better than the co-test. Other studies on smaller numbers have not been able to guess this answer either.
HPV infection is very common. Most infections will be removed in 1-2 years without causing cancer. If it is with high-risk strains, it can persist in transforming cells into malignancy 10-20 years later. HPV tries to find the presence of the villainous virus, while the Pap smear tries to detect its cellular fingerprints at different stages. The continuous co-test may seem the most prudent as long as our species persists in cohabiting rather randomly and with less caution. The race between tests always seems to be "neck and neck".
Frank A. Bures is a semi-retired dermatologist from Winona.
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