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The uterus – also known as the uterus – is the female reproductive organ responsible for housing the egg or zygote and allowing its transition from the lymphatic system. embryo to the fetus. Completed its development, the fetus leaves the uterus through powerful muscular contractions of the organ. It is expelled through the vagina and passes through a muscular structure like a door, called the cervix of the uterus. During labor, the obstetrician monitors the opening or dilation of the cervix to see if it is occurring properly.
The cervix of the uterus is in contact with the vagina and can therefore be observed by opening it with a device called a speculum. It is seen as a rounded structure, located at the bottom of the vagina, and has a hole in the center, known as a cervical orifice, through which the blood of menstruation or the baby comes out.
It is in this cervix of the uterus where the cancer is found that kills more women in many middle and lower income countries, including Peru. Like all cancers, it is silent and causes no symptoms during its development.
– George Papanicolaou –
Born in 1883 and educated in Greece, Dr. George Papanicolaou arrived in the United States in 1913, fleeing the First Balkan War. As a researcher at Cornell University in New York, he discovered that guinea pig hormone cycles can be predicted by microscopically analyzing the cells in his vaginal mucus. By proceeding in the same way in women, he surprised the cancer cells in this vaginal mucus. This research was published in 1928.
Like many great discoveries in medicine, progress has taken many years to become massive. It was only in the mid-1950s that, thanks to the campaigns of the American Cancer Society in the United States, the test began to become popular. At present, it is considered that the Pap test or cytology is able to reduce by 80% the mortality caused by cancer of the cervix in high-income countries in which this disease has very low prevalence.
-Human Papilloma Virus
Over the past 40 years, research has determined that 99.7% of cases of uterine cancer are caused by the infection of some of the Oncogenic varieties of human papillomavirus (HPV). With this in mind, studies have focused not only on the development of a vaccine against this disease (put on sale in 2006 and available for free for girls in Peru since 2011), but also on the establishment of a vaccine against the disease. a method of early detection of this disease. cancer that discovers the presence of HPV in the cervix of the uterus.
For this reason, over the past two decades have developed molecular genetic processes that analyze cervical mucus in search of an oncogenic variety of HPV. They have been available since 1997. However, it was only in 2011 that they were accepted by the US Food and Drug Administration
(FDA) for use with Papanicolaou. in the main diagnosis of the disease; and since 2014, it has been established as the only HPV detection method. The problem is that many health organizations have expressed reluctance to adopt this type of test as the only method because no study has been done that directly confronted the old, effective and reliable Papanicolaou with the modern HPV test for see what is better.
Canadian Study-
Published in July 2017 in the Journal of the North American Medical Association (JAMA) by Canadian researchers, the HPV Focal study is the first to be done in both cases and ] concludes that the HPV test is superior to Pap smear in the detection of precancerous lesions of the cervix in women over 30 years of age .
Research, conducted among Canadian women aged 25 to 65, they were divided into two groups: those who underwent a Pap test in the beginning – and if that was normal, they would have it. repeated at two years and four years – and those who underwent the VP H test early and four years later.
The data analysis showed that none of the methods is perfect. At the end of the four-year study, 22 of the women who had an early negative HPV test had precancerous lesions. On the other hand, 54 of those who were found to have a negative smear at the beginning of labor, developed the same precancerous lesions. The authors of the study conclude that the HPV test is able to detect pre-cancerous lesions earlier than Papanicolaou, and that it could be used as a
replacement.
-Corolar-
100 years have passed since Dr. Papanicolaou discovered the method that bears his name and nearly 70 years after this test was massively adopted by the more developed countries , which has reduced the deaths from cancer of the cervix by 80 years. However, despite the availability of this simple test, mortality from this cancer in poor countries such as Peru remains unacceptably high and is much higher among women with limited resources. The problem is not that new tests are discovered, such as HPV, but that these or those that already exist
are accessible to women at risk. Massive public education programs coupled with effective health systems are the most important.
Having more evidence is not the solution, their judicious use in the population is the challenge.
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