Wednesday, June 2, 2010

cervical cancer and what do the experts know

The medically accepted paradigm, officially endorsed by the American Cancer Society and other organizations, is that a patient must have been infected with HPV to develop cervical cancer, and is hence viewed as a sexually transmitted disease, but most women infected with high risk HPV will not develop cervical cancer.[16] ANDThe widespread introduction of the Papanicolaou test, or Pap smear for cervical cancer screening has been credited with dramatically reducing the incidence and mortality of cervical cancer in developed countries.[8] BUT... Some 1100 clinicians (internists, family practitioners, or obstetrician-gynecologists) were given a series of clinical vignettes that described women by age, sexual experience, and Pap testing history. Participants provided their screening recommendations for each scenario.While over 80% said that at least one set of screening guidelines (e.g., U.S. Preventive Services Task Force) was "very influential" in their practices, only 22% recommended guideline-consistent care for every vignette. Obstetrician-gynecologists were less guideline-concordant than the other specialties.Of note, one third of participants recommended annual Pap testing for an 18-year-old who hadn't had sexual intercourse, while almost half continued to recommend Pap testing for a women whose cervix had been removed for benign reasons.
The most important risk factor in the development of cervical cancer is infection with a high-risk strain of human papillomavirus. The virus cancer link works by triggering alterations in the cells of the cervix, which can lead to the development of cervical intraepithelial neoplasia, which can lead to cancer. Women who have many sexual partners (or who have sex with men who had many other partners) have a greater risk.[10][11]