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Clinical management of HPV‐related disease of the lower genital tract
Author(s) -
Kyrgiou M,
Valasoulis G.,
Founta C.,
Koliopoulos G.,
Karakitsos P.,
Nasioutziki M.,
Navrozoglou I.,
Dalkalitsis N.,
Paraskevaidis E.
Publication year - 2010
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2010.05676.x
Subject(s) - medicine , colposcopy , disease , cervix , cervical cancer , triage , genital tract , clinical trial , fertility , hpv infection , gynecology , obstetrics , intensive care medicine , cancer , population , physiology , emergency medicine , environmental health
Cytology remains the mainstay for cervical screening. The need to achieve effective management, limit complications, and preserve reproductive function led to the popularity of local treatment. Although the cure rates for ablative and excisional methods are similar, the excisional method provides a more reliable histopathological diagnosis. Recent evidence revealed increased perinatal morbidity after treatment that appears to be related to the proportion of cervix removed. The human papillomavirus (HPV) DNA test appears to enhance the detection of disease in primary screening, in the triage of minor cytological abnormalities, and in follow‐up. Further research on the clinical application of a scoring system is ongoing. The vaccines are now available and appear to be safe, well tolerated, and highly efficacious in HPV naive women. A synergy of vaccination and screening will be required. Treatment for early cervical cancer is increasingly shifting toward more fertility‐sparing surgical techniques. Careful selection of patients is essential.