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Chapter 33 - Pre-invasive Cervical Disease and Colposcopy

from Section 7 - Cervix

Published online by Cambridge University Press:  24 November 2021

By
Andre B. Kind ,
Dorothy J. Huang  and
Brigitte Frey Tirri
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Cervical cancer remains the major cause of death from cancer in women worldwide. While well-established screening programmes and treatment of pre-invasive disease are available in economically developed countries, screening remains opportunistic to non -existent in low-income countries. Cervical cancer and its precursors are caused by persistent infections with high-risk HPV. Early-onset sexual intercourse is an important factor for HPV infection. Excisional treatment for pre-invasive disease is preferred to ablative treatment. A simple hysterectomy is adequate for most microinvasive cancers of the cervix. Virus like particles (VLPs) assembled from recombinant HPV coat proteins are used to constitute HPV vaccine. It has the advantage of being non-infectious, as they contain no viral genetic material. The vaccines prevent HPV-related cancers and ideally are given before sexual debut. Guidelines vary between countries, but vaccination is usually initiated between 9–12 years for both sexes. Preventive HPV vaccination for both sexes remains a cornerstone of preventing HPV related cancers globally.

Keywords

pre-invasive disease of cervixmicroinvasive cervical cancercervical dysplasiaCIN 1–3colposcopylarge loop excision of transformation zone ( LLETZ)HPVVLPHPV vaccine
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 275 - 283
Publisher: Cambridge University Press
Print publication year: 2021

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