Cervical cancer: Pap test or DNA research Papilloma Virus?

Cervical cancer: Pap test or DNA research Papilloma Virus?

In recent decades, the incidence of cervical cancer has gradually reduced (-80%) in Italian women thanks to Pap testing, a test that allows the detection of precancerous lesions ( CIN 1, CIN2, CIN3) and to intervene long before they evolve into cancer, The Pap test is so, even today, the prevention method cancer ideal as simple, cheap and effective, The results of the Pap test is, in most cases, a confirmation of the good state of health ; given the presence of early cancer of the cervix alterations, even in the absence of symptoms, the Pap test allows early recognition, resulting in implementation of effective care and respectful anatomical and functional integrity and takes up a place of considerable importance also in tumor diagnosis.

The cytological for the execution of this analysis, performed by the gynecologist or by a midwife, is carried out at two levels of the uterine cervix: ectocervix and endocervix. The material thus obtained is smeared on a glass slide, fixed, stained and observed under the optical microscope. The progress in the field of cancer research has amply demonstrated, through epidemiological studies supported by molecular technologies, persistent infection causal role by Human Papilloma Virus (HPV) with high oncogenic power in the onset of cervical cancer. The low incidence of cervical lesions compared to the high frequency of HPV infections, however, suggests that HPV infection is a necessary cause but not sufficient. Most infections are transient and resolve spontaneously (80%). In 15-20% of cases the infection persist resulting in varying degrees of injuries. Only 1% of these progresses over the years in invasive cervical cancer, for which there are 1,700 deaths a year in Italy. An Italian study, published in the journal Lancet Oncology and conducted on a large female population, showed that the DNA examination Papillomavirus (HPV) is more effective in the prevention of cervical cancer than the Pap smear classic, as It is more sensitive.

The HPV test is in fact more precancerous lesions than the traditional Pap test but gives more false positives because many of the infections resolve spontaneously, hence are less specific than cytology. But then, how to choose between Pap test or DNA research Papilloma Virus? Numerous studies have shown that prevention towards cervical cancer should be done with the HPV test only in over 35, because they are able to detect more lesions of the cervix (caused by HPV), and at an earlier age, compared with the Pap test.
In women under 35 it remains valid indicating the performance of the Pap test, HPV testing because at this age to a range of infections that spontaneously resolve over time without giving injury. Even women who undergo vaccination against this virus should not interrupt the preventive controls because the vaccine does not cover all HPV types with high oncogenic risk, and because they are not yet known data on the same long-term coverage.

Edited by Dr. E. Bartoccini Research Centre Biochemical Analysis Specialist CRABioN