The purpose of cervical screening is to prevent the appearance of invasive disease by the detection and appropriate treatment of pre-cancerous abnormalities.

There is compelling evidence that carcinoma of the cervix is associated with the human papilloma virus (HPV), which is transmitted during sexual intercourse. There are many strains of HPV. Types 16 and 18 are the two most commonly found in association with pre-malignancy and malignancy. When both partners enter marriage as virgins and remain faithful to each other, carcinoma of the cervix is rare. This explains why the disease is uncommon in religious communities that adhere to these principles. The sheath provides protection against sexually transmitted disease.

Cells have the potential to become malignant. This probably happens fairly frequently but the immune system usually destroy the abnormal ones (Q32.1).

The principles of screening are discussed in screening tests. Carcinoma of the cervix is a ‘surface’ disease. With a vaginal speculum the cervix can be readily visualised and cells sampled. There can be little doubt that screening has reduced the incidence of carcinoma of the cervix. Studies suggest that since the introduction of screening there has been a reduction of about 70%. Despite screening with cytology there remains a 30% incidence of malignancy. There is, therefore, a need for further improvement.

Liquid-based cytology involves placing sampling with a brush rather that a spatula and the brush is shaken into a liquid rather than producing a slide. This may prove to be more accurate than conventional smears.

Recently, there has been the development of a vaccine for immunisation against pre-malignancy and malignancy of the cervix - Gardasil - Sanofi Pasteur MSD. It has been suggested that vaccination will reduce the risk of cervical cancer by 70%.0605HPV Types 16 and 18 cause 70% of cervical cancer cases, and HPV Types 6 and 11 cause 90% of genital warts cases.

Gardasil may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings. Anyone who is allergic to the ingredients of GARDASIL should not receive the vaccine. GARDASIL is not for women who are pregnant. GARDASIL will not treat these diseases and will not protect against diseases caused by other types of HPV. GARDASIL is given as 3 injections over 6 months and can cause pain, swelling, itching, and redness at the injection site, fever, nausea, and dizziness. Only a doctor or healthcare professional can decide if GARDASIL is right for you or your daughter.

The recent literature on adolescent knowledge about HPV and attitudes about HPV vaccines supports the importance of designing developmentally appropriate educational materials for adolescents about HPV and HPV vaccines, and provides guidance for the development of key educational messages.0801


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