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The prognostic significance of human papillomavirus (HPV) infections and cancer screening
Syrjänen, Kari J. ; Eržen, Mojca
This communication consists of two parts: 1. the impact of different screeningstrategies on prognosis of cervical cancer, and 2. the data accumulated on the role of human papillomavirus (HPV) as a ...prognostic determinant in cervical carcinogenesis (including the precursors). These two topics are interrelated in that the current technology makes it theoretically possible to take cancer preventive measures by tracing its etiological agent, a sexually transmitted virus, which makes cervical cancer unique among all human malignancies. The feasibility of HPV testing as a screening tool is briefly reviewed as well. There is little doubt that cervical cancer develops through well defined precursor lesions where evidence of HPV involvement is readily detected. These cancer precursors are amenable to early detection by using an organised screening based on the simple and inexpensive PAP test. Themajor goal of all screening programmes is to have an impact on the prognosis of cervical cancer. That prognostic impact can be measured by two important characteristics: cancer incidence and cancer mortality. Dramatic favourable effect in both has been obtained by the most successful screening programmes, implemented in the three Nordic countries (Finland, Iceland and Sweden) since the early 1960's, and similar experience is emerging in countries where screening programmes were red more recently.
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