الفهرس | Only 14 pages are availabe for public view |
Abstract Cervical carcinoma is one of the most common cancers in the world. It ranks as the second leading cancer in women and one of the leading causes of death among women worldwide. The age-adjusted incidence rate varies from an average of 9 cases per 100,000 women in the developed countries to more than 40 cases per 100,000 women in some developing countries. In spite of the overall high incidence and mortality rates, this disease is regarded as the most preventable and treatable form of major cancer, through the early diagnosis of preinvasive and invasive disease. In virtually all population-based screening programs to date, the standard screening method has been the Pap smear. Although the cytologic method for detecting cervical epithelial abnormalities was published more than 50 years ago, it was slowly accepted in many countries, and despite its demonstrated efficacy, the Pap test is still not widely available in all countries. It is clear that if screening for cervical cancer precursors could be more widely applied in the developing nations, many lives could be saved, and cervical cancer incidence rates would decline to the same degree as that in the industrialized nations. A single Pap smear from a patient with a cervical lesion may be falsely negative due to either inadequate sampling of exfoliated cells(sampling error) or to incorrect interpretation (screening error). Different studies have estimated the false negative rate of the Pap smear at 25 to 40%. The false negative rate for a single Pap smear in women with histologically confirmed cervical lesions can be as high as 50%. Up to 58% false negative rate for CIN 1 and 2 has been reported. This has led to concern about its adequacy as a screening tool. Epidemiological studies have shown that genital HPV infection has markedly increased over the past two decades- It is now one of the most, if not the most common sexually transmitted disease. In the past few years, HPV DNA hybridization studies have provided insight into the role of HPV in intraepithelial neoplasia and invasive anogenital cancer. A growing body of evidence has linked HPV with genital. |