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The new screening program to prevent cervical cancer using HPV DNA: getting the balance right in maintaining quality

机译:使用HPV DNA预防宫颈癌的新筛查计划:在保持质量方面取得平衡

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Along with the reduction in human papillomavirus (HPV) infection and cervical abnormalities as a result of the successful HPV vaccination program, Australia is adopting a new screening strategy. This involves a new paradigm moving from cervical cytological screening to molecular nucleic acid technology (NAT), using HPV DNA assays as primary screening methodology for cervical cancer prevention. These assays must strike a balance between sufficient clinical sensitivity to detect or predict high‐grade cervical intraepithelial lesions, the precursor to cervical cancer, without being too sensitive and detecting transient infection not destined for disease. Ensuring the highest quality HPV NAT is thus a priority in order to reduce the possibility of falsely negative screens and manage the risk associated with false positive HPV NAT test results. How to do this needs informed discussion and on‐going refinement of the screening algorithm. This is of relevance as more countries move to more sensitive HPV NAT tests for secondary prevention of cervical cancer and as more HPV assays become available.
机译:通过成功的HPV疫苗接种计划,随着人类乳头瘤病毒(HPV)感染和宫颈异常的减少,澳大利亚正在采取新的筛查策略。这涉及从宫颈细胞学筛查到分子核酸技术(NAT)的新范式,它使用HPV DNA检测作为预防宫颈癌的主要筛查方法。这些检测方法必须在足够的临床敏感性之间找到平衡,以检测或预测宫颈癌的前兆宫颈上皮内高度病变,而又不至于过于敏感,以及检测并非针对疾病的短暂性感染。因此,确保最高质量的HPV NAT是当务之急,目的是减少假阴性筛选的可能性,并管理与假阳性HPV NAT测试结果相关的风险。如何做到这一点需要进行深入的讨论,并对筛选算法进行不断完善。随着越来越多的国家转向对宫颈癌的二级预防使用更敏感的HPV NAT检测,以及越来越多的HPV检测方法,这具有相关性。

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