MEDIX, God. 14 Br. 79  •  Pregledni članak  •  Ginekološka onkologija HR ENG

Suvremene spoznaje u prevenciji raka vrata materniceCurrent knowledge in prevention of cervical cancer

Magdalena Grce, Goran Grubišić

Unatoč drastičnom smanjenju incidencije zahvaljujući probiru po Papanicolaou (Papa-test), rak vrata maternice druga je po učestalosti maligna bolest u žena u svijetu nakon raka dojke. Svjedoci smo izobilja dokaza koji dovode do jedinstvenog zaključka da je svaki rak vrata maternice uzrokovan trajnom infekcijom jednog malog broja papiloma virusa čovjeka (HPV – Human Papilloma Virus), od kojih HPV tip 16 i HPV tip 18 predstavljaju 70% slučajeva. Stoga se, današnje mjere prevencije temelje na toj uzročno-posljedičnoj činjenici. Naime, primarna prevencija može se postići primjenom cjepiva protiv HPV-a tipa 16 i 18, i to osobito kod djevojaka ili mladih žena prije izlaganja infekciji HPV-om, odnosno neposredno prije spolnih odnosa, a sekundarna prevencija testiranjem na HPV u kombinaciji s Papa testom. Populacijski gledano, najbolja zaštita protiv raka vrata maternice postiže se primjenom tih dvaju mjera, probira i cijepljenja, naročito u sklopu nacionalno organiziranih programa

Ključne riječi:
probir; primarna prevencija; sekundarna prevencija; cjepivo protiv HPV-a; rak vrata maternice

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 14 Br. 79

After breast cancer, cervical cancer is the second most common cancer in women in the world despite a drastic reduction in its incidence due to use of Papanicolaou (Pap) smear. A wealth of evidence has led to the conclusion that virtually all cases of cervical cancer are attributable to persistent infection by a subset of Human Papilloma Virus (HPV) types, with HPV type 16 and HPV type 18 representing 70% of the cases. For that reason, preventive measures today rely on this causal connection. Thus, the primary prevention can be achieved by HPV vaccination against HPV types 16 and 18, especially in adolescent girls and young women before their exposure to HPV infection, i.e. before they become sexually active, while the secondary prevention can be based on regular HPV testing combined with the Pap smear. At the population level, the best protection against cervical cancer can be achieved by implementing both screening and immunization, particularly within nationwide organized programmes.

Key words:
mass screening; primary prevention; secondary prevention; papillomavirus vaccines; uterine cervical neoplasms