HPV And Cervical Cancer
The fraction of persistent carriers of HPV is in the range of 4%-10%. People who are persistent carriers of HPV are in a high-risk group for other types of HPV-related cancers.
The rate of prevalent infections in young adult females is as high as 40%-80%. The lifetime probability of ever encounting HPV infections is as high as 80%-90%.
Most HPV infections clear spontaneously without clinical signs of symptoms.
Screening can be based on PAP smears, automated reading of cytology or biomarkers, use of HPV nucleic acid detection technology (DNA and RNA tests). Advances in screening technology will allow increased time intervals between the procedures which will enable the patient not to have to make as frequent physician visits.
The factors that determine the process of clearance or persistence of infection are not completely understood.
The time lag between initial infection and development of cancer is 20-40 years for cervical cancer, which gives physicians and patients a workable timeframe for screening and early detection of these conditions.
The most effective screening methods in developing counties would be to develop low technology methods such as visual inspection with acetic acid, DIA, localized cryotherapy, (Freezing with liquid nitrogen), low cost colposcopes to visualize lesions, and other HPV tests.
The combination of generalized immunization of adolescents in HPV screening with a woman would be implemented in most industrialized countries until more broad spectrum vaccine have been developed.
HPV vaccination in developing countries where routine screening is economically unviable. Screening in populations where a large portion of the population has been vaccinated may implement in such a way that there will be fewer lifetime screenings.
The strategy of conventional screening as established prevention strategy works well in a population that is not vaccinated.