Ukuhlolwa komdlavuza womlomo wesibeletho
Is it safe to extend the screening interval to 5 years or more after a negative screening result? A new study shows that the risk of cervical cancer after one or more combined HPV tests and cytology screening results is negative Is significantly reduced. The study found a follow-up analysis of 1 million female subjects. The analysis showed that the risk of invasive umdlavuza wesibeletho and cervical CIN3 lesions decreased with each round of combined testing and screening. This risk reduction is most significant between the first and second rounds, and is more significant than the second and third rounds. (Ann Intern Med. November 27, 2017 online version)
Iziqondiso zokuhlolwa komdlavuza womlomo wesibeletho bezilokhu zishintsha, ikakhulukazi ngomgomo we-HPV. Uhlelo lwango-2015 lweziqondiso ze-ACOG luncoma ukuthi ukuhlolwa kwe-HPV kungasetshenziswa njengenye indlela yokuhlola yabesifazane abangaphezu kweminyaka engama-25 ubudala. Kunconywa ukuthola i-cytology njalo eminyakeni emi-3. Kuphinde kuvezwe ukuthi i-cytology ehlanganisiwe kanye nokuhlolwa kwe-HPV kukhethwa kakhulu. Umhlahlandlela wokusalungiswa we-USPSTF uncoma ukuhlola kuphela izinhlobo ezincane ezinobungozi obukhulu be-HPV. Njengenye indlela ye-cytology elula yabesifazane abangaphezu kweminyaka engama-30, ukuhlolwa okuhlangene akusanconywa.
Abacwaningi baveze ukuthi abukho ubufakazi obuningi bocwaningo mayelana nokusebenza kokuhlolwa kwe-HPV, futhi iningi lezifundo zokuhlola i-HPV ezishicilelwe zisekelwe emzuliswaneni wokuhlolwa. Abacwaningi bahlaziye abesifazane abangu-990013 ababehlolwe ngokuhlanganyela kusukela ngo-2003 kuya ku-2014, futhi bahlaziya ushintsho engozini yomdlavuza womlomo wesibeletho ngemva kokuba imiphumela yokuhlolwa ngokuhlanganyela okulandelanayo ibe mibi.
Ukuhlaziywa kwathola ukuthi njengoba umphumela omubi wokuhlolwa okuhlanganisiwe wanda, ingozi yomdlavuza womlomo wesibeletho kanye nezilonda ≥CIN3 zaqhubeka nokuncipha, futhi umphumela omubi wokuhlolwa kokuqala okuhlanganisiwe waba nomthelela omkhulu ekunciphiseni ingozi. Kunoma yimuphi umjikelezo wokuhlolwa, umphumela wemiphumela yokuhlolwa kwe-HPV emsulwa engcupheni yomdlavuza uyavumelana, kungakhathaliseki ukuthi imiphi imiphumela yokuhlolwa kwe-cytological, kungakhathaliseki imiphumela yokuhlolwa ehlanganisiwe. Labo ababengenayo ukuhlolwa kwe-HPV kokuqala babe nokuncipha kweminyaka engu-5 engozini yomdlavuza womlomo wesibeletho ohlaselayo ngo-0.0092%, futhi labo ababenemiphumela yokuhlolwa kwesithathu engemihle babe nokuncipha kwengozi ngo-0.0015%; Ingozi yeminyaka emi-3 yomdlavuza womlomo wesibeletho ohlaselayo yayingenayo ukuhlolwa kokuqala nokwesithathu Yehla ngo-0.0081% kanye no-0.0015%. Ingozi ye-cytological negative yeminyaka emithathu yomdlavuza yehliswe ngo-0.0140% no-0.0023%, ngokulandelana.
Umcwaningi waphawula ukuthi ucwaningo lubonise ukuthi ekuhlolweni kokuqala okuhlanganyelwe, abesifazane abahlolelwa i-HPV abangenayo kuphela babesengozini ephakeme kancane yokuba nomdlavuza kunalabo abanokuhlolwa okuhlanganisiwe okungalungile, futhi labo abanemiphumela ye-HPV engemihle ekuhlolweni kwesibili okuhlanganisiwe banciphisa kakhulu ingozi okwesithathu Ngemva kwesibili esinegethivu, sanyamalala. Ekutholeni izilonda ze-CIN3, izinzuzo zokuhlolwa okuhlanganisiwe ngaphezu kokuhlolwa kwe-HPV zincane kakhulu. Ukuhlolwa okuhlangene kuphela kungeze i-colposcopy engadingekile ne-biopsy nangaphezulu kokwelashwa.
