Paradigm shift in cervical cancer prevention
For the upcoming generation of women and their clinicians, the prevention, detection and treatment of precancerous changes in the cervix will undergo a radical change away from excision via surgery to primary prevention. This revolution will be catalysed by twin advances in the biology and immunology of cervical dysplasia. First, we now have the ability to directly detect the human papillomavirus (HPV) that drives dysplasia, and ultimately cancer, rather than rely on the indirect manifestation of HPV infection as cytological changes. Moreover, young men and women can now receive a safe and effective vaccine against these viruses and protect themselves against cervical cancer, dysplasia and genital warts. Annual Papanicolaou smears and excisional biopsies will slowly become the relics of my generation and the antiques of the new generation.
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