Screeningul primar în cancerul de col uterin - citologia cervico-vaginală vs detecţia tulpinilor HPV-HR

Cervical cancer is the third most common cancer worldwide, with more than 500.000 new cases diagnosed every year. The determined factor of this disease is the infection of the cervical cells by the oncogenic types of HPV. Although all the physiopathologic stages of the disease - starting with the first cervical cell infected by HPV and all the modifications induced by it until de invasive stadium, in Romania, the mortality caused by cervical cancer has still a high rate. The most common screening test for cervical cancer is cervico-vaginal smears - either conventional Papanicolau test (Pap smear) or liquid based Pap test; this method has a sensibility of 53%. Another screening test is detecting the high risk types of HPV; this method has a sensibility of 83-90%. The ideal method of primary screening for cervical cancer is co-testing both liquid based Pap test and detecting the high risk types of HPV. Even though, at present in Romania the most common primary screening test for cervical cancer is cervico-vaginal smears, given the fact that an increasing number of European countries is assessing the detection of high risk types of HPV as a primary screening test for cervical cancer, probably Romania will follow the same direction.