Prevention of Cervical Cancer
In Germany, according to the Society of the Epidemiological Cancer Registry e. V. (GEKID) and the Robert Koch Institute registered about 6,200 new cervical carcinomas in 2004 and about 1,660 women died of this disease. As late as the 1970s, cervix cancer was the most common cancer among women. Now primary and secondary prevention offers the opportunity to almost completely combat cervical cancer.
Prof. Walter Jonat, President of the German Society for Gynecology and Obstetrics (DGGG) recommends HPV (Human Papillomavirus) * for vaccine use: * The introduction of the vaccine for girls before sexual intercourse will reduce cervical cancer in the long term. We anticipate a mortality reduction of up to 70 percent. "The vaccine also helps prevent pre-cancer stages, as well as genital warts. The triple vaccine is recommended by the Standing Vaccination Commission (STIKO) and paid by health insurances until the age of 17. The vaccine is well tolerated. The most common side effects include headache and pain at the injection site.
The risk of developing HPV infection is very high after the onset of sexual activity and provides safe protection, e.g. There are no condoms. Investigations showed that as early as five years after sexual activity, approximately 60% of young women are infected with HPV. An effective prophylactic vaccine is therefore necessary, but also the secondary prevention by regular, annual screening tests from 20 years. Since the introduction of the so-called PAP test (Papanicolaou test, smear of cells on the cervix) as an offer of statutory cancer screening, this cancer has been greatly reduced. In addition to the cervical smear, the guideline group is recommended to test for HPV infection from the age of 30, as long as the test results are conspicuous, whereby the predictive value of HPV testing increases with age.
Prof. Klaus Friese, who has been entrusted with drawing up the guideline by the DGGG, sees clear advantages in the additional application: "We want to treat women early and gently. The HPV test allows us to identify precursors that we can treat, and so we can avoid later major surgeries. The HPV test gives added assurance to the PAP test and is therefore so important because cervical cancer can already occur in young women. With an average age of onset of 51 years, this cancer is 18 years ahead of other female cancers and it becomes clear why cancer screening is so important."
The interdisciplinary guideline group has submitted a recommendation on the use of cervical smears in connection with HPV testing. It also details all diagnostic and therapeutic procedures and measures, including: in HPV-associated genital warts, pre-invasive lesions of the external female genitalia and cervical disorders (so-called dysplasia), including during pregnancy, received. However, the incidence of cervical cancer can only be reduced sustainably if the annual screening tests are followed and the participation rate increases in the long term.
According to the available results, Prof. Walter Jonat demands that the HPV testing be taken over by the health insurances: "With the guideline we provide a clear decision basis, on the basis of which the Federal Joint Committee can adopt the HPV testing into the general benefits of the health insurances."