The importance of secondary prevention of cervical cancer

CILJ ISTRAŽIVANJA. Utvrditi koja od pojedinih metoda sekundarne prevencije (PAPA test, kolposkopija, ciljana biopsija, ekskohleacija i HPV testiranje) ima najveću osjetljivost i specifičnost za otkrivanje preinvazivnih lezija i sprečavanje nastanka raka vrata maternice. USTROJ STUDIJE. Retrospektivna stručno istraživačka studija. ISPITANICI I METODE. Ispitanice su bolesnice u Klinici za ginekologiju i opstetriciju KBC Osijek u proteklih pet godina u razdoblju od 2010. do 2014. Podatci su prikupljeni iz kolposkopskih kartona ambulante. Istraživanje je obuhvatilo 60 ispitanica. REZULTATI. Prosječna dob u kojoj se pojavljuju preinvazivne lezije vrata maternice je 39 godina. Kontracepciju ne koristi 62 % ispitanica. Najveći broj njih rodilo je dvoje djece (42 %). PAPA test rezultati pokazuju kako najveći broj ispitanica ima CIN III. HPV testiranje učinjeno je samo kod 22 % ispitanica. Statističkom analizom pokazalo se da postoji statistički značajna povezanost između kolposkopskog nalaza prilikom prvog pregleda i kolposkopskih promjena tijekom praćenja, te između PH nalaza ciljane biopsije i PAPA testa, kolposkopskog nalaza prilikom prvog pregleda i kolposkopskih promjena tijekom praćenja. Osjetljivost PAPA testa je 61,54 %, specifičnost 87,23 % te dijagnostička točnost 81,67 %, a osjetljivost kolposkopije 69,23 %, specifičnost 97,83 % te dijagnostička točnost 91,67 %. ZAKLJUČAK. U otkrivanju preinvazivnih lezija raka vrata maternice ključnu ulogu imaju kolposkopija i PAPA test, koji se koriste kao metode sekundarne prevencije raka vrata maternice. Visoku osjetljivost i dijagnostičku točnost pokazuju obje vrste testa, te time vrlo dobro predviđaju nalaz histologije.TITLE. The importance of secondary prevention of cervical cancer. OBJECTIVES. To determine which of the individual methods of secondary prevention (Pap test, colposcopy, target biopsy, excochleation and HPV testing) has the highest sensitivity and specificity for the detection of preinvasive lesions and prevention of cervical cancer. STUDY DESIGN. Retrospective professional research study. PARTICIPANTS AND METHODS. The subjects were patients at the Clinic of Gynecology and obstetrics, Clinical hospital center Osijek, who were treated in the past five years in the period from 2010 to 2014. Data was collected from the clinic’s colposcopy records. The study included 60 women. RESULTS. The average age at which preinvasive cervical lesions appear was 39. 62 % of subjects do not use contraception. Most of them gave birth to two children (42 %). Pap test results show that the greatest number of subjects had CIN III. HPV testing was done only in 22 % of the subjects. Statistical analysis showed that there is a statistically significant correlation between colposcopy results during the first examination and colposcopic changes during follow-up, and between the PH findings of targeted biopsies and the Pap test, and colposcopy results during the first examination and colposcopic changes during further monitoring. The Pap test has a sensitivity of 61,54 %, specificity of 87,23 %, and diagnostic accuracy of 81,67 %, and the colposcopy has a sensitivity of 69,23 %, specificity of 97,83 %, and diagnostic accuracy of 91,67 %. CONCLUSION. Colposcopy and the Pap test, which are used as methods of secondary prevention of cervical cancer, have a crucial role in the detection of preinvasive lesions of cervical cancer. The high sensitivity and diagnostic accuracy of both tests show, and thus very well predict the histological findings