Organization modalites of screening for cervical cancer and precancerous lesions

Rak vrata maternice zloćudna je bolest kod koje dolazi do promjena na stanicama vrata maternice koji pogađa žene u mlađoj životnoj dobi. U Europi godišnje obolijeva oko 61.000, a umire oko 28.000 žena. Zbog toga se organiziraju preventivni programi za rano otkrivanje raka vrata maternice koji imaju jasno definirane procedure svih postupaka, a ciljna populacija se aktivno poziva na pregled. Oportunistički probir definira se kao uzimanje briseva kada god se pruži prilika ili na zahtjev žene. Probir u žena smanjio je učestalost i smrtnost od raka vrata maternice. Prekancerozne lezije grlića maternice i karcinomi vrata maternice usko su povezani sa spolno prenosivom infekcijom humanim papiloma virusom (HPV), koji uzrokuje više od 99% raka vrata maternice. Metode probira uključuju citologiju (Papa test) i HPV testiranje ili kombinaciju. Cijepljenjem protiv HPV-a pokazalo je učinkovitost unutar 5 godina od primanja cjepiva. Preporuke za pokretanje screeninga u asimptomatskih žena je u dobi od 21 godine. Žene od 21 do 29 godina trebaju biti pregledane svake tri godine citologijom (Papa test). Žene od 30 do 65 godina trebaju biti pregledane svakih pet godina citologijom i HPV testom ili svake tri godine samo citologijom. Screening se ne preporučuje za žene mlađe od 21 godinu ili u žena starijih od 65 godina s odgovarajućom poviješću negativnih rezultata pretrage. Probir se razlikuje od drugih aktivnosti u zdravstvu jer zdravstveni djelatnik započinje komunikaciju s naizgled zdravim pojedincem, stoga zdravstveni djelatnici moraju biti obrazovani, proći obuku te biti maksimalno motivirani.Cervical cancer is a malignant disease with changes in the uterine cell that affects women in younger ages. In Europe, about 61.000 suffer annually and about 28.000 women die. That is why preventive programs for cervical cancer screening have clearly defined procedures for all procedures, and the target population is actively invited to review. The oportunistic screening is defined as taking smears whenever an opportunity is provided or at the request of a woman. Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions and cervical carcinomas are strongly associated with sexually-transmitted human papillomavirus (HPV) infection, which causes more than 99% of cervical cancers. Screening methods include cytology (Papanicolaou test) and HPV testing, or in combination. Vaccination against HPV showed efficacy within 5 years of receiving the vaccine. Recommedation for starting screening in asymptomatic women is at 21 years of age. Women 21 to 29 years of age should be screened every three years with cytology (Pap test). Women 30 to 65 years of age should be screened every five years with cytology plus HPV testing or every three years with cytology alone. Screening is not recommended for women younger than 21 years or in women older than 65 years with an adequate history of negative screening results. Screening is different from other activities in healthcare because the health care worker starts communicating with a seemingly healthy individual, therefore health workers must be educated, trained and be fully motivate