Notes Cervical Cancer Ranks 4th leading cause of female cancer in the world. The second most common cancer in women aged 15 to 44 years. Age-standardises incidence rate of cervical cancer cases attributable to HPV in Ghana 27.4 (2020 Estimates) Primary Prevention : HPV Vaccination Secondary Prevention Screening with Pap Test, HPV DNA Test ,VIA Takes 10 to 20 years to progress from pre-invasive disease to cancer Human papillomavirus (HPV) Most common sexually transmitted disease. Initial infection occurs as a teenager or young adult. More than 80% of people who have HPV at some point in their life. Many types of HPV affect the mouth ,throat or genital area. One can get HPV from any skin-skin contact of the genital area and from vaginal,anal or oral sex. HPV has no symptoms so you may not know if you have it. Cancers linked to high-risk HPV include cervical cancer, anal cancer, cancer of the penis, vulval cancer , vaginal cancer and some types of head and neck cancer. HPV types 16 and 18 infections are responsible for about 70% of all cervical cancer cases worldwide . HPV Vaccines that prevent HPV 16 and 18 infections are now available and have the potential to reduce the incidence of cervical and other anogenital cancers. Burden of cervical HPV Infection Worldwide Global prevalence 12% Prevalence (%) of HPV 16 and 18 among women with : Normal Cytology 3.9% Low-grade cervical lesions (LSIL/CIN-1) 51.9% High-grade cervical lesions (HSIL/CIN-2/CIN-3/CIS) 25.8% Cervical Cancer 69.4% Majority of the cases are squamous cell carcinoma followed by adenocarcinomas Why we still need screening Poor vaccine uptake Existing vaccines do not cover all high-risk HPV types Vaccines do not treat pre-existing HPV infections Accelerators Sufficient , affordable supply of screen and treat technologies and products Prompt certification of new products Price reductions National scale-up of screen and treat Increased quality and coverage of service delivery Countries detailed implementation plans to introduce and scale-up products and delivery models Strengthen patient retention and linkage to treatment HPV-DNA has both high sensitivity and specificity Screening and treatment approaches "Screen-and-treat approach" - treatment decision based on positive primary screening test only "Screen,triage and treat approach" - Treatment decision based on positive primary screening test followed by a positive second test(a"triage"test), with or without histologically confirmed diagnosis.
