A mix-sectional examination of more 5000 cytology screening certainly women elderly than half a century unearthed that personality from genital intraepithelial neoplasia and you may disease was uncommon in this generation shortly after hysterectomy. 63 Inside the the next examination of more 10,000 Pap examination did more 24 months during the 6265 women that had a good hysterectomy that have elimination of the newest cervix, screening yielded 104 unpredictable Pap test outcomes with no cases of cervical malignant tumors; at exactly the same time, 6 instances of large-degree vaginal lesions was indeed thought of, however it is not known if or not detection of them instances enhanced systematic effects. 64
目次
Destroys out of Screening
Evaluation which have cervical cytology and you can hrHPV review may cause harms, plus more frequent realize-up evaluation and you may intrusive diagnostic methods (such, colposcopy and you may cervical biopsy), and too many cures in females which have untrue-achievements. Proof out-of RCTs and you can observational training imply that harms from symptomatic strategies are vaginal hemorrhaging, discomfort, disease, and you will inability to diagnose (due to useless sampling). Irregular examination test results are associated with the psychological destroys. In particular, women that obtained self-confident hrHPV results stated higher stress and lower satisfaction which have earlier in the day and you can latest sexual lovers than women who gotten unusual cytology show.
The new USPSTF discovered enough facts your destroys from hrHPV testing alone in women aged 21 so you’re able to 31 ages was modest. Number 1 hrHPV research has been discovered to bring about highest pricing away from self-confident evaluation inside age group, where HPV attacks will in all probability resolve spontaneously. The latest high frequency out-of transient HPV issues among feminine more youthful than simply three decades may cause way too many go after-right up diagnostic and you can medication interventions with prospect of damage.
Brand new USPSTF receive enough evidence the damage regarding examination to own cervical cancer tumors (that have cytology by yourself, hrHPV research alone, or cotesting having both) in women aged 31 to 65 ages was modest. Tests methods that are included with hrHPV testing try quite far more painful and sensitive than those who tend to be cytology alone and produce a lot more not the case-positive results. Cotesting is additionally a bit a great deal more painful and sensitive than simply cytology alone but guides on the large false-positive rates.
The USPSTF discover adequate evidence that harms off examination having cervical malignant tumors in females over the age of 65 years who’ve had sufficient prior screening and are maybe not if not at the high-risk are no less than short. Brand new USPSTF along with found sufficient evidence the damage away from testing to possess cervical cancer in women young than just 21 ages are reasonable.
The new USPSTF receive sufficient proof one tests getting cervical malignant tumors from inside the ladies who have seen an excellent hysterectomy with removal of the latest cervix and don’t has a history of a high-amounts precancerous lesion or cervical malignant tumors is actually of destroys.
Damages off Procedures
Brand new damages regarding therapy were risks regarding the therapy techniques and you may the potential after that consequences from therapy. Research away from observational education demonstrates specific remedy for precancerous sores (for example, cold-knife conization and you will loop excision) is associated with subsequent bad pregnancy effects, such as for example preterm birth and you may relevant complications. 2 The USPSTF discover persuading proof that numerous precancerous cervical sores often regress and this other sores is indolent, slow growing, and will not feel clinically important over a female’s life; personality and you will treatments for this type of lesions create overdiagnosis. Quoting the precise magnitude out-of overdiagnosis with the people tests otherwise procedures method is hard, but it is of concern whilst confers zero work for and you can results in unnecessary monitoring, tests, and you will providers, having related damages.
Guess out of Magnitude regarding Websites Work with
There clearly was persuading proof you to examination with cervical cytology by yourself, primary hrHPV assessment by yourself, otherwise cotesting is choose large-grade precancerous cervical lesions and you may cervical cancer tumors. New USPSTF discovered persuading proof one to testing female old 21 in order to 65 ages substantially minimizes cervical malignant tumors incidence and death. The brand new USPSTF en gГјzel Papua Yeni Gine kadД±nlar discover sufficient research that harms of evaluation to possess cervical cancer tumors (that have cytology by yourself, hrHPV comparison alone, otherwise cotesting that have one another) in women aged 30 in order to 65 decades is actually average. The new USPSTF comes to an end with a high confidence your benefits associated with testing the three years that have cytology by yourself in women aged 21 in order to 30 years dramatically exceed the new harms. The USPSTF ends with a high confidence that the advantages of examination the 3 years with cytology by yourself, all 5 years with hrHPV comparison alone, otherwise most of the five years with in combination in women old 31 to help you 65 years exceed brand new destroys.
美人になりたい運営事務局
