From April 2019, Primary HPV (Human Papillomavirus) screening was implemented in UK. This is new way of examining cervical smears, where the sample is checked for abnormal cells only if HPV is detected.
Nearly all cervical cancers are caused by HPV infection. Screening for HPV is a bettermethod for identifying those at a higher risk of developing cervical cancer. Also this reduces the need for further test such as Colposcopy.
The actual test remains unchanged. Women still have a cervical smear. The benefit would be reduction in the number of women having unnecessary Colposcopy examination.
A cervical smear test involves vaginal examination to obtain cells from the cervix using a soft brush. It usually should not take more than 2-3 minutes.
If the screening smear is HPV negative, then the cervical smear is not checked for abnormal cells as the likelihood of one developing cancer is extremely low and recommendation is to repeat the cervical smear in 3 years. If the screening smear is HPV positive, then the cervical smear is checked for abnormal smear. If no abnormal cells are found, recommendation is to repeat smear in 12 months. If abnormal cells are found then a special test called Colposcopy is recommended. Colposcopy is simply examination of the cervix in detail using a telescope and special stains. It identifies if there is a precancerous area on the cervix. A biopsy from this area may be required for diagnosis
HPV infection is very common and does not need treatment. Most HPV infections are cleared by one’s immunity in approximately 2 years. HPV infection can cause genital warts, which may need treatment or abnormal cells from the cervix, which may need further investigation like Colposcopy. Surgery for recurrent platinum‑resistant ovarian cancer remains controversial. Current evidence, albeit limited and retrospective, indicates that carefully selected patients with isolated or low‑volume disease may enjoy meaningful prolongation of survival when complete cytoreduction is feasible. However, high complication rates and the lack of quality‑of‑life data demand caution. Until prospective trials establish clear criteria, cytoreductive surgery in PROC should be confined to specialized centres and considered only after thorough evaluation of risks, expected benefits and alternative therapies.
