Cervical Cancer Screening with HPV Testing: Updates on the Recommendation

Abstract

The present update is a reassessment of the 2018 ‘Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil’ (Zeferino et al.)[9], according to the changes observed in new international guidelines and knowledge updates. The most relevant and recent guidelines were assessed. Questions regarding the clinical practice were formulated, and the answers considered the perspective of the public and private sectors of the Brazilian health system. The review addressed risk-based strategies regarding age to start and stop screening, the use of cytology and colposcopy to support management decisions, treatment, follow-up strategies, and screening in specific groups, including vaccinated women. The update aims to improve the prevention of cervical cancer and to reduce overtreatment and the misuse of HPV testing.

Resumo

Esta atualização é uma reavaliação das “Recomendações para o uso de testes de DNA-HPV no rastreamento do câncer do colo do útero no Brasil” (Zeferino et al., 2018),[9] de acordo com as mudanças observadas nas novas recomendações internacionais, além das atualizações no conhecimento. As recomendações mais relevantes e recentes foram avaliadas. Questões referentes à prática clínica foram formuladas, e as respostas consideraram a perspectiva do sistema de saúde brasileiro, tanto público quanto privado. Esta revisão abrange estratégias baseadas em risco sobre idade para início e término de rastreamento, o uso da citologia e colposcopia para apoiar as condutas, tratamento, estratégias de seguimento, e rastreamento em grupos específicos, incluindo mulheres vacinadas. Esta atualização tem o objetivo de melhorar as estratégias de prevenção do câncer do colo de útero e reduzir o supertratamento e o uso incorreto dos testes de HPV.

Keywords

uterine cervical neoplasms - human papillomavirus DNA tests - early detection of cancer - accessibility of health services - mass screening

Palavras-chave

neoplasias do colo do útero - testes de DNA para papilomavírus humano - detecção precoce de câncer - acessibilidade dos serviços de saúde - rastreamento em massa

Publication History

Received: 11 June 2021

Accepted: 14 October 2021

Article published online:
15 February 2022

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