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Invasive Cervical Cancer in the NILM Population


米国(Kaiser Permanente)およびスウェーデンで高く評価されている医療保険制度の検診プログラムでも、子宮頸部浸潤がんのそれぞれ32%および24%が細胞診の結果が正常な女性に認められたことが示されました3,4


細胞診はHPV DNA検査に比べて感度が低い11

細胞診はHPV DNA検査に比べて感度が低い11。


米 国予防医学作業部会(US Preventive Services Task Force;USPSTF)において行われたHPV検査に関する無作為化試験からのエビデンスによると、HPV検査は細胞診よりCIN2以上および CIN3以上の病変を検出する感度が常に高いことが示されました11  。

  • 略語:

参考文献 :

1.National Cancer Institute. Cervical Cancer Screening (PDQ®). http://www.cancer.gov/cancertopics/pdq/screening/cervical/HealthProfessional#Section_115 . Accessed June 2011.

2.Herbert A, Anshu, Gregory M, Gupta SS, Singh N. Invasive cervical cancer audit: a relative increase in interval cancers while coverage increased and incidence declined. BJOG. 2009;116(6):845-853.

3.Leyden WA, Manos MM, Geiger AM, et al. Cervical cancer in women with comprehensive health care access: attributable factors in the screening process. J Natl Cancer Inst. 2005;97(9):675-683.

4.Andrae B, Kemetli L, Sparén P, et al. Screening-preventable cervical cancer risks: evidence from a nationwide audit in Sweden. J Natl Cancer Inst. 2008;100(9):622-629.

5.Castle PE, Stoler MH, Wright TC Jr., Sharma A, Wright TL, Behrens CM. Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol. 2011;12(9):880–890 plus supplementary tables.

6.Herzog TJ, Monk BJ. Reducing the burden of glandular carcinomas of the uterine cervix. Am J Obstet Gynecol. 2007;197(6):566-571.

7.The American Congress of Obstetricians and Gynecologists. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists: Screening for Cervical Cancer. November, 2012.

8.Smith HO, Tiffany MF, Qualls CR, Key CR. The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the U.S. — a 24-year population-based study. Gynecol Oncol. 2000;78(2):97-105.

9.Ault KA, Joura EA, Kjær SK, et al. Adenocarcinoma in situ and associated human papillomavirus type distribution observed in two clinical trials of a quadrivalent human papillomavirus vaccine. Int J Cancer. 2011;128(6):1344-1353.

10.Bosch FX, de Sanjosé S. Human papillomavirus and cervical cancer — burden and assessment of causality. J Natl Cancer Inst Monogr. 2003;31:3-13.

11.Whitlock EP, Vesco KK, Eder M, Lin JS, Senger CA, Burda BU. Liquid-Based Cytology and Human Papillomavirus Testing to Screen for Cervical Cancer: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155(10):687-697.