Cancer of the cervix accounts for fewer than 2% of all cancer deaths, and yet is one of the most common gynecological malignancies. The Papanicolaou (Pap) test remains the basis of cervical cancer prevention. Cervical cancer is treatable, curable, if detected early, and now possibly preventable by vaccine. Cervical cancer has become a problem of access and public health. Cervical cancer: There are approximately 14,000 new cases of cervical cancer yearly in the USA and approximately 4000 deaths from cervical cancer. In 2005, there were approximately 9700 new cases and 3700 deaths from cervical cancer in the USA (Figure 15.1). Non-white races have greater incidence of both cervical cancer and death from cervical cancer. Risk factors include HPV infection and never having had a Pap test. Non-whites have a higher incidence of cervical cancer and death from cervical cancer, but this may be caused more by access and screening than genetic tendency. The Pap test and its limitations: The goal of the Pap test-cervical cytology screening-is to detect precancerous and cancerous lesions at a point when they can be treated and to initiate further evaluation based on the cytological diagnosis. The conventional Pap smear has been used for 50 years and is one of the most effective screening tests developed. Since its introduction by Herbert Traut in 1942, the Pap smear has become the most widely used cancer screening test. The effectiveness of the Pap smear is proportional to the number of tests a woman has had in her life.
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