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Früherkennung des Zervixkarzinoms

Early detection of cervical cancer

  • Leitthema
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Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Seit 1971 existiert in Deutschland ein opportunistisches Früherkennungsprogramm für Zervixkarzinome, wodurch die Inzidenz und Mortalität dieser Erkrankung um 75 % verringert werden konnte. Nun fordert die aktuelle europäische Leitlinie die Einführung eines organisierten Screeningprogramms.

Fragestellung

Ab 2018 soll ein organisiertes HPV-Test-basiertes Screening mit Zytologie-Triage eingeführt werden. Die Hintergründe dieser Entscheidung sollen beleuchtet und die Studien, die zur Entscheidungsfindung beigetragen haben, vorgestellt werden.

Ergebnisse und Diskussion

Die existierenden Daten zeigen eine höhere Sensitivität eines HPV-basierten Zervixkarzinomscreenings im Vergleich zu einem zytologiebasierten Programm. Insgesamt stellt ein HPV-Test-basiertes Screening ein einfaches, verlässliches und objektives Verfahren dar. Durch die höhere Sensitivität und den hohen negativen prädiktiven Wert eines HPV-Tests kann außerdem das Screeningintervall erweitert werden. Allerdings muss auf eine mögliche Übertherapie von mittelgradigen Dysplasien hingewiesen werden.

Abstract

Background

In 1971 an opportunistic screening program for cancer of the uterine cervix was initiated in Germany. This led to a 75 % reduction in the incidence and mortality of cervical cancer. The current European guidelines now recommend the implementation of an organized screening program.

Objective

Starting in 2018 an organized human papillomavirus (HPV) test-based screening with cytology triage will be established in Germany. This article explains the background to this decision and presents the underlying studies which contributed to the decision.

Results and conclusion

The existing data show a higher sensitivity of HPV-based screening for cervical cancer compared to a cytology-based program. The HPV test is a simple, reliable and objective procedure. The higher sensitivity and the high negative predictive value of HPV tests allow the interval between examinations to be extended; however, a possible overtreatment of moderate dysplasia of the uterine cervix has to be considered.

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Authors and Affiliations

  1. Klinik und Lehrstuhl für Frauenheilkunde und Geburtshilfe der Universität Regensburg am Caritas-Krankenhaus St. Josef, Landshuter Str. 65, 93053, Regensburg, Deutschland

    Susanne Schüler-Toprak &  Olaf Ortmann

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  1. Susanne Schüler-Toprak
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  2. Olaf Ortmann
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Corresponding author

Correspondence to Susanne Schüler-Toprak.

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Interessenkonflikt

S. Schüler-Toprak und O. Ortmann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Schüler-Toprak, S., Ortmann, O. Früherkennung des Zervixkarzinoms. Onkologe 22, 562–567 (2016). https://doi.org/10.1007/s00761-016-0050-4

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