Cancer is always the result of the loss of normal control over cell growth


НазваCancer is always the result of the loss of normal control over cell growth
Дата конвертації26.04.2013
Розмір448 b.
ТипПрезентации

































Cancer is always the result of the loss of normal control over cell growth

  • Cancer is always the result of the loss of normal control over cell growth

























HPV L1 VLP vaccines are safe and well tolerated

  • HPV L1 VLP vaccines are safe and well tolerated

  • HPV vaccines are highly immunogenic

  • HPV vaccines were >90% efficacious in preventing HPV-associated neoplasia of the lower genital tract and genital warts

  • Recommended by the ACIP to be given to girls and young women age 9-26 (in 2007) and for boys and young men between 9-21, with “catch-up” to 26 acceptable (in 2011)

  • Ideal target age for both sexes is 11-12





Public health experts are concerned:

  • Public health experts are concerned:

    • Only a minority of adolescent girls are getting vaccinated against HPV, even in neighborhoods where most are eligible
    • In the underserved wards of D.C. only 12% of 6th grade girls are getting the vaccine
    • Just over 40% of teens nationwide have gotten at least one shot, but the number completing the series is far less
    • In England and Australia, with free school-based administration, coverage is over 80%
    • While cytology screening has reduced SCC rates by 70-80%, adenoCA rates keep rising


Public concern about:

  • Public concern about:

    • Safety
      • Now over 40 million doses given. Syncope and local skin infections
















Women <21 No screening

    • Women <21 No screening






Women <21 No screening

    • Women <21 No screening


When should women have their first Pap?

  • When should women have their first Pap?

  • 1970s-2003: Age 18 or at first intercourse, whichever came first

















All screening recommendations are for women NOT having the following risk factors

  • All screening recommendations are for women NOT having the following risk factors



How often to screen: Age 21-29

  • How often to screen: Age 21-29



































Khan MJ, et al. J Natl Cancer Inst 2005; 97:1072–1079.

  • Khan MJ, et al. J Natl Cancer Inst 2005; 97:1072–1079.













When to stop cervical screening:

  • When to stop cervical screening:





When to stop cervical screening: Post-hysterectomy with no history of CIN 2,3

  • When to stop cervical screening: Post-hysterectomy with no history of CIN 2,3





When to stop cervical screening: Post-hysterectomy with previous CIN 2,3

  • When to stop cervical screening: Post-hysterectomy with previous CIN 2,3









Should women who have had the HPV vaccine be screened the same as women not vaccinated?

  • Should women who have had the HPV vaccine be screened the same as women not vaccinated?





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