UK National Health Service To Trial DIY Cervical Screening Kits To Boost Testing Numbers - IFLScience
UK National Health Service To Trial DIY Cervical Screening Kits To Boost Testing Numbers - IFLScience |
| Posted: 26 Feb 2021 08:18 AM PST  Smear tests, also known as a pap screen, are an effective tool in the fight against cervical cancer. By running a small device across the surface of the cervix where the womb meets the vagina, smears can look for specific variants of human papillomavirus (HPV) that can cause changes to the cells and potentially later give rise to cervical cancers. These types are known as "high risk" HPV owing to their potential to cause serious problems later down the line. A vaccine for high-risk variants has proven very effective, but there is still a need for accessible testing. According to the Center for Disease Control and Prevention, almost all of us will get HPV at some point in our lives because it's so common among sexually active individuals, with around 100 variants known to be circulating. HPV spreads through skin-to-skin contact such as anal, oral, or vaginal sex with someone who is currently infected. An infection may cause noticeable symptoms such as warts (papilloma means a small wart-like growth), but often people don't experience any symptoms meaning they don't know they are infected and are more likely to pass it on. Catching HPV for most people won't have a significant impact on your health but catching a high-risk variant is something that merits watchful waiting for early cell changes which can be picked up in a pap smear. The procedure is safe and usually only causes mild discomfort but both mental and physical conditions, as well as cultural obstacles, can make the prospect of a smear an intimidating one for people with a cervix. To tackle some of these barriers and hopefully boost the number of people having smear tests, the National Health Service (NHS) in England is trialing a do-it-at-home kit that will give people the freedom to test themselves at home. The test is posted to those overdue for a smear test and involves using a long, cotton bud to swab the inside of the vagina which is then sealed in a water-tight container. The test can then be sent for analysis using post boxes which are easy to access in almost all parts of the country. The swab-and-send protocol is similar to existing test kits given out to people who wish to check if they have the sexually transmitted infections chlamydia and gonorrhea. The tests will be sent to people between the ages of 25 and 64 and if they come back positive for HPV, they will be invited to their General Practitioner who will carry out a more extensive smear test to get a better sample of cervical cells and check these for changes. According to a report from the BBC, last year between April and May around 600,000 tests didn't happen and with the COVID-19 pandemic still causing delays in the UK it's likely the backlog of missed appointments - which is usually around 1.5 million - could be even greater than in previous years. "Self-sampling has been hailed as a 'game-changer' for cervical screening that will make screening more accessible and acceptable to women," reads the YouScreen website that is launching the initiative. "Women can take their own sample for cervical screening, in private and at a time and place of their choosing. "The fact that women don't need to have a speculum examination is a key advantage. Self-sampling has already been integrated into the national screening programmes of The Netherlands, Denmark, Australia and Malaysia."  |
| What Pharmacists Should Know About Cervical Cancer - Pharmacy Times Posted: 16 Feb 2021 09:17 AM PST  Most cases of cervical cancer can be prevented by1 :
When detected early and treated effectively, cervical cancer is one of the most successfully treatable cancers. The WHO predicts that with a "comprehensive approach to prevent, screen and treat, cervical cancer can be eliminated as a public health problem within a generation."1 Cervical Cancer Data According to the American Cancer Society (ACS), in 2020, about 13,800 new cases of invasive cervical cancer will be diagnosed, and about 4290 women will die from this disease.2 The average age at diagnosis is 50 years. Although many women do not realize cervical cancer can be detected as they get older, more than 20% of cases are diagnosed in women older than 65 years. However, cervical cancer rarely occurs in women who are regularly tested.2 Survival Rates
These numbers are based on women who received a diagnosis and were treated at least 5 years prior. Because treatments improve over time, the outlook may be better than these numbers indicate. Other factors, such as age and overall health, also can affect the outlook.3 Prevention and Risk Factors
Signs and Symptoms of Cervical Cancer Because cervical cancer may not cause symptoms (especially in the early stages), regular cervical cancer screening should start for patients aged 21 years (or as determined by their physician). Symptoms, which may or may not be present, may include pain/bleeding with sexual intercourse, pelvic pain, unusual discharge, and/or unusual bleeding. Patients who experience any of these symptoms should consult their physician immediately.5 Diagnosis Abnormal results from a Papanicolaou or HPV test will require the patient to undergo further testing, including history and physical examination, and various biopsies and/or procedures. If cancer is present, more testing will be performed, including additional procedures and imaging.7 Types and Staging Most (almost 90%) of cervical cancers and precancers are squamous cell carcinomas. Most other cervical cancers are adenocarcinomas. Some cervical cancers are mixed carcinomas.8 Cervical cancer is classified from stage 0 to stage IVB, depending on the location and spread.9 Cervical Cancer Treatment Chemotherapy may be given, often with radiation, depending on the type and stage of cervical cancer.10 Some examples of chemotherapy drugs for cervical cancer include cisplatin (Platinol; Bristol Myers Squibb), carboplatin (Paraplatin; Bristol Myers Squibb), paclitaxel (Taxol; Bristol Myers Squibb) and topotecan (Hycamtin; Novartis), or a combination of drugs.11 Common adverse effects (AEs) of chemotherapy include nausea, vomiting, diarrhea, appetite loss, hair loss, mouth sores, and fatigue. Low blood counts may result in increased chance of infection, bleeding, bruising, shortness of breath, and fatigue. AEs are often worse when chemotherapy is given with radiation.11 Targeted therapy drugs target the changes in cancer cells. The monoclonal antibody bevacizumab (Avastin; Genentech) is a targeted therapy medication that treats advanced cervical cancer. Common AEs include high blood pressure, fatigue, and nausea.11-13 Immunotherapy stimulates the immune system to recognize and destroy cancer cells, and is used to treat cervical cancer that has spread or recurred. Pembrolizumab (Keytruda; Merck) is a monoclonal antibody that targets proteins on T cells to shrink tumors or slow growth.14 The most common AEs of immunotherapy drugs are fatigue, fever, nausea, diarrhea or constipation, headache, rash, appetite loss, and joint or muscle pain.14 The treatment selected for cervical cancer depends on the stage, location, and type of cancer, as well as age, overall health, and whether the patient wants to have children.15 HPV Vaccine Since 2016, there has been only 1 HPV vaccine available in the United States. This vaccine is administered to boys and girls, in 2 or 3 doses, depending on age. The vaccine can be administered to children as young as 9 years, but generally is first given to children aged 11 or 12 years. Administration of the vaccine is recommended to continue up to patients aged 26 years. The vaccine also can be administered to patients as old as 45 years. Patients can consult their physician to see whether they need HPV vaccination.16 The most common AEs of the HPV vaccine are injection site reactions, fever, nausea, headache, fatigue, muscle or joint pain, and dizziness or fainting. To prevent fainting and associated injuries, adolescents should sit or lie down during vaccination and remain in position for 15 minutes after receiving the vaccine.16 The Pharmacist's Role KAREN BERGER, PHARMD, is a pharmacist at an independent pharmacy in northern New Jersey. REFERENCES
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