PREVENCIJA KARCINOMA GRLIĆA MATERICE
DOI:
https://doi.org/10.46793/PP231209005TKljučne reči:
karcinom grlića materice, mladi, prevencija, vakcinacijaApstrakt
I pored razvijenih sistema prevencije, ali i savremenih, uspešnih modaliteta lečenja, karcinom grlića materice predstavlja i dalje veliki socijalni i epidemiološki problem u svetu, naročito izražen u nerazvijenim zemljama i zemljama u razvoju. Prema incidenci i mortalitetu od karcinoma grlića materice, Srbija se decenijama unazad nalazi u vrhu liste evropskih zemalja.
Dokazana centralna uloga hronične HPV infekcije i perzistentnog prisustva virusne DNK u genetskom materijalu ćelija cervikalne sluznice, dovela je i do razvoja uspešnih mera prevencije.
Primarna prevencija je predstavljena kroz HPV imunizaciju populacije u dečijem/ranom adolescentnom dobu, što omogućava smanjenje učestalosti HPV infekcije, a time i smanjenje incidence patoloških promena na sluznici grlića. Sekundarna prevencija je predstavljena kroz skrining sa ciljem otkrivanja asimptomatskih premalignih promena ili ranih stadijuma invazivne bolesti.
Pokazano je da se populacioni benefit od vakcinacije postiže kada nivo imunizacije pređe 50%. U Srbiji je trenutno dostupna devetovalentna HPV vakcina, mada sama vakcinacije nije obavezna već je na nivou preporuke, što uz nedovoljnu informisanost o HPV infekciji, udruženo sa već naširoko rasprostranjenom negativnom senzibilizacijom opšte populacije u Srbiji prema vakcinaciji uopšte, daje ukupno nizak procent vakcinisanih. Takođe, još uvek ne postoji adekvatno razvijen organizovani skrining, on se najčešće sprovodi kao povremeni, oportuni skrining, baziran na kolposkopiji sa PAP testiranjem, dok se HPV testiranje sprovodi u znatno manjem obimu, što sve predstavlja razloge visoke incidence i mortaliteta od karcinoma grlića materice u Srbiji.
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