Cytopathology & Histopathology

Biography

Biography: Philip Davies

Abstract

Cervical cancer is one of the most common cancers among women in low and middle income countries, although the vast majority of cases could be prevented by well organized, population-based cervical screening programs. At this time, the current trend in developed countries is to move from cytology (the Pap test) to the use of HPV testing for cervical screening. However, the use of HPV testing in many low and middle income countries is problematic because of the high prevalence of HPV infection combined with suboptimal adherence to, or the complete absence of, clinical guidelines for the triage and follow-up of HPV-positive women and the incentives to conduct these follow-up and treatment procedures that are created by formal or informal payment to doctors. Therefore, cytology-based cervical screening with a lower sensitivity but high specificity than HPV testing is likely to be a more cost-effective and safer option for many low and middle income countries, but particularly for Eastern European and Central Asian countries where cytology and cytopathology were highly developed during Soviet times. In recognition of these issues, this presentation will discuss: 1) the status of cytology and cytopathology in Eastern Europe and Central Asia during Soviet times; 2) the current status of cervical screening in this region; 3) the potential problems with using HPV testing in this region including HPV prevalence rates and the issues pertaining to clinical guidelines for the follow-up and treatment of screen-positive women; 3) the process that is required to implement cytology-based cervical screening programs in this region, and 4) the progress that has been achieved with the implementation of a cytology-based cervical screening program in the Republic of Moldova.