Evaluation of primary versus secondary prevention of cervical cancer: an evidence based literature review

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Vestle, Jennifer
Carter, John W.

The Pap smear improves the probability of detecting cervical abnormalities, caused by Human Papillomavirus (HPV) at an early stage where HPV is more easily treated. Thus, the Pap smear is a valuable tool in the secondary prevention of cervical cancer. Cervical cancer is most commonly found in women who are middle-aged or elderly, low socio-economic status, and minorities. These women are less likely to attend Pap smear screening. Therefore, it is important to determine whether primary (i.e. condom use and awareness) or secondary prevention is more appropriate in reducing the morbidity and mortality of cervical cancer.

Methodology: A systematic literature review was performed to assess the efficacy of primary and secondary prevention of cervical cancer. The articles reviewed included women of various age groups, their knowledge of cervical cancer, their attendance at Pap smear screening, risk factors for cervical cancer, and the value of Pap smears.

Results: Pap smear screening was found to be an effective tool in decreasing the incidence of cervical cancer; however, to target women most at risk it is not as effective as primary prevention. In fact, several studies showed a majority of these high-risk women do not obtain Pap smears and are not aware of the link between HPV and cervical cancer. Furthermore, several studies also showed that condom use significantly reduces the contraction of sexually transmitted HPV, thus reducing the precursor to cervical cancer.

Conclusion: In addition to promoting Pap smear screening, more consideration should be given toward education and condom use in the prevention of cervical cancer. Together these two prevention strategies can help reduce the morbidity and mortality of cervical cancer in women of all groups.

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A project presented to the Department of Physician Assistant of Wichita State University in partial fulfillment of the requirements for the degree of Master of Physician Assistant.