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Las pautas de detección del cáncer de cuello uterino recomiendan comenzar a los 21 años con citología cada 3 años, o a los 30 años con citología, prueba de virus del papiloma humano de alto riesgo (hrHPV), o co-prueba cada 3-5 años. No se recomienda el cribado en mujeres menores de 21 años o mayores de 65 con un cribado previo adecuado.

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Área de la Ciencia:

  • En el campo de la oncología
  • La medicina preventiva
  • Salud pública

Sus antecedentes:

  • Las muertes por cáncer cervical han disminuido debido al cribado.
  • El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF, por sus siglas en inglés) actualizó sus recomendaciones de 2012.
  • Se revisaron las pruebas sobre los métodos y los intervalos de detección.

Objetivo del estudio:

  • Actualizar las recomendaciones de la USPSTF para el cribado del cáncer cervical.
  • Evaluar las estrategias de detección, incluidas las pruebas y la citología del virus del papiloma humano de alto riesgo (VPHH).
  • Determinar las edades y los intervalos óptimos de detección y comparar los beneficios y los daños.

Principales métodos:

  • Revisión sistemática de los ensayos clínicos y los estudios de cohorte.
  • Evaluación del cribado con la prueba del VPH solo, la citología sola o la prueba conjunta.
  • Modelado de análisis de decisiones para parámetros y estrategias de cribado.

Principales resultados:

  • La detección reduce la incidencia y la mortalidad por cáncer de cuello uterino en mujeres de 21 a 65 años.
  • Los beneficios del cribado superan los daños para las mujeres de 21 a 65 años.
  • Alta certeza de que los beneficios superan los daños para la citología sola (21-29 años) y para la citología, el VPH crónico o las pruebas conjuntas (30-65 años).

Conclusiones:

  • Se recomienda el cribado cada 3 años con citología en mujeres de 21 a 29 años.
  • Se recomienda el cribado cada 3 años con citología, cada 5 años con hrHPV, o cada 5 años con pruebas conjuntas para mujeres de 30 a 65 años.
  • No se recomienda el cribado en mujeres menores de 21 años, mayores de 65 años (con cribado adecuado) o después de la histerectomía sin antecedentes de lesiones de alto grado.