Kuchepetsa chiopsezo cha khansa ya pachibelekero

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Chaka chatha, mwawona mitu yankhani - kuchokera "Katemera wa Khansa Wamtsogolo?" ku "Momwe Mungaphere Khansa" - zomwe zakhala zikuwonetsa zoyambitsa zazikulu za khansa ya pachibelekero. Zowonadi, pakhala pali uthenga wabwino kwa azimayi m'dera lino la zamankhwala: Kutheka kwa katemera, komanso malangizo atsopano owunikira, zikutanthauza kuti madotolo akutseka njira zabwino zothanirana, kuchiza komanso kupewetsa matendawa, omwe amakantha 13,000. Amayi aku America ndipo amatenga miyoyo 4,100 pachaka.

Chimodzi mwazofunikira kwambiri m'zaka zaposachedwa ndikupeza kuti 99.8 peresenti ya khansa ya pachibelekeropo imayamba chifukwa cha mitundu ina ya matenda opatsirana pogonana (STI) omwe amadziwika kuti human papillomavirus, kapena HPV. Kachilomboka kameneka n’kofala kwambiri moti 75 peresenti ya Achimereka ochita zachiwerewere amachipeza panthaŵi ina m’miyoyo yawo ndipo matenda atsopano 5.5 miliyoni amapezeka chaka chilichonse. Chifukwa chokhala ndi kachilomboka, pafupifupi 1% ya anthu amakhala ndi zotupa kumaliseche ndipo 10% ya amayi amatenga zilonda zachilendo kapena zotupa pachibelekero, zomwe nthawi zambiri zimapezeka ndi mayeso a Pap.

Kodi muyenera kudziwa chiyani kuti mudziteteze ku khansa ya pachibelekero? Nawa mayankho amafunso omwe amafunsidwa kwambiri za ubale wapakati pa khansa ya pachibelekero ndi matenda a HPV.

1. Kodi katemera wa khomo lachiberekero adzapezeka liti?

Pazaka zisanu mpaka 10, akatswiri amati. Nkhani yabwino ndiyakuti kafukufuku waposachedwa wasindikizidwa mu The New England Journal of Medicine adawonetsa kuti katemera amatha kupereka chitetezo cha 100% ku HPV 16, vuto lomwe limalumikizidwa kwambiri ndi khansa ya pachibelekero. Merck Research Laboratories, yomwe idapanga katemera wogwiritsidwa ntchito mu kafukufukuyu, pakali pano ikugwira ntchito yokonza njira ina yomwe ingateteze ku mitundu inayi ya HPV: 16 ndi 18, yomwe imathandizira 70 peresenti ya khansa ya khomo lachiberekero, akutero wolemba kafukufuku Laura A. Koutsky, Ph. .D., University of Washington epidemiologist, ndi HPV 6 ndi 11, zomwe zimayambitsa 90% ya ma warts.

Koma ngakhale katemera atapezeka, n’zokayikitsa kuti inu, mayi wachikulire, mudzakhala woyamba pamzere kumulandira. "Otsatira abwino adzakhala atsikana ndi anyamata azaka 10 mpaka 13," akutero a Koutsky. "Tiyenera kupereka katemera kwa anthu asanayambe kugonana komanso kuti atenge kachilomboka."

Katemera wambiri - yemwe angaperekedwe atatenga kachilombo kuti apititse patsogolo chitetezo cha mthupi ku kachilomboka - akuwerengedwanso, atero a Thomas C. Wright Jr., MD, omwe ndi pulofesa wothandizirana ndi matenda ku Columbia University ku New York City, koma sanawonetsedwe kuti ndi othandiza (komabe).

2. Kodi mitundu ina ya HPV ndi yowopsa kuposa ina?

Inde. Mwa mitundu yoposa 100 ya HPV yomwe yadziwika, zingapo (monga HPV 6 ndi 11) zimadziwika kuti zimayambitsa maliseche, omwe ndi owopsa ndipo sagwirizana ndi khansa ya pachibelekero. Zina, monga HPV 16 ndi 18, ndizowopsa kwambiri. Vuto ndiloti ngakhale kuyesa kwa HPV komwe kulipo pano (onani yankho No. 6 kuti mudziwe zambiri) kumatha kuzindikira mitundu 13 ya HPV, sikungakuuzeni kuti muli ndi mtundu wanji.

A Thomas Cox, MD, director of the Women's Clinic ku University of California, Santa Barbara, akuti mayesero atsopano akupangidwa omwe azitha kusankha mitundu ya anthu, koma sangapezeke kwa chaka chimodzi kapena ziwiri. "Kuyesaku kukudziwitsani ngati muli ndi mtundu wa HPV wowopsa, womwe umawonjezera chiopsezo cha khansa ya m'chiberekero, kapena mtundu wa HPV womwe ungakhale wosakhalitsa [mwachitsanzo, udzatha wokha] kapena chiopsezo chochepa, "akuwonjezera.

3. Kodi HPV imachiritsidwa?

Ndizo mkangano. Madokotala alibe njira iliyonse yothanirana ndi kachilomboka. Angathe, komabe, kuchiza kusintha kwa selo ndi njerewere zomwe zingayambitse ndi mankhwala monga Aldara (imiquimod) ndi Condylox (podofilox) kapena kuzizira, kuwotcha kapena kudula njerewere. Kapena angakulimbikitseni kungoyang'ana zomwe zikuchitika kuti musinthe. M'malo mwake, 90 peresenti ya matenda - kaya atulutsa zizindikilo kapena ayi - amatha mwadzidzidzi pakatha chaka chimodzi kapena ziwiri. Koma madotolo sakudziwa ngati izi zikutanthauza kuti mwachiritsidwadi kachilomboka kapena chitetezo chanu cha mthupi changochigonjetsa ndiye kuti chagona tulo m'thupi mwanu momwe kachilombo ka herpes kamachitira.

4. Kodi ndipeze mayeso atsopano a "Pap Pap" m'malo mwa Pap smear?

Pali zifukwa zomveka zopezera ThinPrep, momwe mayeso a cytology amatchedwa, Cox akuti. Mayesero onsewa amayang'ana kusintha kwa selo pa khomo lachiberekero komwe kungayambitse khansa, koma ThinPrep imapanga zitsanzo zabwinoko kuti ziwunikidwe ndipo ndizolondola pang'ono kuposa Pap smear. Kuphatikiza apo, maselo omwe adachotsedwa pachibelekeropo a ThinPrep amatha kusanthula HPV ndi matenda ena opatsirana pogonana, chifukwa chake ngati zina zapezeka, simuyenera kubwerera kwa dokotala wanu kuti mukapatsenso chitsanzo china. Pazifukwa izi, kuyezetsa kwamadzimadzi tsopano ndiko kuyezetsa komwe kumachitika kawirikawiri ku United States. (Ngati simukudziwa kuti mukuyesedwa pati, funsani dokotala kapena namwino.)

5. Kodi ndimafunikirabe kuyezetsa Pap chaka chilichonse?

Malangizo atsopano ochokera ku American Cancer Society akuti ngati mungasankhe ThinPrep osati Pap smear, muyenera kuyesedwa zaka ziwiri zilizonse. Ngati muli ndi zaka zoposa 30 (pambuyo pake chiopsezo chanu chotenga kachilombo ka HPV chimachepa) ndipo mwakhala ndi zotsatira zotsatizana zitatu, mutha kuyesa kuyesa zaka ziwiri kapena zitatu zilizonse.

Chenjezo limodzi ndiloti ngakhale mutadumpha ma Paps apachaka, akatswiri azachipatala amalimbikitsabe kuti muzichita mayeso m'chiuno chaka chilichonse kuti muwonetsetse kuti mazira anu ndi abwinobwino ndipo, ngati simukwatira nokha, kuti muyese matenda ena opatsirana pogonana, monga chlamydia.

6. Tsopano pali kuyesa kwa HPV. Kodi ndiyenera kuchipeza?

Pakadali pano, ndizoyenera ngati muli ndi zotsatira zosayembekezereka za mayeso a Pap otchedwa ASCUS, omwe amayimira Atypical Squamous Cell of Undetermined Significance (onani yankho nambala 7 kuti mumve zambiri), chifukwa ngati zotsatira zake ndi zabwino, zimawuza adotolo kuti mukufunika kuyesedwa kwina kapena chithandizo. Ndipo ngati alibe, mumakhala otsimikiza kuti simuli pachiwopsezo cha khansa ya pachibelekero.

Koma kuyesa kwa HPV sikoyenera ngati kuyesa kwapachaka (mwina ndi mayeso a Pap kapena payekha), chifukwa kumatha kutenga matenda osakhalitsa, kumabweretsa kuyesedwa kwina kosafunikira komanso kuda nkhawa. Komabe, U.S. Food and Drug Administration (FDA) yangovomereza kuti mayesowa agwiritsidwe ntchito limodzi ndi Pap smear ya azimayi azaka zopitilira 30, ndipo madotolo ambiri amalimbikitsa kuti muyesedwe kawiri zaka zitatu zilizonse. "Nthawiyi ingapereke nthawi yokwanira kuti agwire zilonda zam'mimba, zomwe zimachedwa kupita patsogolo," akutero Wright, osatenga milandu yakanthawi. (Zowona, ndizokhazo ngati zotsatira zake zili zabwinobwino. Ngati zili zachilendo, mufunika kubwereza kapena kuyezetsanso.)

7. Ndikalandira zotsatira zoyezetsa za Pap, ndi mayeso ena ati omwe ndikufunika?

Ngati mayeso anu a Pap abwezedwa ndi zotsatira za ASCUS, malangizo aposachedwa akuwonetsa kuti muli ndi njira zitatu zofananira kuti mupeze matenda ena: Mutha kukhala ndi mayeso awiri obwereza a Pap omwe amakhala pakati pa miyezi inayi kapena isanu ndi umodzi, kuyesa kwa HPV, kapena colposcopy (njira yantchito nthawi zomwe adotolo amagwiritsa ntchito poyatsa kuti awone omwe angathe kutsogola). Zotsatira zina zowopsa kwambiri - ndi zilembo monga AGUS, LSIL ndi HSIL - ziyenera kutsatiridwa nthawi yomweyo ndi colposcopy, atero a Diane Solomon, MD, National Cancer Institute, omwe adathandizira kulemba malangizo aposachedwa pankhaniyi.

8. Ngati ndili ndi HPV, kodi mwamuna kapena mkazi wanga ayenera kuyezetsa?

Ayi, palibe chifukwa chake, atero a Cox, popeza mwina mumagawana nawo kale matendawa ndipo palibe chomwe chingachitike kuti mumuchiritse ngati alibe ma warts kapena HPV changes (yotchedwa zilonda) kumaliseche kwake. Kuphatikiza apo, pakadali pano palibe mayeso ovomerezeka a FDA ovomerezeka a amuna.

Ponena za kufalitsa kwa HPV kwa anzanu atsopano, kafukufuku akuwonetsa kuti kugwiritsa ntchito kondomu kumachepetsa chiopsezo cha matenda okhudzana ndi HPV, kuphatikiza njerewere ndi khansa ya pachibelekero. Koma makondomu amawoneka ngati otetezera pang'ono, chifukwa samaphimba khungu lonse loberekera. Wright akufotokoza kuti: "Kudziletsa ndiyo njira yokhayo yopewera kutenga kachilombo ka HPV." Katemera wa HPV akayamba kupezeka, amuna - kapena anyamata makamaka omwe sanakwanitse zaka 20 - adzapatsidwa katemera limodzi ndi atsikana azaka zomwezo.

Kuti mudziwe zambiri za HPV, funsani:

- The American Social Health Association (800-783-9877, www.ashastd.org)- The Centers for Disease Control and Prevention STD Hotline (800-227-8922, www.cdc.gov/std)

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