Yehlisa ingozi yomdlavuza womlomo wesibeletho

-Delile

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Onyakeni odlule, ubone izihloko zezindaba -- ezivela "Umuthi Wokugoma Umdlavuza Wekusasa?" eya "Ungawubulala Kanjani Umdlavuza" - lokho kube yizimbangela zokuphumelela okukhulu komdlavuza womlomo wesibeletho. Ngempela, kube nezindaba ezinhle kwabesifazane kule ndawo yezokwelapha: Amandla okuthola umuthi wokugoma, kanye nemihlahlandlela emisha yokuhlola, kusho ukuthi odokotela bavala izindlela ezingcono zokuphatha, ukwelapha nokuvikela lesi sifo sabesifazane, esigadla kwabangu-13,000 Abesifazane baseMelika futhi bathatha izimpilo ze-4,100 minyaka yonke.

Enye yentuthuko ebaluleke kakhulu kule minyaka edlule kube ukutholakala kokuthi amaphesenti angama-99.8 abantu abanomdlavuza womlomo wesibeletho abangelwa izinhlobo ezithile zezifo ezithathelwana ngocansi (STI) ezaziwa nge-human papillomavirus, noma i-HPV. Leli gciwane livame kakhulu kangangokuthi amaphesenti angama-75 abantu baseMelika abaya ocansini balithola ngesikhathi esithile ezimpilweni zabo kanti amacala amasha ayizigidi ezi-5.5 ayenzeka minyaka yonke. Njengomphumela wokutheleleka, cishe iphesenti elilodwa labantu liba nezinsumpa ezithweni zangasese kanti amaphesenti ayi-10 abesifazane eba nezilonda ezingavamile noma ezingapholi emlonyeni wesibeletho, okuvame ukutholakala ngokuhlolwa kwePap.

Yini okudingeka uyazi ukuze uzivikele emdlavuzeni wesibeletho? Nazi ezinye izimpendulo zemibuzo evame ukubuzwa mayelana nobudlelwano phakathi komdlavuza womlomo wesibeletho kanye nokutheleleka nge-HPV.

1. Uyotholakala nini umuthi wokugomela umdlavuza womlomo wesibeletho?

Ochwepheshe bathi eminyakeni emihlanu kuya kweyishumi. Izindaba ezinhle ukuthi ucwaningo lwakamuva olushicilelwe ku INew England Journal of Medicine ikhombise ukuthi umuthi wokugoma unganikeza ukuvikelwa okungamaphesenti ayi-100 ku-HPV 16, uhlobo oluvame kakhulu ukuxhunyaniswa nomdlavuza womlomo wesibeletho. I-Merck Research Laboratories, eyakha umuthi wokugoma osetshenziswe ocwaningweni, njengamanje isebenza kolunye uhlobo oluzovikela ezinhlotsheni ezine ze-HPV: 16 no-18, ezinikela kumaphesenti angama-70 omdlavuza womlomo wesibeletho, kusho umlobi ocwaningweni uLaura A. Koutsky, Ph. .D., Ingculazi yezifo ezitholakala e-University of Washington, kanye ne-HPV 6 no-11, okubangela amaphesenti angama-90 ezinsumpa ezithweni zobulili.

Kodwa noma ngabe umuthi wokugoma utholakala, akunakwenzeka ukuthi wena, wesifazane osekhulile, uzoba semgqeni wokuqala ukuwuthola. "Abazongenela ukhetho kuzoba ngamantombazane nabafana abaneminyaka eyishumi kuya kwengu-13 ubudala," kusho uKoutsky. "Kumele sigome abantu ngaphambi kokuba baye ocansini futhi bathole igciwane."

Imithi yokugoma eminingana yokwelapha -- ezonikezwa ngemuva kokutheleleka ukusheshisa ukusabela komzimba kugciwane - nayo iyacwaningwa, kusho uThomas C. Wright Jr., MD, uprofesa ohlanganyele we-pathology e-Columbia University eNew York City, kodwa akukakhonjiswa ukuthi kuyasebenza (okwamanje).

2. Ingabe ezinye izinhlobo ze-HPV ziyingozi kakhulu kunezinye?

Yebo. Ezingxenyeni ezehlukene ezingaphezu kwe-100 ze-HPV ezitholakele, eziningana (ezifana ne-HPV 6 ne-11) ziyaziwa ukuthi zibanga izinsumpa zangasese, ezinobungozi futhi ezingahlangene nomdlavuza womlomo wesibeletho. Ezinye, njenge-HPV 16 ne-18, ziyingozi kakhulu. Inkinga ukuthi nakuba ukuhlolwa kwe-HPV okutholakalayo njengamanje (bheka impendulo engunombolo 6 ukuze uthole ulwazi olwengeziwe) kungathola izinhlobo eziyi-13 ze-HPV, akukwazi ukukutshela ukuthi yiluphi uhlobo onalo.

UThomas Cox, MD, umqondisi we-Women's Clinic e-University of California, eSanta Barbara, ubika ukuthi kwenziwa izivivinyo ezintsha ezizokwazi ukukhetha izinhlobo ngazinye, kepha ngeke zitholakale komunye unyaka noma emibili. "Lokhu kuhlolwa kuzokwazi ukubona ukuthi unohlobo oluqhubekayo lwe-HPV oluyingozi, okwandisa ingozi yakho yomdlavuza womlomo wesibeletho, noma uhlobo lwe-HPV olungase lube okwesikhashana [okungukuthi, luzozihambela lodwa] noma lube sengozini encane, "uyanezela.

3. Iyelapheka i-HPV?

Lokho kuyaphikiswa. Odokotela abanayo indlela yokulwa naleli gciwane uqobo. Nokho, bangakwazi ukwelapha izinguquko zeseli kanye nezinsumpa ezingabangela ngemithi efana ne-Aldara (imiquimod) kanye ne-Condylox (podofilox) noma ngokubandisa, ukushisa noma ukusika izinsumpa. Noma bangeluleka ngokubuka nje izimo zezinguquko ezengeziwe. Eqinisweni, amaphesenti angama-90 okutheleleka -- kungakhathaliseki ukuthi aveza izimpawu noma cha - azonyamalala ngokuzenzakalelayo phakathi nonyaka owodwa kuya kwemibili. Kodwa odokotela abazi ukuthi lokhu kusho ukuthi welaphekile yini kuleli gciwane noma amasosha akho omzimba asanda kulinqoba ngakho-ke alele emzimbeni wakho ngendlela igciwane le-herpes elenza ngayo.

4. Ngabe kufanele ngithole ukuhlolwa okusha kwe- "liquid Pap" esikhundleni sePap smear?

Kunezizathu ezithile zokuthola i-ThinPrep, njengoba kubizwa ukuhlolwa kwe-cytology ketshezi, kusho uCox. Kokubili ukuhlolwa kubheka izinguquko zamaseli emlonyeni wesibeletho ezingaholela kumdlavuza, kodwa iThinPrep ikhiqiza amasampula angcono ukuze ahlaziywe futhi inembe kakhudlwana kune-Pap smear. Ukwengeza, amaseli akhishwe emlonyeni wesibeletho e-ThinPrep angahlaziywa i-HPV nezinye izifo ezithathelwana ngocansi, ngakho-ke uma kutholakala okungavamile, asikho isidingo sokuthi ubuyele kudokotela wakho ukuze anikeze elinye isampula. Ngalezi zizathu, ukuhlolwa ketshezi manje sekuyindlela yokuhlola ukuhlolwa komdlavuza womlomo wesibeletho e-United States. (Uma ungaqiniseki ukuthi yiluphi uvivinyo olutholayo, buza udokotela wakho noma umhlengikazi.)

5. Ngabe ngisafuna yini ukuhlolwa iPap minyaka yonke?

Imihlahlandlela emisha evela kwi-American Cancer Society ithi uma ukhetha iThinPrep kunePap smear, udinga ukuhlolwa kuphela njalo eminyakeni emibili. Uma ungaphezu kweminyaka engama-30 (ngemuva kwalokho ingozi yakho yokutheleleka nge-HPV yehla) futhi ube nemiphumela ejwayelekile emithathu elandelanayo, ungabeka isikhala sokuhlola njalo eminyakeni emibili noma emithathu.

Esinye isixwayiso siwukuthi noma weqa ama-Paps aminyaka yonke, odokotela bezifo zabesifazane basancoma ukuthi uhlolwe i-pelvic njalo ngonyaka ukuze uqiniseke ukuthi ama-ovari akho ajwayelekile futhi, uma ungenayo indoda eyodwa, ukuhlola ezinye izifo ezithathelwana ngocansi, njenge-chlamydia.

6. Manje kukhona ukuhlolwa kwe-HPV. Ngabe ngidinga ukuyithola?

Njengamanje, kufaneleke ngokuphelele uma unomphumela wokuhlolwa wePap ongajwayelekile obizwa nge-ASCUS, omele ama-Atypical Squamous Cells of Undetermined Significance (bheka impendulo No. 7 ukuthola okuningi ngalokho), ngoba uma imiphumela ilungile, itshela udokotela wakho ukuthi udinga ukuhlolwa okwengeziwe noma ukwelashwa. Futhi uma zimbi, uthola isiqiniseko sokuthi awusengozini yomdlavuza womlomo wesibeletho.

Kodwa ukuhlolwa kwe-HPV akufanelekile njengokuhlola ukuhlolwa kwaminyaka yonke (okungaba ngokuhlolwa kwe-Pap noma kukodwa), ngoba kungathola izifo zesikhashana, okuholela ekuhlolweni okwengeziwe nokukhathazeka okungadingekile. Kodwa-ke, i-U.S. Food and Drug Administration (FDA) isanda kugunyaza ukusetshenziswa kokuhlolwa kuhlanganiswe ne-Pap smear kwabesifazane abaneminyaka engaphezu kuka-30, futhi odokotela abaningi batusa ukuthi wenze ukuhlolwa okukabili njalo ngemva kweminyaka emithathu. "Leso sikhathi singanikeza isikhathi esanele sokubamba omdlavuza womlomo wesibeletho, ophuza ukuqhubekela phambili," kusho u-Wright, ngenkathi engabambi amacala esikhashana. (Vele, lokho kuphela uma imiphumela ijwayelekile. Uma ingajwayelekile, uzodinga ukuphinda noma ukuhlolwa okwengeziwe.)

7. Uma ngithola umphumela wokuhlolwa kwe-Pap ongajwayelekile, yiziphi ezinye izivivinyo engizidingayo?

Uma ukuhlolwa kwakho kwePap kubuyiswa nomphumela we-ASCUS, imihlahlandlela yakamuva ikhombisa ukuthi unezinketho ezintathu ezilinganayo ngokulingene zokuxilonga okuthe xaxa: Ungaba nokuhlolwa okuphindiwe kabili kwePap okuhlukaniswe izinyanga ezine kuya kweziyisithupha ngokuhlukana, ukuhlolwa kwe-HPV, noma i-colposcopy (inqubo yehhovisi ngesikhathi lapho udokotela asebenzisa khona isikophu esikhanyisiwe ukuze ahlole labo abangaba khona umdlavuza). Eminye imiphumela engahle ibe mibi kakhulu - nama-akhronimi afana ne-AGUS, i-LSIL ne-HSIL - kufanele ilandelwe ngokushesha nge-colposcopy, kusho uDiane Solomon, MD, weNational Cancer Institute, osize ukubhala imihlahlandlela yakamuva ngale ndaba.

8. Uma ngine-HPV, ingabe isoka lami noma engishade naye kufanele ahlolwe?

Cha, asikho isizathu esincane salokho, kusho uCox, ngoba kungenzeka ukuthi wabelana ngaleli gciwane kanti futhi akukho okungenziwa ukwelashwa uma engenazo izinsumpa noma izinguquko ze-HPV (ezaziwa njengezilonda) esithweni sakhe sangasese. Ngaphezu kwalokho, okwamanje akukho sivivinyo sokuhlola esivunyelwe i-FDA sabesilisa.

Ngokuphathelene nokudluliswa kwe-HPV kozakwethu abasha, ucwaningo lukhombisa ukuthi ukusetshenziswa kwamakhondomu kunganciphisa ubungozi bezifo ezihlobene ne-HPV, kufaka phakathi izinsumpa zangasese nomdlavuza womlomo wesibeletho. Kodwa amakhondomu abonakala evikela ngandlela thize, ngoba awasimbozi sonke isikhumba sangasese. "Ukuzithiba ukuphela kwendlela yangempela yokuvimbela ukutheleleka nge-HPV," kuchaza uWright. Lapho umuthi wokugoma we-HPV utholakala, noma kunjalo, abesilisa - noma ikakhulukazi abafana abangakafiki ebusheni - bazobhekiswa ekugomeni kanye namantombazane aneminyaka efanayo.

Ngeminye imininingwane nge-HPV, thinta:

- I-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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