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MIMM 387 (17)

feb 10 2012.docx

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McGill University
Microbiology and Immun (Sci)
MIMM 387
Robert Murgita

thFriday February 10 2012 Disclosure Not something that he normally adds into teaching lectures Having these connections does not have to be a conflict of interest The problem starts when you start hiding this informationTimeline In the early 80s we seemed to have a cancer that we knew the cause of herpes Except HPV DNA was present in cervical tumors so there was confusion whether it was herpes or HPV This was the time that different techniques were becoming available So they didnt know which was the culprit or if HPV was doing something in addition to herpes Over time the proportion of HPV DNA in cancers increased until 1990 when it was 997 Today we know the facts and can move on with further measures white boxMost important is that we need political courage because of the upcoming argumentsFor the sake of analogy later keep in mind that you could get lung cancer from things other than smoking Incidence of Invasive Cervical Cancer Colours represent incidence of cervical cancer Latin America and the Caribbean SubSaharan African and Southern Asia have the highest incidence Breast cancer is a disease that affects educated women who delay child birth Cervical cancer is a disease of women who have multiple children Cervical cancer is also a disease that takes away your dignity it rots you from the inside In Africa often they make women with cervical cancer live outside of the house because of the smell This is unlike breast cancer Age standardized England had the distinction of having very high rates of cervical cancer When they adopted a national screening process pap tests rates got better But people only thought that increasing coverage was important Other countries try to emulate just increasing use of the tool Pap cytology Countries try to increase coverage like Canada UK etc to try and decrease mortality But why does it work for the UK Sweden etc and not for Latin America How good is pap cytology Because you need good technique the problem is quality control This has been shown in a variety of studies that showed the sensitivity of the test Sensitivity the proportion of positive tests for women who have the disease The good thing about the tests is that it has a
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