The Cervical smear known as Pap test examines the health of the superficial cells of the transformation zone (TZ) found around the cervical os. The TZ cells are affected by the ovarian cyclical hormonal changes, menstruation, sexual intercourse and the overall general health condition of a woman. During intercourse 20% of all women will be infected by the Human Papilloma virus (HPV). Only a very small number of these cases will develop damages to the TZ cells and an even smaller number will develop cervical pre-cancerous cells noted as low or high grade of squamous intraepithelial lesions (LSIL / HSIL).
The general good health of a woman and daily exercise induce high immune response reducing the risk of permanent HPV infection and cervical cancer. Smoking, multiple sexual partners and stress increase the risk of HPV infection by reducing immunity resistance.
The role of the HVP vaccination is very important since it induces antibodies for life and offers protection against the virus. The experience and the results reported by Australia, the first country which implemented massive school HPV vaccination 15 years ago, are very encouraging. All 28 European Union countries follow the Australian model and example of school vaccination opting to eradication of the disease. In the last 2 years Australia and other countries offer also vaccination to boys.
The contraindications and complications to HPV vaccination are minimal and very similar to the other vaccinations. The Pap test has to be performed every 1 to 3 years, in all females that were not vaccinated. The young women have higher risk of HPV infection due to increased sexual activity and absence of monogamic relationship. The annual Pap test is strongly recommended in this population.