{"id":9836,"date":"2022-04-12T12:09:47","date_gmt":"2022-04-12T10:09:47","guid":{"rendered":"https:\/\/inovie.fr\/biolyss-v2\/?p=9836"},"modified":"2022-10-26T18:56:20","modified_gmt":"2022-10-26T16:56:20","slug":"depistage-des-cancers-du-col-uterin-frottis-par-cytologie-ou-test-hpv","status":"publish","type":"post","link":"https:\/\/biolyss.fr\/2022\/04\/12\/depistage-des-cancers-du-col-uterin-frottis-par-cytologie-ou-test-hpv\/","title":{"rendered":"D\u00e9pistage des cancers du col ut\u00e9rin"},"content":{"rendered":"<h1>Mise en place de l\u2019auto-pr\u00e9l\u00e8vement pour le test HPV dans le cadre du d\u00e9pistage du cancer du col ut\u00e9rin<\/h1>\n<p>Depuis le 1er avril 2020, le test HPV-HR est\u00a0 pris en charge par la s\u00e9curit\u00e9 sociale sur simple prescription explicite du test (Ne plus prescrire examen cytologique ou frottis \u00a0mais bien recherche ou test HPV chez la femme de plus de 30 ans).<\/p>\n<div style=\"width: 640px;\" class=\"wp-video\"><!--[if lt IE 9]><script>document.createElement('video');<\/script><![endif]-->\n<video class=\"wp-video-shortcode\" id=\"video-9836-1\" width=\"640\" height=\"360\" preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/biolyss.fr\/wp-content\/uploads\/sites\/64\/2022\/09\/V4-Les-papillomas-virus-humain-HPV-et-cancers-du-col-de-luterus.mp4?_=1\" \/><a href=\"https:\/\/biolyss.fr\/wp-content\/uploads\/sites\/64\/2022\/09\/V4-Les-papillomas-virus-humain-HPV-et-cancers-du-col-de-luterus.mp4\">https:\/\/biolyss.fr\/wp-content\/uploads\/sites\/64\/2022\/09\/V4-Les-papillomas-virus-humain-HPV-et-cancers-du-col-de-luterus.mp4<\/a><\/video><\/div>\n<h2>Pourquoi proposer l\u2019auto-pr\u00e9l\u00e8vement\u00a0?<\/h2>\n<ul>\n<li>\n<h3>Accro\u00eetre le d\u00e9pistage\u00a0:<\/h3>\n<\/li>\n<\/ul>\n<p>Afin d\u2019augmenter la couverture de d\u00e9pistage de la population, la HAS recommande de proposer l&rsquo;auto-pr\u00e9l\u00e8vement vaginal (APV) \u00e0 partir de 30 ans, aux femmes non d\u00e9pist\u00e9es ou insuffisamment d\u00e9pist\u00e9es. Le but \u00e9tant d&rsquo;augmenter le nombre de patientes d\u00e9pist\u00e9es pour passer de 50 \u00e0 60 % actuellement \u00e0 80%.<\/p>\n<ul>\n<li>\n<h3>Proposer une alternative simple et rapide au pr\u00e9l\u00e8vement endocervical\u00a0:<\/h3>\n<\/li>\n<\/ul>\n<p>L&rsquo;APV peut \u00eatre consid\u00e9r\u00e9 comme une modalit\u00e9 de pr\u00e9l\u00e8vement alternative au pr\u00e9l\u00e8vement cervical par un professionnel de sant\u00e9, permettant de faciliter le d\u00e9pistage des femmes qui ne se font jamais d\u00e9pister ou qui ne se font pas d\u00e9pister selon le rythme recommand\u00e9.<\/p>\n<ul>\n<li>\n<h3>Performance technique \u00e9quivalente\u00a0:<\/h3>\n<\/li>\n<\/ul>\n<p>Plusieurs \u00e9tudes ont permis de pr\u00e9ciser les performances de la strat\u00e9gie APV. D&rsquo;apr\u00e8s ces \u00e9tudes, les performances sont \u00e9quivalentes entre une recherche d&rsquo;\u00a0HPV r\u00e9alis\u00e9e par auto-pr\u00e9l\u00e8vement et la recherche r\u00e9alis\u00e9e par pr\u00e9l\u00e8vement par un professionnel de sant\u00e9.<\/p>\n<h3>En pratique, comment faire\u00a0?<\/h3>\n<p style=\"text-align: center\"><strong>Pour toute patiente de plus de 30 ans, prescrire un test HPV.<\/strong><\/p>\n<p style=\"text-align: center\"><strong>La patiente se rend au laboratoire et demande un kit d\u2019auto-pr\u00e9l\u00e8vement.<\/strong><\/p>\n<p style=\"text-align: center\"><strong>Le personnel du laboratoire lui expliquera les modalit\u00e9s de pr\u00e9l\u00e8vement.<\/strong><\/p>\n<p>&nbsp;<\/p>\n<h3>Comment interpr\u00e9ter le r\u00e9sultat\u00a0?<\/h3>\n<p>En cas de r\u00e9sultat n\u00e9gatif, interpr\u00e9ter selon l\u2019algorithme ci-dessous (contr\u00f4le \u00e0 5 ans en dehors de tout ant\u00e9c\u00e9dent ou contexte clinique sp\u00e9cifique).<br \/>\nEn cas de r\u00e9sultat positif du test HPV\u00a0par auto-pr\u00e9l\u00e8vement vaginal (environ 15% des d\u00e9pistages), la patiente devra faire un nouveau pr\u00e9l\u00e8vement pour r\u00e9alisation d\u2019une cytologie cervico-ut\u00e9rine par un professionnel de sant\u00e9 (prendre rendez-vous au laboratoire ou aupr\u00e8s de son m\u00e9decin traitant).<\/p>\n<p><img decoding=\"async\" class=\"aligncenter size-full wp-image-17835\" src=\"https:\/\/biolyss.fr\/wp-content\/uploads\/sites\/64\/2022\/04\/HPV-Interpretation.jpg\" alt=\"\" width=\"639\" height=\"474\" srcset=\"https:\/\/biolyss.fr\/wp-content\/uploads\/sites\/64\/2022\/04\/HPV-Interpretation.jpg 639w, https:\/\/biolyss.fr\/wp-content\/uploads\/sites\/64\/2022\/04\/HPV-Interpretation-300x223.jpg 300w\" sizes=\"(max-width: 639px) 100vw, 639px\" \/><\/p>\n<h2><strong>Frottis par cytologie ou test HPV ?<\/strong><\/h2>\n<p>Au niveau mondial, le cancer du col ut\u00e9rin repr\u00e9sente le \u00a04\u00e8me cancer de la femme avec\u00a0 569 847 nouveaux cas par an. Il est responsable de 311 365 d\u00e9c\u00e8s par an en \u00e9tant la 4\u00e8me cause de mortalit\u00e9 par cancer.<\/p>\n<p>En France, il repr\u00e9sente le 12\u00e8me cancer de la femme avec 3000 nouveaux cas par an. Il est responsable de 1100 d\u00e9c\u00e8s par an en \u00e9tant la 10\u00e8me cause de mortalit\u00e9 par cancer.<\/p>\n<p>L\u2019agent causal est le virus HPV (Human PapillomaVirus), le d\u00e9lai entre la contamination par le virus HPV et le d\u00e9veloppement du cancer se situe entre 10 et 15 ans ( par succession de diff\u00e9rentes \u00e9tapes allant de la dysplasie l\u00e9g\u00e8re \u00ab\u00a0CIN 1\u00a0\u00bb \u00e0 la dysplasie s\u00e9v\u00e8re \u00ab\u00a0CIN 3\u00a0\u00bb puis au stade de cancer infiltrant).<\/p>\n<p><u>Il existe 3 niveaux de pr\u00e9vention<\/u><\/p>\n<ul>\n<li>la pr\u00e9vention primaire par la vaccination<\/li>\n<li>la pr\u00e9vention secondaire par le d\u00e9pistage<\/li>\n<li>la pr\u00e9vention tertiaire par le suivi post th\u00e9rapeutique<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><strong>Pourquoi remettre en cause le d\u00e9pistage par le FCU (frottis cervico-ut\u00e9rin) cytologique?<\/strong><\/h2>\n<p>S\u2019agit-il d\u2019une mauvaise organisation\u00a0? d\u2019une mauvaise application des recommandations\u00a0?<\/p>\n<p>L\u2019analyse des circonstances de d\u00e9couverte des cancers du col\u00a0confirme qu\u2019il s\u2019agit majoritairement d\u2019une absence de d\u00e9pistage (dans 37% des cas) ou d\u2019un intervalle de d\u00e9pistage sup\u00e9rieur \u00e0 3 ans (dans 33% des cas). Enfin, cela rel\u00e8ve d\u2019une prise en charge inad\u00e9quate malgr\u00e9 un frottis anormal (18% des cas).<\/p>\n<p>Il semble aussi indispensable de recourir \u00e0 un test plus sensible (Sensibilit\u00e9 FCU = 76.6 contre 97.1 pour le test HPV)<\/p>\n<p>(R\u00e9f\u00e9rence: Pr Henri Jean Philippe, Dr Jacques Marchetta, Journ\u00e9e du Groupe de Vaccination-Pr\u00e9vention de la Spilf, 22 mai 2019<\/p>\n<p>Soci\u00e9t\u00e9 Fran\u00e7aise de Colposcopie et pathologie cervico-vaginal)<\/p>\n<p>&nbsp;<\/p>\n<h2><u>En r\u00e9sum\u00e9\u2026.<\/u><\/h2>\n<p><strong>Le test HPV augmente la sensibilit\u00e9 de d\u00e9pistage des l\u00e9sions de haut grade (CIN 3+) de 30%.<\/strong><\/p>\n<p><strong>Le test HPV d\u00e9piste plus pr\u00e9cocement des l\u00e9sions de haut grade (CIN 3+) que les FCU.<\/strong><\/p>\n<p><strong>La Valeur pr\u00e9dictive n\u00e9gative du test HPV est 4 fois sup\u00e9rieure \u00e0 celle du FCU \u00e0 5 ans.<\/strong><\/p>\n<p><strong>Le d\u00e9pistage par HPV g\u00e9n\u00e8re une diminution de l\u2019incidence des cancers.<\/strong><\/p>\n<p>&nbsp;<\/p>\n<h2><u>Nouveaut\u00e9s \u00e0 prendre en compte imm\u00e9diatement\u2026<\/u><\/h2>\n<p>Le Journal Officiel du 15 ao\u00fbt 2020 a modifi\u00e9 profond\u00e9ment l&rsquo;organisation du d\u00e9pistage du cancer du col de l\u2019ut\u00e9rus:<\/p>\n<p>Le d\u00e9pistage est fond\u00e9 :<\/p>\n<ul>\n<li><strong>entre 25 et 30 ans<\/strong>, sur la r\u00e9alisation d\u2019un examen cytologique : le frottis cytologique sur milieu liquide est recommand\u00e9 dans ce cas. Deux frottis \u00e0 un an d\u2019intervalle. Le suivant sera r\u00e9alis\u00e9 \u00e0 trois ans si les deux premiers sont n\u00e9gatifs.<\/li>\n<li><strong>\u00e0 partir de 30 ans et jusqu\u2019\u00e0 65 ans inclus<\/strong>, sur la r\u00e9alisation d\u2019un test HPV (d\u00e9pistage du Papillomavirus HR) : trois ans apr\u00e8s le dernier frottis cytologique n\u00e9gatif ou d\u00e8s 30 ans en l\u2019absence de frottis ant\u00e9rieur. Le rythme entre deux d\u00e9pistages par test HPV est de cinq ans, d\u00e8s lors que le r\u00e9sultat du test est n\u00e9gatif.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Biolyss vous propose de prendre en charge vos d\u00e9pistages de cancer du col, il s\u2019agit d\u2019un simple pr\u00e9l\u00e8vement endocervical sur milieu liquide, \u00e0 transmettre au laboratoire avec le bon de renseignement clinique.<\/h3>\n<h3>1 seul pr\u00e9l\u00e8vement endocervical = d\u00e9pistage r\u00e9alis\u00e9 par test HPV ou analyse cytologique selon le contexte clinique.<\/h3>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Mise en place de l\u2019auto-pr\u00e9l\u00e8vement pour le test HPV dans le cadre du d\u00e9pistage du cancer du col ut\u00e9rin Depuis le 1er avril 2020, le test HPV-HR est\u00a0 pris en charge par la s\u00e9curit\u00e9 sociale sur simple prescription explicite du &hellip; <a href=\"https:\/\/biolyss.fr\/2022\/04\/12\/depistage-des-cancers-du-col-uterin-frottis-par-cytologie-ou-test-hpv\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":55,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[1,100,227],"tags":[],"class_list":["post-9836","post","type-post","status-publish","format-standard","hentry","category-actualites","category-actualites-medicales","category-actualites-pro"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.4 - 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