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Papanicolaou smear
0%
0/51
HPV vaccination
71%
36/51
HAART medication
All of the above
2%
1/51
None of the above
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Primary prevention prevents disease occurrence. In this scenario, the only intervention that can prevent disease from occurring is vaccination for HPV. Public health disease prevention mechanisms can be divided into primary prevention, secondary prevention, and tertiary prevention. Primary prevention is an intervention that prevents a disease from occurring (e.g. influenza vaccinations and polio vaccinations). Secondary prevention detects a disease in its subclinical (and optimally treatable) form. Screening tests (Papanicolaou smear for cervical carcinoma and colonoscopy for colon carcinoma) are often cited as successful forms of secondary prevention. Tertiary prevention is treatment of a symptomatic condition to reduce morbidity (HAART for HIV). In a review of current cancer screening guidelines, Gates summarizes the U.S. Preventive Services Task Force recommendations for colon cancer and lung cancer screening. For colon cancer screening, they recommend colonoscopy every 10 years between the ages of 50-75, yearly fecal occult blood testing, or flexible sigmoidoscopy every 5 years with fecal occult blood testing every 3 years. For lung cancer screening they recommend annual low-dose CT lung cancer screening in patients ages 55-80 with greater than 30 pack-year smoking history. In an analysis of screening mammography for women of average risk of breast cancer ages 40-49, Health Quality Ontario showed no significant reduction in mortality in screened women. The benefit of screening mammography in this demographic has been under debate. Figure A shows a "clue cell", pathognomonic for bacterial vaginosis. Illustration A summarizes recommendations for cervical cancer screening. Incorrect Answers: Answer 1: Papanicolaou smear for early detection of cervical carcinoma or carcinoma in situ is an example of secondary prevention. Answer 3: HAART medication for the treatment of HIV is an example of tertiary prevention Answers 4-5: Administering the HPV vaccination is an example of primary prevention.
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