Cervical screening strategies: a modern perspective

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According to World Health Organization cervical cancer is the fourth most common malignant disease among women in the world, the number of new cases in 2020 has reached 604 000. The Global Strategy to accelerate cervical cancer elimination as a public health problem, adopted in 2020, cervical screening is of paramount importance. Modern cervical screening involves a transition to primary screening for human papillomavirus (HPV screening) or co-testing (HPV test + cytology), followed by triage for high-risk HPV (HPV). A review and analysis of current data of domestic and foreign researches on this problem over the past 10 years are presented. Data on the efficacy of isolated cytological screening from the point of view of the cytological and histological correlation are presented. Evidence for informative HPV screening, triage-strategies of HPV-positive women, and the HPV screening interval are discussed. The role of the HPV test both as part of cervical screening and after treatment as a predictor of cervical intraepithelial neoplasia (CIN) recurrence is shown. The immunocytochemical method of double staining for proteins p16/Ki67 is suggested to determine the tactics for further management of HPV-positive women as a more informative one than the cytological method to detect CIN2+/CIN3+, the stratification of precancer risk was estimated if this method is used. The need for further studies to improve cervical screening strategies and to cooperate with the public health system to reduce morbidity and mortality associated with skin cancer is apparent.

Keywords:

cervical screening

HPV test

HPV test + cytology

triage

p16/Ki67

Authors:

Klinyshkova T.V.

Omsk State Medical University

ORCID: 0000-0002-0544-8184

Received:

18.07.2022

Accepted:

09.08.2022

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