Evolution and future of cervical cancer screening: from cytology to primary HPV testing and the impact of vaccination.

IF 3.9 3区 医学 Q1 PATHOLOGY
Mariam El-Zein, Eduardo L Franco
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引用次数: 0

Abstract

Introduction: Cervical cancer remains a significant global health challenge despite decades of progress in screening and prevention. Global cervical cancer screening practices vary substantially, with many countries still relying on cytology-based methods, despite evidence supporting the superior performance of human papillomavirus (HPV)-based screening.

Areas covered: This review explores the historical evolution as well as current landscape and policies of cervical cancer screening, with a focus on Western countries. We discuss the gradual transition from cytology to HPV DNA testing as the primary screening method, while recognizing the continuing role of cytology as a triage method. We also argue that HPV vaccination will have a transformative impact on screening practices, necessitating the need for adapting screening strategies to a post-vaccination world.

Expert opinion: The role of cytology in cervical cancer screening will become increasingly limited due to its diminished effectiveness post-HPV vaccination, as many abnormal cytology results will likely be false positives. This could lead to unnecessary procedures, underscoring the need for adjustments in screening strategies and HPV testing to align with the fact that cervical precancerous lesions will become exceedingly rare.

宫颈癌筛查的演变和未来:从细胞学到原发性HPV检测和疫苗接种的影响。
导言:尽管几十年来在筛查和预防方面取得了进展,但宫颈癌仍然是一个重大的全球健康挑战。全球宫颈癌筛查做法差异很大,尽管有证据支持基于人乳头瘤病毒(HPV)的筛查具有优越的性能,但许多国家仍依赖基于细胞学的方法。涵盖领域:本综述以西方国家为重点,探讨宫颈癌筛查的历史演变、现状和政策。我们讨论从细胞学到HPV DNA检测作为主要筛查方法的逐渐过渡,同时认识到细胞学作为分诊方法的持续作用。我们还认为,HPV疫苗接种将对筛查实践产生变革性影响,需要调整筛查策略以适应疫苗接种后的世界。专家意见:由于hpv疫苗接种后细胞学检查的有效性降低,细胞学检查在宫颈癌筛查中的作用将越来越有限,因为许多异常细胞学结果可能是假阳性。这可能导致不必要的程序,强调需要调整筛查策略和HPV检测,以配合宫颈癌前病变将变得极其罕见的事实。
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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
71
审稿时长
1 months
期刊介绍: Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting. Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy. Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.
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