天美传媒

Cervical cancer screening; Human Papillomavirus (HPV); HPV self-sampling; Artificial Intelligence (AI); Telemedicine; HPV vaccination; Underserved populations; Social determinants of health; Screening guidelines; Cost-effectiveness

Introduction

This article provides an overview and update of cervical cancer screening guidelines, emphasizing the shift towards Human Papillomavirus (HPV)-based primary screening and extended screening intervals. It discusses the evolving recommendations for different age groups and risk stratifications, aiming to optimize screening benefits while minimizing potential harms and resource utilization [1].

This systematic review and meta-analysis evaluates the effectiveness of Human Papillomavirus (HPV) self-sampling as a primary screening method for cervical cancer. It concludes that self-sampling significantly increases screening uptake, particularly among underscreened populations, and demonstrates comparable sensitivity to clinician-collected samples for detecting high-risk Human Papillomavirus (HPV) and precancerous lesions, making it a promising tool for expanding screening coverage [2].

This systematic review identifies key barriers and facilitators to cervical cancer screening in low-income and middle-income countries. Barriers include lack of awareness, financial constraints, fear, and geographical access, while facilitators involve community-based programs, mobile screening units, and health education initiatives. Understanding these factors is crucial for designing effective interventions to improve screening uptake globally [3].

This systematic review investigates the application of Artificial Intelligence (AI), particularly deep learning, in enhancing cervical cancer screening through colposcopy and cytology. It highlights the potential of Artificial Intelligence (AI) algorithms to improve diagnostic accuracy, reduce inter-observer variability, and streamline the interpretation of screening tests, offering a pathway for more efficient and accessible screening programs [4].

This systematic review examines the impact of Human Papillomavirus (HPV) vaccination on cervical cancer screening programs globally. It identifies a decline in Human Papillomavirus (HPV) prevalence and associated precancerous lesions in vaccinated populations, suggesting a need for recalibrating screening guidelines to optimize resources and potentially extend screening intervals in highly vaccinated cohorts while maintaining efficacy for unvaccinated or partially vaccinated groups [5].

This systematic review and meta-analysis evaluates the cost-effectiveness of various cervical cancer screening strategies. It finds that Human Papillomavirus (HPV) primary screening, either alone or in combination with cytology, offers a highly cost-effective approach compared to cytology-only screening, especially in settings with good infrastructure. The review underscores the economic benefits of adopting modern, evidence-based screening protocols [6].

This systematic review explores effective strategies to enhance cervical cancer screening rates among underscreened populations, including racial/ethnic minorities, rural residents, and low-income individuals. Interventions such as patient navigation, culturally tailored education, Human Papillomavirus (HPV) self-sampling, and clinic-based reminders are highlighted as promising approaches to overcome disparities and improve access to screening [7].

This systematic review and meta-analysis compares liquid-based cytology (LBC) with high-risk Human Papillomavirus (HPV) testing for primary cervical cancer screening. The findings indicate that Human Papillomavirus (HPV) testing demonstrates higher sensitivity for detecting high-grade cervical intraepithelial neoplasia (CIN2+) compared to liquid-based cytology (LBC), while liquid-based cytology (LBC) offers higher specificity. This suggests that co-testing or primary Human Papillomavirus (HPV) screening with triage cytology offers a more effective strategy for early detection [8].

This systematic review explores the role of telemedicine in colposcopy and cervical cancer screening. It demonstrates that telehealth solutions can enhance access to expert consultation and follow-up care, especially in remote or underserved areas. Remote colposcopy, facilitated by digital imaging and real-time communication, shows promise in improving diagnostic efficiency and reducing patient travel burden, thereby streamlining the screening pathway [9].

This systematic review and meta-analysis explores the profound impact of social determinants of health on cervical cancer screening uptake and outcomes. It identifies education level, income, race/ethnicity, geographic location, and access to healthcare services as critical factors influencing screening participation. Addressing these underlying social inequities is essential for achieving equitable cervical cancer prevention [10].

Description

Current cervical cancer screening guidelines are shifting towards Human Papillomavirus (HPV)-based primary screening with extended intervals to optimize benefits and minimize harms and resource use [1]. A systematic review and meta-analysis comparing liquid-based cytology (LBC) with high-risk Human Papillomavirus (HPV) testing for primary screening found Human Papillomavirus (HPV) testing offers higher sensitivity for detecting high-grade cervical intraepithelial neoplasia (CIN2+), while liquid-based cytology (LBC) provides higher specificity. This supports co-testing or primary Human Papillomavirus (HPV) screening with triage cytology as a more effective early detection strategy [8].

Innovations are significantly enhancing screening reach and effectiveness. Human Papillomavirus (HPV) self-sampling has proven effective as a primary screening method, substantially increasing uptake, particularly among underscreened populations. It demonstrates sensitivity comparable to clinician-collected samples for detecting high-risk Human Papillomavirus (HPV) and precancerous lesions, making it a promising, accessible tool to expand screening coverage and address public health gaps [2].

Technological advancements are also being leveraged. Artificial Intelligence (AI), particularly deep learning, is applied to improve cervical cancer screening through colposcopy and cytology. Artificial Intelligence (AI) algorithms show potential to boost diagnostic accuracy, reduce inter-observer variability, and streamline test interpretation, leading to more efficient and accessible screening programs [4]. Additionally, telemedicine enhances access to expert consultation and follow-up, especially for remote or underserved areas. Remote colposcopy, utilizing digital imaging and real-time communication, improves diagnostic efficiency and reduces patient travel burden, streamlining the screening pathway [9].

External factors significantly influence screening outcomes. Human Papillomavirus (HPV) vaccination has a global impact, showing a decline in Human Papillomavirus (HPV) prevalence and associated precancerous lesions in vaccinated populations. This suggests a need to recalibrate screening guidelines, potentially extending intervals in highly vaccinated groups while maintaining efficacy for others [5]. Furthermore, social determinants of health profoundly affect screening uptake and outcomes. Education, income, race/ethnicity, geographic location, and access to healthcare services are critical factors. Addressing these underlying social inequities is essential for equitable cervical cancer prevention [10].

Despite advancements, significant barriers persist, especially in low-income and middle-income countries, including lack of awareness, financial constraints, fear, and limited geographical access. Facilitators like community-based programs, mobile screening units, and health education initiatives are crucial for effective interventions to boost global screening participation [3]. Economically, Human Papillomavirus (HPV) primary screening, alone or with cytology, is highly cost-effective compared to cytology-only screening, particularly where infrastructure supports it, underscoring the benefits of modern, evidence-based protocols [6]. For underscreened populations (minorities, rural, low-income), effective strategies include patient navigation, culturally tailored education, Human Papillomavirus (HPV) self-sampling, and clinic-based reminders, promising to overcome disparities and improve access [7].

Conclusion

Cervical cancer screening guidelines are evolving, prioritizing Human Papillomavirus (HPV)-based primary screening and extended intervals to optimize benefits and minimize harms. Innovations like HPV self-sampling significantly boost screening uptake, especially in underserved populations, showing comparable sensitivity to clinician-collected samples. Technological advancements, including Artificial Intelligence (AI) in colposcopy and cytology, promise improved diagnostic accuracy and streamlined interpretation. Telemedicine further enhances access to expert consultation and follow-up, particularly in remote areas. The global impact of HPV vaccination is evident, with declining HPV prevalence leading to a need for recalibrating screening protocols for vaccinated cohorts. Cost-effectiveness analyses support HPV primary screening as a superior approach compared to cytology-only. However, persistent barriers to screening, such as lack of awareness, financial constraints, fear, and geographical access, remain prevalent in low-income and middle-income countries. These challenges are often compounded by broader social determinants of health, including education, income, race/ethnicity, and healthcare access, which profoundly affect screening participation and outcomes. Effective strategies to improve screening rates among underscreened populations include patient navigation, culturally tailored education, self-sampling, and clinic-based reminders. Addressing these multi-faceted issues through evidence-based protocols and targeted interventions is essential for achieving equitable and effective cervical cancer prevention worldwide.

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