An integrated approach to cervical cancer prevention

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Abstract

Cervical cancer (CC) is the fourth most common cancer among women in the world. In the Russian Federation, the incidence of cervical cancer is in second position in the structure of genital cancers. The WHO Global Strategy to Accelerate the Elimination of CC as a Public Health Problem recommends an integrated approach to prevention and control of CC that combines vaccination, screening and treatment. A review and analysis of modern data on this problem over the past decade is presented. Scaling up HPV vaccination, increasing the level of cervical screening and coverage of the female population, developed post-screening management and timely treatment of precancer will reduce the incidence and mortality associated with cervical cancer.

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About the authors

T. V. Klinyshkova

Omsk State Medical University

Author for correspondence.
Email: klin_tatyana@mail.ru
ORCID iD: 0000-0002-0544-8184

MD, Professor

Russian Federation, Omsk

N. B. Frolova

Clinical hospital of Russian Railways-Medicine

Email: klin_tatyana@mail.ru
ORCID iD: 0000-0002-4393-6904

Candidate of Medical Sciences

Russian Federation, Omsk

References

  1. Sung H., Ferlay J., Siegel R.L. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71: 209–49. doi: 10.3322/caac.21660
  2. Каприн А.Д., Старинский В.В., Шахзадова А.О. Состояние онкологической помощи населению России в 2021 году. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2022; 239 с. [Kaprin A.D., Starinsky V.V., Shakhzadova A.O. The state of oncological care to the population of Russia in 2021. M.: MNIOI im. P.A. Gertsena – filial FGBU "NMITs radiologii" Minzdrava Rossii, 2022; 239 s. (in Russ.)]. URL: https://oncology-association.ru/wp-content/uploads/2022/05/sostoyanie-onkologicheskoj-pomoshhi-naseleniyu-rossii-v-2021-godu.pdf
  3. Bruni L., Diaz M., Castellsagué X. et al. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. Infect Dis. 2010; 202 (12): 1789–99. doi: 10.1086/657321
  4. Castellsagué X., Paavonen J., Jaisamrarn U. et al. Risk of first cervical HPV infection and pre-cancerous lesions after onset of sexual activity: analysis of women in the control arm of the randomized, controlled PATRICIA trial. BMC Infect Dis. 2014; 14: 551. doi: 10.1186/s12879-014-0551-y
  5. Gilham C., Sargent A., Kitchener H.C. et al. HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT. Health Technol Assess. 2019; 23 (28): 1–44. doi: 10.3310/hta23280
  6. Zhang Z., Zhang J., Xia N. et al. Expanded strain coverage for a highly successful public health tool: Prophylactic 9-valent human papillomavirus vaccine. Hum Vaccin Immunother. 2017; 13 (10): 2280–91. doi: 10.1080/21645515.2017.1346755
  7. Petrosky E., Bocchini J.A. Jr., Hariri S. et al. Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2015; 64 (11): 300–4.
  8. Genovese C., La Fauci V., Squeri A. et al. HPV vaccine and autoimmune diseases: systematic review and meta-analysis of the literature. J Prev Med Hyg. 2018; 59 (3): E194–E199. doi: 10.15167/2421-4248/jpmh2018.59.3.998
  9. Burger E.A., Campos N.G., Sy S. et al. Health and economic benefits of single-dose HPV vaccination in a Gavi-eligible country. Vaccine. 2018; 36 (32 Pt A): 4823–9. doi: 10.1016/j.vaccine.2018.04.061
  10. Burger E.A., Campos N.G., Sy S. et al. Sustained efficacy, immunogenicity, and safety of the HPV-16/18 AS04-adjuvanted vaccine: final analysis of a long-term follow-up study up to 9.4 years post-vaccination. Hum Vaccin Immunother. 2014; 10 (8): 2147–62. doi: 10.4161/hv.29532
  11. Адамян Л.В., Аполихина И.А., Артымук Н.В. и др. Цервикальная интраэпителиальная неоплазия, эрозия и эктропион шейки матки. Клинические рекомендации. М., 2020; 59 с. [Adamyan L.V., Apolihina I.A., Artymuk N.V et al. Cervical intraepithelial neoplasia, erosion and ectropion of the cervix. Clinical recommendations. M., 2020; 59 p. (in Russ.)]. URL: https://www.dzhmao.ru/spez/klin_recom/akushGinekol/2020/KR_597_CINeoplaziyaMatki.pdf
  12. Cuschieri K., Ronco G., Lorincz A. et al. Eurogin 2017 Roadmap: Triage strategies for the management of HPV-positive women in cervical screening programs. Int J Cancer. 2018; 143 (4): 735–45. doi: 10.1002/ijc.31261
  13. Клинышкова Т.В., Турчанинов Д.В., Самосудова И.Б. Эпидемиологические аспекты цервикального предрака у женского населения г. Омска (по материалам выборочного исследования). Российский вестник акушера-гинеколога. 2013; 13 (4): 13–7 [Klinyshkova T.V., Turchaninov D.V. Epidemiological aspects of cervical precancerous disease in the female population of Omsk (based on the materials of a sample study). Russian Bulletin of Obstetrician-Gynecologist. 2013; 13 (4): 13–7 (in Russ.)].
  14. Arbyn M., Simon M., de Sanjosé S. et al. Accuracy and effectiveness of HPV mRNA testing in cervical cancer screening: a systematic review and meta-analysis. Lancet Oncol. 2022; 23 (7): 950–60. doi: 10.1016/S1470-2045(22)00294-7
  15. Guan P., Howell-Jones R., Li N. et al. Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int J Cancer. 2012; 131: 2349–59. doi: 10.1002/ijc.27485
  16. Wentzensen N., Arbyn M., Berkhof J. et al. Eurogin 2016 Roadmap: how HPV knowledge is changing screening practice. Int J Cancer. 2017; 140 (10): 2192–200. doi: 10.1002/ijc.30579
  17. Ronco G., Dillner J., Elfström K.M. et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014; 383 (9916): 524–32. doi: 10.1016/S0140-6736(13)62218-7
  18. Arbyn M., Smith S.B., Temin S. et al. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018; 363: k4823. doi: 10.1136/bmj.k4823
  19. Клинышкова Т.В., Турчанинов Д.В., Буян М.С. Эпидемиологические аспекты рака шейки матки. Российский вестник акушера-гинеколога. 2018; 18 (2): 22–6 [Klinyshkova T.V., Turchaninov D.V., Buyan M.S. Epidemiological aspects of cervical cancer. Russian Bulletin of Obstetrician-Gynecologist. 2018; 18 (2): 22–6 (in Russ.)]. doi: 10.17116/rosakush201818222-26
  20. Klug S.J., Neis K.J., Harlfinger W. et al. A randomized trial comparing conventional cytology to liquid-based cytology and computer assistance. Int J Cancer. 2013; 132: 2849–57. doi: 10.1002/ijc.27955
  21. Pankaj S., Nazneen S., Kumari S. et al. Comparison of conventional Pap smear and liquid-based cytology: A study of cervical cancer screening at a tertiary care center in Bihar. Indian J Cancer. 2018; 55 (1): 80–3. doi: 10.4103/ijc.IJC_352_17
  22. Strander B., Andersson-Ellström A., Milsom I. et al. Liquid-based cytology versus conventional Papanicolaou smear in an organized screening program: a prospective randomized study. Cancer. 2007; 111: 285–91. doi: 10.1002/cncr.22953
  23. Liang L.A., Einzmann T., Franzen A. et al. Cervical Cancer Screening: Comparison of Conventional Pap Smear Test, Liquid-Based Cytology, and Human Papillomavirus Testing as Stand-alone or Cotesting Strategies. Cancer Epidemiol Biomarkers Prev. 2021; 30 (3): 474–84. DOI: 1055-9965.EPI-20-1003
  24. Gage J.C., Schiffman M., Katki H.A. et al. Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test. J Natl Cancer Inst. 2014; 106 (8): dju153. doi: 10.1093/jnci/dju153
  25. Khan M.J., Werner C.L., Darragh T.M. et al. ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice. J Low Genit Tract Dis. 2017; 21 (4): 223–9. doi: 10.1097/LGT.0000000000000338
  26. Baasland I., Hagen B., Vogt C. et al. Colposcopy and additive diagnostic value of biopsies from colposcopy-negative areas to detect cervical dysplasia. Acta Obstet Gynecol Scand. 2016; 95 (11): 1258–63. doi: 10.1111/aogs.13009
  27. Ruan Y., Liu M., Guo J. et al. Evaluation of the accuracy of colposcopy in detecting high-grade squamous intraepithelial lesion and cervical cancer. Arch Gynecol Obstet. 2020; 302 (6): 1529–38. doi: 10.1007/s00404-020-05740-x
  28. Bai A., Wang J., Li Q. et al. Assessing colposcopic accuracy for high-grade squamous intraepithelial lesion detection: a retrospective, cohort study. BMC Womens Health. 2022; 22 (1): 9. doi: 10.1186/s12905-022-01592-6
  29. Wei B., Zhang B., Xue P. et al. Improving colposcopic accuracy for cervical precancer detection: a retrospective multicenter study in China. BMC Cancer. 2022; 22 (1): 388. doi: 10.1186/s12885-022-09498-0
  30. Клинышкова Т.В., Миронова О.Н. Влияние инозин пранобекса на экспрессию р16, Ki67 у больных с ВПЧ-ассоциированными цервикальными интраэпителиальными неоплазиями. Гинекология. 2018; 20 (4): 29–34 [Klinyshkova T.V., Mironova O.N. Effect of inosine pranobex on p16, Ki-67 expression in patients with HPV-associated cervical intraepithelial neoplasia. Gynecology. 2018; 20 (4): 29–34 (in Russ.)]. doi: 10.26442/2079-5696_2018.4.29-34
  31. Wright T.C. Jr., Behrens C.M., Ranger-Moore J. et al. Triaging HPV-positive women with p16/Ki-67 dual-stained cytology: Results from a sub-study nested into the ATHENA trial. Gynecol Oncol. 2017; 144 (1): 51–6. doi: 10.1016/j.ygyno.2016.10.031
  32. Wentzensen N., Clarke M.A., Bremer R. et al. Clinical Evaluation of Human Papillomavirus Screening With p16/Ki-67 Dual Stain Triage in a Large Organized Cervical Cancer Screening Program. JAMA Intern Med. 2019; 179 (7): 881–8. doi: 10.1001/jamainternmed.2019.0306
  33. Han Q., Guo H., Geng L. et al. p16/Ki-67 dual-stained cytology used for triage in cervical cancer opportunistic screening. Chin J Cancer Res. 2020; 32 (2): 208–17. doi: 10.21147/j.issn.1000-9604.2020.02.08
  34. Сухих Г.Т., Ашрафян Л.А. Киселев В.И. и др. Исследование эффективности и безопасности препарата на основе дииндолметана у пациенток с цервикальной интраэпителиальной неоплазией (CIN 1–2). Акушерство и гинекология. 2018; 9: 91–8 [Sukhikh G.T., Ashrafyan L.A., Kiselev V.I. et al. Investigation of the efficacy and safety of a diindolylmethane-based drug in patients with cervical intraepithelial neoplasia grades 1-2 (CIN 1-2). Obstetrics and Gynecology. 2018; 9: 91–8 (in Russ.)]. doi: 10.18565/aig.2018.9.91-98
  35. Elit L., Levine M.N., Julian J.A. et al. Expectant management versus immediate treatment for low-grade cervical intraepithelial neoplasia: a randomized trial in Canada and Brazil. Cancer. 2011; 117 (7): 1438–45. doi: 10.1002/cncr.25635
  36. Costa-Fagbemi M., Yakubu M., Meggetto O. et al. Risk of Cervical Dysplasia After Colposcopy Care and Risk-Informed Return to Population-Based Screening: A Systematic Revie. J Obstet Gynaecol Can. 2020; 42 (5): 607–24. doi: 10.1016/j.jogc.2019.05.017
  37. Arbyn M., Redman C.W.E., Verdoodt F. et al. Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis. Lancet Oncol. 2017; 12: 1665–79. doi: 10.1016/S1470-2045(17)30700
  38. Alder S., Megyessi D., Sundström K. et al. Incomplete excision of cervical intraepithelial neoplasia as a predictor of the risk of recurrent disease-a 16-year follow-up study. Am J Obstet Gynecol. 2020; 222 (2): 172.e1–172.e12. doi: 10.1016/j.ajog.2019.08.042
  39. Andersson S., Megyessi D., Belkić K. et al. Age, margin status, high-risk human papillomavirus and cytology independently predict recurrent high-grade cervical intraepithelial neoplasia up to 6 years after treatment. Oncol Lett. 2021; 22 (3): 684. doi: 10.3892/ol.2021.12945
  40. Fan A., Wang C., Han C. et al. Factors affecting residual/recurrent cervical intraepithelial neoplasia after cervical conization with negative margins. J Med Virol. 2018; 90 (9): 1541–8. doi: 10.1002/jmv.25208

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