Secondary prevention of cervical cancer: a modern approach to diagnosis
https://doi.org/10.51793/OS.2022.25.12.004
Abstract
According to WHO, cervical cancer is the fourth most common type of cancer among women in the world, in 2020 the number of new cases of the disease reached 604,000. Among women of reproductive age, cervical cancer is the second most com[1]mon type of cancer and the second cause of cancer death in the world. In the Russian Federation, the incidence of cervical cancer in recent years has been in the second position after uterine body cancer in the structure of genital cancers in the country. The problem of increasing incidence of cervical cancer requires the improvement of cervical screening. The last decade is characterized by the emergence of new highly informative methods for diagnosing precancer and the active introduction of modern approaches into practice in many countries. In the WHO Global Strategy to Accelerate the Elimination of cervical cancer as a public health problem, cervical screening is given priority. Modern cervical screening includes switching to primary human papillomavirus (HPV) screening or a соtesting followed by a triage in case of human papillomavirus detection. An overview and analysis of current data on this problem over the past decade is presented. The issues of evidence of the informativeness of traditional cytological screening, liquid cytology, HPV screening, cotesting, triage strategies of HPV-positive women, human papillomavirus screening interval are discussed. The immunocytochemical method of double staining p16/Ki67 is proposed for triage HPV-positive women, as more informative than cytological for the detection of CIN2+/CIN3+, an assessment of the risk stratification of precancerous using this method was carried out. Along with the expansion of human papillomavirus vaccination, increasing the level of cervical screening and coverage of the female population will help to reduce the morbidity and mortality associated with cervical cancer.
About the Author
T. V. Klinyshkova
Federal State Budgetary Educational Institution of Higher Education Omsk State Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
Tatyana V. Klinyshkova, Dr. of Sci. (Med.), Professor of the Department of Obstetrics and Gynecology No. 1
5 Petr Nekrasov str., Omsk, 644037
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: 209-249.
2. https://doi.org/10.3322/caac.21660.
3. Arbyn M., Weiderpass E., Bruni L., et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis // Lancet Glob Health. 2020; 8 (2): e191-e203. https://doi.org/10.1016/S2214-109X(19)30482-6.
4. Malignant neoplasms in Russia in 2020 (morbidity and mortality) / Edited by A. D. Kaprin, V. V. Starinsky, A. O. Shakhzadova. M.: P. A. Herzen Moscow State Medical Research Institute Branch of the Federal State Budgetary Institution «NMIC of Radiology» of the Ministry of Health of Russia, 2021. 252 p. (In Russ.)
5. Klinyshkova T. V., Turchaninov D. V., Frolova N. B. Clinical and epidemiological aspects of uterine body cancer from the perspective of prevention of recurrence of endometrial hyperplasia // Obstetrics and gynecology. 2020; 1: 135-140. (In Russ.) https://dx.doi.org/10.18565/aig.2020.1.135-140.
6. 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: 2349-2359 https://doi.org/10.1002/ijc.27485.
7. Prilepskaya V. N. HPV-associated diseases of the cervix: screening, examination methods, principles of treatment // Ginekologiya. 2019; 21 (3): 6-8. (In Russ.) https://doi.org/10.26442/20795696.2019.3.190595.
8. Wentzensen N., Arbyn M., Berkhof J., et al. Eurogin 2016 Roadmap: how HPV knowledge is changing screening practice // Int J Cancer. 2017; 140 (10): 2192-2200. https://doi.org/10.1002/ijc.30579.
9. 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: 524-532. https://doi.org/10.1016/S0140-6736(13)62218-7.
10. Bonde J. H., Sandri M. T., Gary D. S., et al. Clinical Utility of Human Papillomavirus Genotyping in Cervical Cancer Screening: A Systematic Review // J Low Genit Tract Dis. 2020; 24 (1): 1-13. https://doi.org/10.1097/LGT.0000000000000494.
11. 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): 735-745. https://doi.org/10.1002/ijc.31261.
12. Arbyn M., Castle P. E., Schiffman M., et al. Meta-analysis of agreement/ concordance statistics in studies comparing self-vs clinician-collected samples for HPV testing in cervical cancer screening // Int J Cancer. 2022; 151 (2): 308-312. https://doi.org/10.1002/ijc.33967.
13. Cho H. W.., Shim S. R., Lee J. K., et al. Accuracy of human papillomavirus tests on self-collected urine versus clinician-collected samples for the detection of cervical precancer: a systematic review and meta-analysis // J Gynecol Oncol. 2022; 33 (1): e4. https://doi.org/10.3802/jgo.2022.33.e4.
14. 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-k4823. https://doi.org/10.1136/bmj.k4823 PMID: 30518635.
15. Klinyshkova T. V., Turchaninov D. V., Buyan M. S. Epidemiological aspects of cervical cancer in the Omsk region // Akusherstvo i ginekologiya. 2018; 3: 102-108 (In Russ.) https://dx.doi.org/10.18565/aig.2018.3.102-108.
16. Adamyan L. V., Apolikhina I. A., Artymuk N. V., et al. Cervical intraepithelial neoplasia, erosion and ectropion of the cervix // Clinical recommendations. M., 2020. 59 p.
17. 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-dju153. https://doi.org/10.1093/jnci/dju153. PMID: 25038467.
18. Goodman S., Mody R. R., Coffey D., et al. Negative Pap tests in women with high-grade cervical lesions on follow-up biopsies: Contributing factors and role of human papillomavirus genotyping // Diagn Cytopathol. 2018; 46 (3): 239-243. https://doi.org/10.1002/dc.23874.
19. Gupta R., Hariprasad R., Dhanasekaran K., et al. Reappraisal of cytology-histology correlation in cervical cytology based on the recent American Society of Cytopathology guidelines (2017) at a cancer research centre // Cytopathology. 2020; 31 (1): 53-58.
20. https://doi.org/10.1111/cyt.12774. PMID: 31535740.
21. Trzeszcz M., Mazurec M., Jach R., et al. Liquid-Based Screening Tests Results: HPV, Liquid-Based Cytology, and P16/Ki67 Dual-Staining in Private-Based Opportunistic Cervical Cancer Screening // Diagnostics (Basel). 2021; 11 (8): 1420. https://doi.org/10.3390/diagnostics11112012. PMID: 34441354.
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: 285-291. https://doi.org/10.1002/cncr.22953. PMID: 17724676.
23. 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: 2849-2857. https://doi.org/10.1002/ijc.27955. PMID: 23175270.
24. 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): 80-83. https://doi.org/10.4103/ijc.IJC_352_17.
25. Pan Q. J., Hu S. Y., Guo H. Q., et al. Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China // Gynecol Oncol. 2014; 133 (2): 172-179. https://doi.org/10.1016/j.ygyno.2014.03.008.
26. 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): 474-484. https://doi.org/10.1158/1055-9965.EPI-20-1003.
27. 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.
28. https://doi.org/10.3310/hta23280.
29. Klinyshkova T. V., Samosudova I. B., Buyan M. S. Comparative evaluation of the results of an immunocytochemical study of p16/Ki-67 coexpression among patients with cervical intraepithelial neoplasia associated with human papillomavirus // Ginekologiya. 2021; 23 (4): 341-345. (In Russ.)
30. https://doi.org/10.26442/20795696.2021.4.200949.
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 substudy nested into the ATHENA trial // Gynecol Oncol. 2017; 144 (1): 51-56. https://doi.org/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): 881-888. https://doi.org/10.1001/jamainternmed.2019.0306
33. Gustinucci D., Giorgi Rossi P., et al. Use of Cytology, E6/E7 mRNA, and p16INK4a-Ki-67 to Define the Management of Human Papillomavirus (HPV)-Positive Women in Cervical Cancer Screening // Am J Clin Pathol. 2016; 145 (1): 35-45. https://doi.org/10.1093/ajcp/aqv019.
34. Benevolo M., Allia E., Gustinucci D., et al. Interobserver reproducibility of cytologic p16INK4a /Ki-67 dual immunostaining in human papillomavirus-positive women // Сancer Cytopathol. 2017; 125 (3): 212-220. https://doi.org/10.1002/cncy.21800.
35. Peeters E., Wentzensen N., Bergeron C., et al. Meta-analysis of the accuracy of p16 or p16/Ki-67 immunocytochemistry versus HPV testing for the detection of CIN2+/CIN3+ in triage of women with minor abnormal cytology // Cancer Cytopathol. 2019; 127 (3): 169-180. https://doi.org/10.1002/cncy.22103.
36. Clarke M. A., Cheung L. C., Castle P. E., et al. Five-Year Risk of Cervical Precancer Following p16/Ki-67 Dual-Stain Triage of HPV-Positive Women // JAMA Oncol. 2019; 5 (2): 181-186. https://doi.org/10.1001/jamaoncol.2018.4270.
Review
For citations:
Klinyshkova T.V. Secondary prevention of cervical cancer: a modern approach to diagnosis. Lechaschi Vrach. 2022;(12):26-31. (In Russ.) https://doi.org/10.51793/OS.2022.25.12.004
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