ORGANIZATION OF CERVICAL SCREENING IN WORLD PRACTICE AND IN RUSSIA: LITERATURE REVIEW
ORGANIZATION OF CERVICAL SCREENING IN WORLD PRACTICE AND IN RUSSIA: LITERATURE REVIEW
Kononova I.N., Dobrokhotova Yu.E.
For quotation:
Kononova I.N., Dobrokhotova Yu.E. Organization of cervical screening in world practice
and in Russia: literature review. Questions of practical colposcopy. Genital infections. 2022; (2): 8–16.
10.46393/27826392_2022_2_8
Annotation:
The introduction of cervical cancer (CC) screening in a number of countries using validated HPV testing platforms, demonstrating a significant reduction in the incidence of cervical cancer, as well as the experience of a number of regions of the Russian Federation were a prerequisite for conducting this study to justify the reorganization of domestic screening programs.
Purpose of the study: analysis of the scientific basis for organizing cervical screening with the methodology of HPV testing in world practice.
Material and methods. A selection of relevant publications was carried out in the scientific citation database PubMed over the past 20 years on the organization of cervical screening using methodologically validated platforms.
Results and discussion. A meta-analysis of the results of the successful implementation of HPV testing as primary screening for cervical cancer, presented in the world literature, demonstrated a paradigm shift in the approach to organizing preventive technologies for detecting cervical oncopathology from cytoscreening to the virological method. A large number of molecular methods for detecting HPV DNA have been limited by the introduction of the Mayer criteria, with validation and demonstration of successful results from randomized clinical trials in CC screening strategies. In Russia, the screening developed in 2017 currently needs to be reorganized due to ineffectiveness, manifested by the growth of cervical oncopathology and low rates of active detection of cervical cancer against the backdrop of outdated technologies and subjectivization of screening.
conclusions
1. Considering the higher sensitivity of HPV testing compared to cytoscreening in many countries of the world, virological screening has become a priority, with proven effectiveness in identifying precancerous and cancerous diseases and reducing CC.
2. In the Russian Federation, screening needs to be reorganized to reduce the socio-economic burden of cervical cancer.
3. The successful experience of a number of countries in reducing cervical cancer can be extrapolated to the territory of Russia or taken as a basis for the development of domestic test systems.
4. To maximize the detection of cervical oncopathology (organized screening), it is advisable to create digitalized monitoring of the inclusion of the female population in screening with the condition of introducing it into co-screening or as primary screening of modern HPV testing methods on a validated platform, with ranking into groups depending on detection 16, 18 and 14 types of HPV of high oncogenic risk, with maximum automation of amplification, detection and interpretation of results, cut-off of clinically insignificant results and subsequent management decisions for routing and optimization of treatment technologies.
Journal “Issues of practical colposcopy. Genital infections" No. 2_2022