Journal
CANCER EPIDEMIOLOGY
Volume 84, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.canep.2023.102369
Keywords
Cervical cancer prevention; Resource-limited settings; HPV testing; Automated visual, evaluation; Risk-based screening
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Cervical cancer screening and management in resource-limited settings can be optimized by adopting a risk-based approach. This includes using effective screening methods to separate low-risk from high-risk patients, directing resources to populations at highest cancer risk, utilizing HPV testing via self-sampling, improving risk stratification with HPV genotyping, and implementing automated visual evaluation with artificial intelligence to further enhance risk stratification. Risk-based screening and management allows for targeted triage and treatment while minimizing interventions in lower risk patients in resource-limited settings.
Cervical cancer screening and management in the U.S. has adopted a risk-based approach. However, the majority of cervical cancer cases and deaths occur in resource-limited settings, where screening and management are not widely available. We describe a conceptual model that optimizes cervical cancer screening and management in resource-limited settings by utilizing a risk-based approach. The principles of risk-based screening and management in resource limited settings include (1) ensure that the screening method effectively separates low-risk from high-risk patients; (2) directing resources to populations at the highest cancer risk; (3) screen using HPV testing via self-sampling; (4) utilize HPV genotyping to improve risk stratification and better determine who will benefit from treatment, and (5) automated visual evaluation with artificial intelligence may further improve risk stratification. Risk-based screening and management in resource limited settings can optimize prevention by focusing triage and treatment resources on the highest risk patients while minimizing interventions in lower risk patients.
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