期刊
VACCINES
卷 9, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/vaccines9101081
关键词
colposcopy; HPV vaccines; high grade intraepithelial lesions; cervical cancer; cervical adenocarcinoma; risk stratification; HPV genotyping; colposcopic referral criteria
The combination of primary and secondary prevention has influenced colposcopic practice, prompting proposed strategies for maintaining diagnostic accuracy through patient risk stratification and the application of artificial intelligence. Italy's strong colposcopic tradition calls for more accredited colposcopists to adapt to the vaccination era.
The combination of primary and secondary prevention has already influenced the colposcopic practice by reduction in HPV (human papillomavirus) vaccine-type HSIL (HIGH-GRADE SIL), colposcopy referral numbers, colposcopic positive predictive value (PPV) for CIN2+, and by modification of referral pattern, colposcopic performance, and procedures. Different strategies, both isolated and combined, have been proposed in order to maintain the diagnostic accuracy of colposcopy: patient risk stratification based on immediate or future risk of CIN3+ or on HPV genotyping after a positive screening test. Data are needed to support alternative colposcopic strategies based on vaccination status and on the application of artificial intelligence where the patient's risk stratification is implicit in precision medicine which involves the transition from an operator-dependent morphology-based to a less-operator dependent, more biomolecular management. The patient's risk stratification based on any combination of history and test results to decrease colposcopy workload further reduce colposcopic and histologic morphological approaches, while adding genotyping to the risk stratification paradigm means less cytologic morphologic diagnosis. In Italy, there is a strong colposcopic tradition and there is currently no immediate need to reduce the number of colposcopies. Instead, there is a need for more accredited colposcopists to maintain the diagnostic accuracy of colposcopy in the vaccination era.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据