Department of Bioengineering, Rice University , Houston , TX , USA.
Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center , Houston , TX , USA.
Expert Rev Mol Diagn. 2019 Aug;19(8):695-714. doi: 10.1080/14737159.2019.1648213. Epub 2019 Aug 1.
: Cervical cancer mortality rates remain high in low- and middle-income countries (LMICs) and other medically underserved areas due to challenges with implementation and sustainability of routine screening, accurate diagnosis, and early treatment of preinvasive lesions. : In this review, we first discuss the standard of care for cervical cancer screening and diagnosis in high- and low-resource settings, biomarkers that correlate to cervical precancer and cancer, and needs for new tests. We review technologies for screening and diagnosis with a focus on tests that are already in use in LMICs or have the potential to be adapted for use in LMICs. Finally, we provide perspectives on the next five years of technology development for improved cervical cancer screening and diagnosis in LMICs. : Innovation toward improved molecular and imaging tests is needed to enable effective, affordable see-and-treat approaches to detect and treat cervical precancer in a single visit. Current molecular tests remain too complex and/or costly for widespread use. Especially with imaging tests, decision support may improve performance of new technologies.
宫颈癌的死亡率在中低收入国家(LMICs)和其他医疗服务不足的地区仍然很高,这是由于常规筛查、准确诊断和早期治疗癌前病变的实施和可持续性方面存在挑战。在这篇综述中,我们首先讨论了高资源和低资源环境下宫颈癌筛查和诊断的标准护理、与宫颈癌前病变和癌症相关的生物标志物,以及对新检测方法的需求。我们回顾了筛查和诊断技术,重点是已经在 LMICs 使用或有可能适应于 LMICs 使用的检测方法。最后,我们对未来五年改善 LMICs 宫颈癌筛查和诊断的技术发展提出了看法。需要创新的分子和成像检测方法,以实现有效的、负担得起的“一看即治”方法,在一次就诊中检测和治疗宫颈癌前病变。目前的分子检测方法仍然过于复杂和/或昂贵,无法广泛使用。特别是对于成像检测方法,决策支持可能会提高新技术的性能。