The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Australia.
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Curr Opin Obstet Gynecol. 2024 Oct 1;36(5):345-352. doi: 10.1097/GCO.0000000000000979. Epub 2024 Jul 22.
Cervical cancer can be eliminated as a public health problem through a three-pillar approach including high coverage of human papillomavirus (HPV) vaccination and HPV-based cervical screening, and treatment of precancers and invasive cancers. However, access inequities prevent many women and people with a cervix benefitting from these life-saving advances. This review focuses on evidence-based interventions that can improve equity and scale-up of cervical screening.
The transition from conventional cytology to HPV screening provides multiple opportunities to address equity and a multipronged approach can be used to identify priority groups, understand barriers and develop tailored solutions. There are proven financing mechanisms, tools, technologies and screening delivery methods to overcome screening barriers in different settings. This includes self-sampling interventions, point-of-care testing, health service integration, consumer-led co-design processes and digital screening registries.
To achieve cervical cancer elimination globally, cervical screening must be delivered in an inclusive, culturally safe and context-appropriate manner. There are multiple tools and strategies that can be implemented to improve participation of never- and under-screened groups, and to enhance equity in cervical screening.
通过包括人乳头瘤病毒（HPV）疫苗接种和 HPV 为基础的宫颈癌筛查的高覆盖率，以及对癌前病变和浸润性癌症的治疗在内的三管齐下的方法，宫颈癌可以作为一个公共卫生问题被消除。然而，由于获得机会的不平等，许多女性和有子宫颈的人无法从这些挽救生命的进步中受益。本综述重点介绍了可以改善宫颈癌筛查公平性和扩大规模的循证干预措施。
从传统细胞学向 HPV 筛查的转变提供了多个解决公平问题的机会，可以采用多管齐下的方法来确定优先群体，了解障碍并制定量身定制的解决方案。有经过验证的融资机制、工具、技术和筛查提供方法，可以克服不同环境下的筛查障碍。这包括自我采样干预、即时检测、卫生服务整合、以消费者为导向的共同设计过程和数字筛查登记。
为了在全球范围内实现宫颈癌消除，必须以包容、文化安全和适合具体情况的方式提供宫颈癌筛查。有多种工具和策略可以用来提高从未接受过或接受不足的人群的参与度，并增强宫颈癌筛查的公平性。
