Karimi Parvin, Reza Hosseini Seyed Mohammad, Mousavian Hiagh Zahra Sadat, Aboulhassanzadeh Sobhan, Asghari Nahid, Aghazadeh Hamed
Fars Population-Based Cancer Registry, Shiraz University of Medical Sciences, Shiraz, Iran.
School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Iran J Public Health. 2024 Dec;53(12):2671-2682.
Cervical Intraepithelial Neoplasia grade III (CIN III) represents a critical precursor to invasive cervical cancer, necessitating a comprehensive understanding of its etiology, progression, diagnosis, and preventive strategies. This review integrates an approach to synthesize current literature, conducted through a meticulous search of databases (Scopus, Web of Science, and Google Scholar) for relevant articles discussing CIN III and its association with Human Papillomavirus (HPV). The review delineates the multifaceted landscape of CIN III, elucidating the pathogenesis involving high-risk HPV types, demographic factors (age and sexual behavior), behavioral determinants (smoking and contraceptive use), and environmental influences impacting disease epidemiology. Diagnostic modalities, including Pap smears, HPV testing, and colposcopy, were assessed for their role in early detection and intervention. The results highlight the significance of HPV vaccination, screening programs, and robust public health policies in mitigating the burden of CIN III. Effective interventions, particularly excisional procedures, demonstrate efficacy in reducing the risk of progression to invasive cancer, emphasizing the importance of vigilant follow-up. A comprehensive approach integrating vaccination initiatives, early detection through screening, and equitable healthcare policies stands pivotal in combating CIN III. The review underscores the imperative of evidence-based interventions for disease prevention, reducing disparities, and enhancing public health outcomes for individuals affected by or at risk of CIN III.
宫颈上皮内瘤变3级（CIN III）是浸润性宫颈癌的关键前驱病变，因此有必要全面了解其病因、进展、诊断和预防策略。本综述采用一种综合当前文献的方法，通过对数据库（Scopus、科学网和谷歌学术）进行细致搜索，以查找讨论CIN III及其与人乳头瘤病毒（HPV）关联的相关文章。该综述描绘了CIN III的多方面情况，阐明了其发病机制，涉及高危HPV类型、人口统计学因素（年龄和性行为）、行为决定因素（吸烟和使用避孕药具）以及影响疾病流行病学的环境因素。对包括巴氏涂片、HPV检测和阴道镜检查在内的诊断方法在早期检测和干预中的作用进行了评估。结果突出了HPV疫苗接种、筛查项目以及强有力的公共卫生政策在减轻CIN III负担方面的重要性。有效的干预措施，特别是切除手术，在降低进展为浸润性癌症的风险方面显示出成效，强调了密切随访的重要性。将疫苗接种举措、通过筛查进行早期检测以及公平的医疗政策相结合的综合方法对于抗击CIN III至关重要。该综述强调了基于证据的干预措施对于疾病预防、减少差异以及改善受CIN III影响或有风险的个体的公共卫生结果的必要性。
