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解锁早期检测:筛查如何拯救宫颈癌患者的生命。

Unlocking early detection: How screening can save lives from cervical cancer.

作者信息

Yin Chen, Li Xiao-Bing

机构信息

Department of Oncology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China.

Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China.

出版信息

World J Clin Oncol. 2025 May 24;16(5):102456. doi: 10.5306/wjco.v16.i5.102456.

Abstract

Cervical cancer remains a significant public health challenge, particularly in low- and middle-income countries. Screening of cervical cancer is crucial because it can detect precancerous changes and early-stage cancer. Regard to the screening methods, combination of human papillomavirus (HPV) testing and cytological examination has superior sensitivity and specificity compared to cytology alone. Thus, recent guidelines recommend this combined approach instead of cytology alone to reduced cervical cancer incidence and mortality. By using this combination, HPV testing identifies high-risk strains associated with cervical cancer, while cytology helps detect abnormal cellular changes. This dual strategy enhances early detection rates, allowing for timely intervention and treatment. Moreover, recent studies demonstrated that this screening strategy also significantly reduced detection costs, indicating the potential for this screening strategy to be promoted, especially in economically constrained regions. Despite challenges in screening, such as accessibility, public awareness, and cultural attitudes, educating communities on the importance of HPV testing and cytology can improve participation rates. Overall, a combined HPV testing and cytology screening strategy represents a proactive approach to cervical cancer prevention, promising to save lives through early detection and treatment.

摘要

宫颈癌仍然是一项重大的公共卫生挑战,在低收入和中等收入国家尤为如此。宫颈癌筛查至关重要,因为它可以检测出癌前病变和早期癌症。关于筛查方法,与人乳头瘤病毒(HPV)检测和细胞学检查相结合相比,单纯的细胞学检查具有更高的敏感性和特异性。因此,最近的指南推荐这种联合方法而非单纯的细胞学检查,以降低宫颈癌的发病率和死亡率。通过使用这种组合方式,HPV检测可识别与宫颈癌相关的高危毒株,而细胞学检查有助于检测异常细胞变化。这种双重策略提高了早期检测率,从而能够及时进行干预和治疗。此外,最近的研究表明,这种筛查策略还显著降低了检测成本,这表明该筛查策略具有推广潜力,特别是在经济受限地区。尽管在筛查方面存在挑战,如可及性、公众意识和文化观念等,但对社区进行HPV检测和细胞学检查重要性的教育可以提高参与率。总体而言,HPV检测和细胞学联合筛查策略是一种积极主动的宫颈癌预防方法,有望通过早期检测和治疗挽救生命。

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The evolution of cervical cancer screening.宫颈癌筛查的演变
J Am Soc Cytopathol. 2024 Jan-Feb;13(1):10-15. doi: 10.1016/j.jasc.2023.09.007. Epub 2023 Sep 25.
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Two Years of Cytology and HPV Co-Testing in Germany: Initial Experience.德国两年的细胞学和人乳头瘤病毒联合检测:初步经验
Geburtshilfe Frauenheilkd. 2022 Aug 16;82(12):1378-1386. doi: 10.1055/a-1886-3311. eCollection 2022 Dec.
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Cervical cancer in Nepal: Current screening strategies and challenges.尼泊尔的宫颈癌:现行筛查策略和挑战。
Front Public Health. 2022 Nov 17;10:980899. doi: 10.3389/fpubh.2022.980899. eCollection 2022.
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Patterns of cervical cancer screening among Medicaid beneficiaries.医疗补助受益人群的宫颈癌筛查模式。
BJOG. 2022 Jun;129(7):1104-1111. doi: 10.1111/1471-0528.17050. Epub 2021 Dec 29.
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The IARC Perspective on Cervical Cancer Screening.国际癌症研究机构对宫颈癌筛查的观点。
N Engl J Med. 2021 Nov 11;385(20):1908-1918. doi: 10.1056/NEJMsr2030640.

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