Izadi-Najafabadi Sara, Smith Laurie W, Gottschlich Anna, Booth Amy, Peacock Stuart, Ogilvie Gina S
BC Cancer, Vancouver, BC V5Z 0B4, Canada.
Women's Health Research Institute, BC Women's Hospital, Vancouver, BC V6H 3N1, Canada.
Curr Oncol. 2025 Jul 17;32(7):407. doi: 10.3390/curroncol32070407.
Cervical cancer is a major global health concern, causing approximately 350,000 deaths annually. It is also preventable through effective prevention and early detection. To facilitate elimination, the World Health Organization (WHO) set targets for HPV vaccination, screening, and treatment. Achieving these goals requires frameworks to monitor screening program performance. As many regions transition to HPV primary screening, a standardized Cervical Cancer Screening Cascade can track performance, identify gaps in follow-up, and optimize resource allocation. This paper introduces a structured cascade developed to monitor uptake, retention, and outcomes in HPV-based screening programs. The Cascade was created through collaboration between public health experts, clinicians, and researchers at the University of British Columbia (UBC), the Women's Health Research Institute, and BC Cancer. The Cascade outlines four phases: screening, triage, detection, and treatment. Each phase includes two substages: "uptake" and "results," with an additional substage in screening ("invitation"). "Screening" assesses invitation effectiveness and participation. "Triage" tracks follow-up after a positive screen. "Detection" evaluates attendance at diagnostic appointments, and "Treatment" measures the treatment rate for those with precancerous lesions. The Cascade can guide emerging and existing HPV screening programs within Canada and other similarly resourced settings and serve as a benchmark tool for programs to assess their progress towards cervical cancer elimination.
宫颈癌是全球主要的健康问题，每年导致约35万人死亡。它也可通过有效的预防和早期检测来预防。为促进消除宫颈癌，世界卫生组织（WHO）设定了HPV疫苗接种、筛查和治疗的目标。实现这些目标需要监测筛查项目绩效的框架。随着许多地区转向HPV初筛，标准化的宫颈癌筛查流程可以跟踪绩效、识别后续跟进中的差距并优化资源分配。本文介绍了一个结构化流程，用于监测基于HPV的筛查项目中的参与率、留存率和结果。该流程是由英属哥伦比亚大学（UBC）、妇女健康研究所和卑诗癌症机构的公共卫生专家、临床医生和研究人员合作创建的。该流程概述了四个阶段：筛查、分流、检测和治疗。每个阶段包括两个子阶段：“参与”和“结果”，筛查阶段还有一个额外的子阶段（“邀请”）。“筛查”评估邀请效果和参与情况。“分流”跟踪阳性筛查后的后续跟进。“检测”评估诊断预约的到场情况，“治疗”衡量癌前病变患者的治疗率。该流程可以指导加拿大及其他资源类似地区正在开展和已有的HPV筛查项目，并作为项目评估其在消除宫颈癌方面进展的基准工具。
