Table of Contents
Overview
Definition and Importance
Cervical cancer is defined as a malignancy that originates in the cervix, which is the narrow opening connecting the uterus to the vagina. The cervix is typically covered with flat, thin cells known as squamous cells, and the normal ectocervix appears as a healthy pink color.[1.1] This type of cancer often develops from abnormal changes in cervical cells, particularly at the entrance to the womb, where tumors can form.[2.1] The significance of cervical cancer lies in its potential for early detection and prevention. Regular screening tests can identify cervical cancer at an early stage, making it one of the most successfully treatable cancers when diagnosed promptly.[3.1] Furthermore, any woman with a cervix is at risk, with the highest incidence occurring in women over the age of 30. The primary cause of cervical cancer is a long-lasting infection with certain types of human papillomavirus (HPV), a common sexually transmitted virus.[4.1] Cervical cancer typically progresses slowly, beginning with a condition known as dysplasia, where abnormal cells appear in the cervical tissue. If these abnormal cells are not addressed, they may eventually develop into cancer.[5.1] Preventative measures, such as vaccination against HPV, are highly effective in reducing the risk of cervical cancer. Vaccination is recommended for girls aged 9 to 14 years, ideally before they become sexually active, and screening is advised starting at age 30.[6.1] In addition to individual health measures, community health workers (CHWs) play a crucial role in promoting cervical cancer screening and education, particularly in areas with limited healthcare resources. Their involvement can significantly contribute to reducing morbidity and mortality associated with cervical cancer globally.[27.1]Epidemiology and Statistics
Cervical cancer is predominantly caused by high-risk types of human papillomavirus (HPV), with HPV types 16 and 18 being the most significant contributors to its development. Epidemiological studies have established a clear link between high-risk HPV infections and the incidence of cervical cancer, highlighting the importance of preventive measures such as vaccination and regular screenings for early detection.[34.1] The prevalence of high-risk HPV infections and cervical cancer exhibits significant disparities between developed and developing countries. In many developing nations, there remains a low level of awareness regarding the existence and availability of HPV vaccines, which correlates with a higher incidence of cervical cancer due to insufficient screening programs.[29.1] In contrast, developed countries have established well-organized cervical cancer screening and HPV vaccination initiatives, which have contributed to better health outcomes.[29.1] The recognition of the link between high-risk HPV types and cervical cancer development has led to the introduction of novel screening programs, including the WHO's recommendation to test for high-risk HPV as a screening tool.[30.1] Additionally, measuring the levels of HPV E6/E7 oncoproteins is emerging as a potential biomarker for high-risk HPV infection, particularly for type 16, which accounts for more than 50% of all cervical cancer cases.[29.1] Cervical cancer is predominantly caused by human papillomavirus (HPV), with virtually all cases linked to this virus, particularly high-risk types such as HPV16 and HPV18.[34.1] Routine screening methods, including HPV testing and Pap tests, play a crucial role in preventing cervical cancer by enabling healthcare providers to detect and remove precancerous lesions, thereby significantly reducing the incidence of this disease.[31.1] A critical event in the progression from HPV infection to cervical cancer is the integration of HPV DNA into the host genome; however, this specific integration does not occur frequently. In most cases, the immune system effectively clears HPV infections before they can lead to cancer.[35.1] Thus, while HPV is the greatest risk factor for cervical cancer, the majority of infections are resolved without progressing to malignancy.[35.1] Since the introduction of the HPV vaccine in 2006, there has been a significant reduction in the incidence of HPV infections and cervical precancers among young women. Reports indicate that infections with cancer-causing HPV types have decreased by 88% among teen girls and that rates of precancerous lesions among women aged 20-24 dropped by approximately 80% from 2008 to 2022.[37.1] Despite advancements in cervical cancer prevention, significant challenges remain, particularly in low- and middle-income countries (LMICs). Even if HPV vaccination were to eradicate high-risk HPV types, such as 16, 18, 31, 33, 45, 52, and 58, a proportion of LMICs, especially in sub-Saharan Africa, would still experience cervical cancer incidence exceeding the critical threshold of four cases per 100,000 women-years, as approximately 10% of cervical cancers are attributable to HPV types not included in current vaccination programs.[39.1] Over the past decade, there has been an overall decreasing trend in both the incidence and mortality rates of cervical cancer, which aligns with findings from previous studies that have identified similar trends in the burden of this disease.[41.1] These changes in cervical cancer epidemiological patterns underscore the importance of continuously tracking evolving trends in this context.[42.1]History
Historical Context of Cervical Cancer
Cervical cancer has a long and complex history that reflects broader societal attitudes towards women's health and the evolution of medical understanding. The disease itself is not new; its historical context has been studied as part of women's history and the history of medicine and gynecology, providing insights into how current knowledge has developed and how cervical cancer is perceived in various societies today.[47.1] The understanding of cervical cancer began to evolve significantly in the 18th century with advancements in morbid anatomy. Notably, Matthew Baillie's 1793 work, "The Morbid Anatomy of Some of the Most Important Parts of the Human Body," included the first drawing of a cancerous uterus, although it remains unclear whether this specifically depicted cervical cancer.[48.1] In the mid-20th century, significant strides were made in cervical cancer research. In 1958, one of the earliest cervical screening studies in the UK was conducted by researcher Erica Wachtel, who analyzed smear tests from patients treated for gynecological cancers. Her findings highlighted the predictive value of measuring estrogen activity in assessing cancer risk.[46.1] This period marked the beginning of a more systematic approach to cervical cancer screening, which has evolved over the decades. By 2019, cervical cancer was diagnosed in approximately 13,170 new cases in the United States, with nearly 4,300 women succumbing to the disease. Once the leading cause of cancer death among American women, cervical cancer has since dropped to the 14th most common cancer due to the widespread adoption of the Pap test.[49.1] This shift underscores the impact of early detection and preventive measures in reducing mortality rates associated with the disease. Despite advancements, cervical cancer continues to pose significant public health challenges, particularly among marginalized groups. Research indicates that incidence and mortality rates disproportionately affect racial and ethnic minorities and low-income women, highlighting persistent barriers to healthcare access.[60.1] Furthermore, societal attitudes towards women's health have historically influenced research and treatment approaches, with educated women demonstrating more favorable attitudes towards cervical cancer screening, yet significant gaps remain between perception and practice.[58.1] The global landscape of cervical cancer has also been shaped by socioeconomic factors. While cervical cancer is relatively rare in high-income countries, it remains a leading cause of cancer death in low- and middle-income countries (LMICs), where 94% of deaths occurred in 2022.[75.1] The World Health Organization's 2022 global recommendation for one-dose HPV vaccine schedules aims to reduce barriers to vaccination and improve health outcomes for women in these regions.[76.1]Evolution of Screening and Treatment Methods
Advancements in cervical cancer screening and treatment have significantly evolved over the past few decades, particularly with the integration of artificial intelligence (AI) and image processing technologies. Since 2019, various intelligent diagnosis tools have been progressively applied in cervical cancer screening, enhancing the accuracy and efficiency of detection methods.[54.1] These developments are complemented by innovations in digital optical technology, which have led to the creation of highly portable digital colposcopes. Such advancements hold the potential to greatly reduce cervical cancer incidence, especially in developing regions where access to traditional screening methods may be limited.[55.1] In addition to technological advancements, the introduction of the Human Papillomavirus (HPV) Vaccine has played a crucial role in cervical cancer prevention. The HPV-IMPACT project, initiated in 2008, has been instrumental in monitoring trends in cervical lesions that could progress to cancer, as well as tracking the reduction of cancer-causing HPV types that the vaccine can prevent. This project provides valuable data on the impact of the HPV vaccine by observing rates of high-grade cervical lesions in the United States.[56.1] Since the introduction of the HPV vaccine, there has been a notable decline in HPV infections and cervical precancers. Specifically, among vaccinated women, the incidence of cervical precancers caused by the HPV types most commonly linked to cervical cancer has decreased by 40%.[57.1]Causes And Risk Factors
Human Papillomavirus (HPV) Infection
Long-lasting infection with high-risk types of human papillomavirus (HPV) is the primary cause of cervical cancer, accounting for virtually all cases of the disease. Among the various HPV types, HPV 16 and HPV 18 are particularly significant, as they are responsible for approximately 70% of cervical cancers worldwide.[98.1] The mechanism by which HPV contributes to cervical cancer involves the persistence of the virus, which can lead to precancerous changes in cervical cells over time.[99.1] Human papillomavirus (HPV) infection is the most significant risk factor for cervical cancer, with nearly all cases of cervical cancer attributed to this virus.[91.1] Several factors related to an individual's sexual history can further elevate the risk of developing cervical cancer. For instance, having multiple sexual partners increases the likelihood of contracting HPV, which can lead to persistent infection.[90.1] Additionally, co-infection with other sexually transmitted infections, such as Chlamydia, may facilitate the persistence of HPV in the cervix, thereby increasing the risk of cervical cancer.[90.1] It is important to note that cervical cancer screening tests and the HPV vaccine are effective measures that can help prevent the onset of cervical cancer.[91.1] Preventive measures, including HPV vaccination and routine cervical cancer screening, are crucial in reducing the incidence of cervical cancer. The HPV vaccine is effective in preventing infections from the most common high-risk HPV types, but it does not cover all strains that can lead to cervical cancer, making regular screening essential.[91.1] Without screening and vaccination, the risk of developing cervical cancer increases significantly, particularly as women age.[92.1] Thus, understanding the role of HPV in cervical cancer is vital for implementing effective prevention and treatment strategies.Lifestyle and Environmental Factors
Cervical cancer is primarily caused by long-lasting infections with high-risk types of human papillomavirus (HPV), with HPV 16 and HPV 18 responsible for approximately 70% of cases worldwide.[88.1] This virus can be transmitted through sexual contact and has various types, some of which can lead to changes in the cervix that may result in cervical cancer over time.[89.1] Several factors can increase the likelihood that an HPV infection will progress to cancer, highlighting the importance of preventive measures. Nearly all cervical cancers could be prevented through HPV vaccination, routine screening, and appropriate follow-up treatment when necessary.[88.1] Despite these preventive strategies, disparities in cervical cancer incidence and mortality persist, influenced by various lifestyle and environmental factors that are closely linked to social determinants of health. Cervical cancer is predominantly caused by infection with the human papillomavirus (HPV), which is recognized as the most significant risk factor associated with the disease.[90.1] In addition to HPV, various factors related to sexual history can further elevate the risk of developing cervical cancer. For instance, studies indicate that the presence of Chlamydia bacteria may facilitate the persistence of HPV in the cervix, thereby increasing the likelihood of cervical cancer.[90.1] Preventive measures, such as cervical cancer screening tests and the HPV vaccine, are essential in reducing the incidence of this cancer.[91.1] These interventions underscore the importance of awareness regarding risk factors and the implementation of effective strategies to prevent cervical cancer.[91.1] Cervical cancer typically develops from abnormal cells at the opening of the cervix, a process that can take years or even decades. A woman's risk of developing cervical cancer is significantly influenced by her screening practices, whether she has received the HPV vaccine, and her age. Without screening or vaccination, estimates indicate that women of various ages face different risks of developing cervical cancer within the next ten years. Screening is crucial as it allows for the detection and removal of abnormal (precancerous) tissue before it can progress to cervical cancer.[92.1]In this section:
Symptoms And Diagnosis
Common Symptoms
Cervical cancer often develops without noticeable symptoms in its early stages, making early detection challenging. However, as the disease progresses, several common symptoms may emerge. The most frequently reported symptom is abnormal vaginal bleeding, which can manifest as bleeding after sexual intercourse, bleeding between menstrual periods, or bleeding following menopause.[132.1] Additionally, women may experience unusual vaginal discharge, which can also be an early sign of cervical cancer.[135.1] Pain during sexual intercourse, known as dyspareunia, is one of the early signs of cervical cancer, along with abnormal vaginal bleeding and other sexual health issues.[129.1] It is essential for women to be aware of these symptoms, as they can be vague and may overlap with benign conditions, which can complicate diagnosis.[132.1] Recognizing these early signs is crucial for seeking timely medical attention and beginning treatment, thereby preventing severe complications.[136.1] Despite the potential for these symptoms to arise, many women with early cervical cancers and pre-cancers report having no symptoms at all.[135.1] Therefore, regular pelvic exams and Pap tests are essential for early detection, even in the absence of symptoms.[131.1] Awareness of these signs is vital, as timely medical attention can significantly improve treatment outcomes.[134.1]Diagnostic Procedures
A range of cervical abnormalities can be identified through various screening methods, which are essential for detecting precancerous conditions and early-stage cervical cancer. Precancerous conditions of the cervix involve changes to cervical cells that increase the likelihood of developing cancer.[146.1] Among the key screening methods, Pap smears play a crucial role as they specifically target cervical cell abnormalities, enabling early detection often before any symptoms appear.[154.1] While distinct, Pap smears and pelvic exams are often performed together during a single visit; the pelvic exam provides a broader context for assessment, while the Pap smear focuses on cervical cell changes.[151.1] This combination allows for a more comprehensive evaluation of women's reproductive health. Early detection through these methods is vital, as cervical cancer is highly treatable when identified in its initial stages.[154.1] The screening for cervical cancer has evolved to include both HPV testing and Pap smears, which are typically performed during a pelvic exam. During this exam, cells are collected from the cervix and subsequently analyzed in a laboratory.[152.1] This dual testing approach allows for the detection of a range of cervical abnormalities, some of which may indicate precancerous or cancerous lesions.[148.1] In cases where significant abnormalities are identified, further evaluation through colposcopy is often warranted.[147.1] It is important to note that while oncogenic human papillomavirus (HPV) is a significant risk factor in cervical carcinogenesis, it is not the sole factor contributing to the disease.[149.1] Routine Pap tests are essential for the early detection of cervical cancer, as they can identify cervical abnormalities at an early stage, often before any symptoms appear.[154.1] The significance of these tests lies in their ability to detect precancerous changes on the cervix, which could develop into cervical cancer if not treated appropriately.[155.1] Early detection is crucial because cervical cancer is highly treatable when identified in its initial stages.[154.1] Additionally, the integration of the HPV test alongside the Pap test enhances the prevention and early detection of cervical cancer.[155.1] If a cervical cancer screening test reveals abnormal results, it is important to consult a healthcare provider for further evaluation and potential follow-up testing.[154.1] Overall, regular screenings play a vital role in reducing the incidence of cervical cancer through early intervention and treatment.Recent Advancements
Innovations in Screening Technologies
Innovative technologies have emerged to enhance cervical cancer screening, significantly improving the accuracy, efficiency, and cost-effectiveness of traditional methods. One notable advancement is the development of a computer-aided system utilizing deep learning techniques on whole slide images (WSIs), which has the potential to greatly improve the precision of cervical cancer screening and facilitate early detection and treatment.[178.1] Emerging screening techniques include HPV DNA testing, which is increasingly recognized for its effectiveness in identifying women at risk for cervical cancer. This method, when combined with cytology, offers a more comprehensive approach to screening compared to traditional methods that often require multiple visits and incur higher costs.[181.1] The Abbott RealTime High Risk HPV test exemplifies a clinically validated assay that can be used for triage in referral populations and in primary screening for women aged 30 and older.[179.1] Artificial intelligence (AI) has also been integrated into cervical cancer screening frameworks, enhancing the capabilities of existing diagnostic tools. AI-assisted systems analyze cytologic images and employ deep learning algorithms to identify normal and abnormal cells, thereby streamlining the screening process.[196.1] These systems not only reduce the time required for analysis but also minimize the need for extensive professional input, addressing biases that may arise from subjective interpretations.[194.1] Furthermore, AI technologies can standardize screening procedures, improve the identification of early lesions, and increase the diagnostic accuracy of targeted biopsies.[197.1] The integration of digital health interventions and mobile health applications has further expanded the landscape of cervical cancer screening, promoting patient education and engagement.[193.1] As these innovative technologies continue to evolve, they hold significant promise for improving cervical cancer prevention and treatment strategies, particularly in regions where cervical cancer remains a leading cause of cancer-related deaths among women.[180.1]Advances in Treatment Options
Recent advancements in the treatment of cervical cancer have focused on innovative approaches that enhance patient outcomes and personalize therapy. One significant development is the use of antibody-drug conjugates, such as Tivdak, which received FDA approval for treating cervical cancer. This treatment demonstrated a 30% reduction in the risk of death compared to traditional chemotherapy in patients who had previously undergone treatment for the disease.[185.1] Additionally, a new treatment strategy involving short bursts of chemotherapy prior to the main treatment has shown promising results. This method not only improves outcomes for women with cervical cancer but also demonstrates efficacy across various cancer types, marking a substantial advancement in treatment protocols.[186.1] In the realm of personalized medicine, the integration of companion diagnostics (CDx) has become crucial. These diagnostics help identify the most effective treatments based on specific tumor characteristics, thereby enhancing the safety and effectiveness of therapies.[198.1] Furthermore, the application of precision medicine in cervical cancer treatment has gained traction, leveraging biomarkers and molecular targets to tailor therapies to individual patients. This approach has been associated with improved patient outcomes, including higher response rates and progression-free survival in clinical trials.[200.1] Recent clinical trials have also explored the combination of induction chemotherapy with chemoradiation for patients with locally advanced cervical cancer. This approach aims to extend survival rates for patients whose cancer has spread beyond the cervix but has not yet metastasized to distant sites.[177.1] Notably, the KEYNOTE-A18 study highlighted the potential of combining pembrolizumab, an immunotherapy agent, with chemoradiation, showing significant benefits for patients with high-risk locally advanced cervical cancer.[183.1]Prevention Strategies
HPV Vaccination
Human papillomavirus (HPV) vaccination is a critical strategy in the prevention of cervical cancer, as persistent HPV infections are the primary cause of this malignancy. Vaccination is most effective when administered to girls aged 9 to 14 years, prior to the onset of sexual activity, as it significantly reduces the risk of HPV infection and subsequent cervical cancer development.[220.1] The World Health Organization (WHO) has emphasized the importance of high HPV vaccination coverage among girls, predicting that such efforts could lead to the elimination of cervical cancer in many lower-middle-income countries by the end of the century.[218.1] Cervical cancer is primarily caused by persistent human papillomavirus (HPV) infections, which can lead to cervical pre-cancer. If left untreated, these pre-cancerous conditions may progress to invasive cancer over a span of 10 to 20 years.[216.1] Effective prevention strategies are essential, and comprehensive cervical cancer prevention and control programs are crucial in this regard. These programs aim to provide universal access to HPV vaccination for girls and ensure that women at risk receive appropriate screening and treatment for pre-cancer.[216.1] Screening tests, such as the Pap test and the HPV test, are well-established methods for detecting pre-cancerous conditions before they develop into invasive cancer.[222.1] The World Health Organization recommends that women begin screening with HPV DNA testing as the primary method starting at age 25, with intervals of every 3 to 5 years.[216.1] By ensuring widespread access to both HPV vaccination and screening, it is possible to significantly reduce the incidence of cervical cancer and improve health outcomes for women at risk.[216.1] Participation of culturally and linguistically diverse (CALD) women from migrant and refugee backgrounds in cervical screening is crucial to eliminate cervical cancer as a public health problem within the next 20 years. Co-designed, culturally tailored cervical screening health promotion forums have been found to be both feasible and acceptable to CALD women, whether delivered in face-to-face or online formats.[231.1] This approach addresses the lack of understanding regarding changes to the Australian cervical screening program and aims to improve health literacy around cervical screening within CALD communities.[231.1] Furthermore, a systematic review of published studies has shown that self-sampling and reminder interventions are generally cost-effective strategies for increasing cervical cancer screening uptake rates among underscreened women.[232.1] These findings highlight the importance of targeted interventions to enhance participation in cervical cancer prevention efforts.Screening Recommendations
Screening for cervical cancer is a critical component of prevention strategies, particularly in identifying precancerous changes that can lead to cancer if left untreated. The primary goal of cervical cancer screening is to detect these precancerous cervical cell changes early, allowing for timely intervention that can prevent the progression to cancer.[240.1] Current screening methods for cervical cancer include the HPV test, which is recognized as the most effective, cost-effective, and efficient option, particularly in low- and middle-income countries (LMICs). Screening with HPV every five years has been shown to be more effective and cost-effective than screening with visual inspection with acetic acid (VIA) or cytology conducted every three years.[237.1] Additionally, VIA has been associated with generating more than double the number of pre-cancer treatments compared to HPV screening.[237.1] Therefore, primary HPV screening is recommended as a superior strategy for early detection and prevention of cervical cancer.[237.1] The Pap test, or Pap smear, is another vital screening tool that detects precancerous changes in cervical cells. It is effective in reducing the incidence of invasive cervical cancer across all histologies and stages, with the benefits increasing with the age of the women being screened.[238.1] The Pap test can identify cell changes that might develop into cervical cancer if not treated appropriately, thus contributing significantly to early detection efforts.[239.1] In resource-limited settings, the choice of screening methods is crucial, as many cases of cervical cancer occur in developing countries with inadequate screening programs.[241.1] The incidence and mortality rates of cervical cancer have significantly decreased in the United States over the past 30 years, largely due to the implementation of widespread screening programs.[241.1] This highlights the importance of effective screening recommendations in reducing the burden of cervical cancer globally.In this section:
Global Impact And Efforts
Cervical Cancer Burden Worldwide
The global burden of cervical cancer remains a significant public health challenge, with an estimated 662,044 new cases and 348,709 deaths reported in 2022, making it the fourth leading cause of cancer morbidity and mortality among women worldwide.[263.1] Projections indicate that if current rates persist, the incidence of cervical cancer could rise by 56.8% and mortality by 80.7% by 2050.[263.1] By 2030, the number of new cases is expected to increase to 760,082, reflecting a 14.8% rise, while deaths could reach 411,035, marking a 17.8% increase.[262.1] Cervical cancer continues to pose a significant global health challenge, with an estimated 662,044 new cases and 348,709 deaths reported in 2022, making it the fourth leading cause of cancer morbidity and mortality among women worldwide.[263.1] Projections indicate that if the rates from 2022 remain unchanged, the global burden of cervical cancer could rise to 760,082 new cases and 411,035 deaths by 2030, reflecting a 14.8% increase in incidence and a 17.8% increase in mortality.[262.1] Disparities in the burden of cervical cancer are evident, as age-standardized incidence and mortality rates are presented according to countries, 20 United Nations-defined world regions, and four-tier Human Development Index (HDI) levels.[281.1] This highlights the urgent need for tailored public health interventions to address the persistent and widening geographic and socioeconomic inequalities in cervical cancer outcomes.[262.1] In 2020, the World Health Organization (WHO) launched the global Cervical Cancer Elimination Initiative to accelerate the elimination of cervical cancer, aiming to reduce the incidence to below 4 cases per 100,000 women-years in every country and to address international disparities associated with this disease.[264.1] However, an accompanying article from a collaboration with IARC researchers highlighted that most countries are not on track to meet the WHO's Cervical Cancer Elimination target, which aims to end cervical cancer by 2030.[265.1] This situation underscores the urgent need for intensified global efforts to combat cervical cancer effectively. Preventive measures, such as HPV vaccination and regular screening, are critical in reducing the incidence of cervical cancer. Vaccination is most effective when administered to girls aged 9–14 years, prior to sexual activity, as it protects against the high-risk HPV types responsible for the majority of cervical cancers.[266.1] Screening programs, particularly starting at age 30 (or 25 for women living with HIV), can detect cervical disease early, allowing for timely treatment and prevention of cancer progression.[266.1]Initiatives for Elimination and Awareness
In 2020, the World Health Organization (WHO) endorsed a global strategy aimed at the elimination of cervical cancer, which calls for 70% of women worldwide to be screened regularly for cervical disease using high-performance tests, and for 90% of those identified as needing treatment to receive appropriate care.[286.1] This initiative emphasizes the integration of cervical cancer screening and treatment with existing platforms for HIV care, thereby addressing the health needs of women living with HIV and enhancing access to necessary services.[286.1] Public education and targeted outreach are critical components of effective cervical cancer screening programs, particularly in underserved communities. Community-based programs, such as those supported by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), have demonstrated success in increasing awareness and participation in screening through evidence-based interventions (EBIs).[273.1] These strategies include educational initiatives that inform and motivate women to undergo recommended screenings, as well as addressing barriers to access.[275.1] Despite the effectiveness of screening programs in high-income countries, there remains a significant gap in the implementation of successful cervical cancer screening initiatives in low- and middle-income countries (LMICs).[274.1] Research indicates that barriers such as lack of access, financial constraints, and cultural stigma hinder participation in screening.[275.1] To combat these challenges, healthcare providers are encouraged to implement mobile screening units, education initiatives, self-testing options, and financial assistance programs.[275.1] Community health workers play a crucial role in increasing cervical cancer screening rates, particularly among underserved populations. Evidence indicates that interventions led by community health workers can effectively enhance screening rates when these workers deliver programs independently or as part of an implementation team.[276.1] Specific studies have demonstrated the effectiveness of community-based interventions in addressing multilevel barriers to cervical cancer screening, particularly among Korean American women and Vietnamese Americans.[276.1] For instance, randomized trials and community health worker-led initiatives have been implemented to improve screening literacy and participation in these populations.[276.1] These findings underscore the importance of community-driven approaches in promoting awareness and facilitating access to cervical cancer screening programs.[276.1] The WHO's global strategy is further supported by significant financial commitments from governments and organizations, totaling nearly US$ 600 million, aimed at expanding vaccine coverage and strengthening screening and treatment programs.[289.1] This collaborative effort underscores the importance of partnerships among various stakeholders, including multilateral institutions and local organizations, to ensure equitable access to cervical cancer prevention and treatment.[290.1]In this section:
Global Health ChallengeHuman DevelopmentPublic Health InterventionsHIVTreatment And Prevention
References
[1] Cervical Cancer Overview - NCCC — Cervical Cancer Overview. Cervical cancer is cancer that starts in the cervix, the narrow opening into the uterus from the vagina. The normal "ectocervix" (the portion of the uterus extending into the vagina) is a healthy pink color and is covered with flat, thin cells called squamous cells.
[2] Overview: Cervical cancer - InformedHealth.org - NCBI Bookshelf — Overview: Cervical cancer. Last Update: September 6, 2021; Next update: 2024. Introduction. Cervical cancer is the term used to describe tumors that can grow at the lower end of the womb. These tumors usually develop from abnormal cell changes at the entrance to the womb from the vagina (the opening of the cervix). Abnormal tissue can be
[3] Cervical Cancer Overview | Guide To Cervical Cancer — Cervical cancer can often be found early, and sometimes even prevented, by having regular screening tests. If detected early, cervical cancer is one of the most successfully treatable cancers. About Cervical Cancer . Cervical Cancer Causes, Risk Factors, and Prevention.
[4] Cervical Cancer Basics | Cervical Cancer | CDC - Centers for Disease ... — Any woman with a cervix is at risk for cervical cancer. It occurs most often in women over age 30. Long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a common virus that is passed from one person to another during sex. At least half of sexually active people will have HPV at some
[5] What Is Cervical Cancer? - NCI - National Cancer Institute — Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue. Over time, if not destroyed or removed, the abnormal cells may become cancer cells and start to grow and spread more deeply into
[6] Cervical cancer - World Health Organization (WHO) — Being vaccinated at age 9–14 years is a highly effective way to prevent HPV infection, cervical cancer and other HPV-related cancers. Screening from the age of 30 (25 years in women living with HIV) can detect cervical disease, which when treated, also prevents cervical cancer. All protect against the high-risk HPV types 16 and 18, which cause most cervical cancers and have been shown to be safe and effective in preventing HPV infection and cervical cancer.As a priority, HPV vaccines should be given to all girls aged 9–14 years, before they become sexually active. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries
[27] PDF — Screening can help to reduce morbidity and mortali-ty from cervical cancer. Community health workers (CHWs) have been pro-posed as one strategy to help reduce cervical cancer morbidity and mortality globally, especially in regions of the world where there are shortages of healthcare professionals to conduct screening.
[29] Human Papillomavirus and Cervical Cancer - PMC - PubMed Central (PMC) — Several epidemiologic studies have clearly shown that the risk of contracting genital high-risk HPV infection and cervical cancer is influenced by sexual activity (Erickson et al 2013, ACOG 2017). However, in most developing countries, there is still a generally low level of awareness of the existence and availability of these HPV vaccines (Okunade et al 2017b) compared to the developed countries with well-organized cervical cancer screening and HPV vaccination programs. Measuring the levels of HPV E6/E7 oncoproteins is now a potential biomarker for high-risk HPV infection and this may have a role in the future screening of women for high-risk HPV especially type 16 which accounts for more than 50% of all cervical cancer cases (Schiffman et al 2007, Li et al 2011, Schiffman et al 2013).
[30] Human Papillomavirus Infection and Cervical Cancer: Epidemiology ... — The link between high-risk HPV types and cervical cancer development contributed to the introduction of novel screening programs. For example, testing for the presence of high-risk HPV is recommended as a screening tool by the WHO and the European Guidelines for Quality Assurance for Cervical Cancer Screening [ 21 , 22 ].
[31] HPV and Cancer - NCI - National Cancer Institute — Anal cancer: Over 90% of anal cancer is caused by HPV. Both new cases and deaths from anal cancer are increasing.Learn about trends in diagnosis and survival rates for anal cancer.; Cervical cancer: Virtually all cervical cancer is caused by HPV.Routine screening with an HPV test or Pap test can prevent most cervical cancer by allowing health care providers to find and remove precancerous
[34] Comprehensive insights into human papillomavirus and cervical cancer ... — HPV is widely recognized as a primary etiological factor in the development of cervical cancer, particularly high-risk types such as HPV16 and HPV18 . A critical event in the progression from HPV infection to cervical cancer is the integration of HPV DNA into the host genome . Initially, during the first infection of host epithelial
[35] Involvement of Human Papillomaviruses in Cervical Cancer — Role of HPV in Cervical Carcinogenesis. While HPV is the greatest risk factor for cervical cancer, many researchers propose that the specific integration of viral DNA in the host cell does not frequently happen, and in the majority of the time, HPV infection is removed quite speedily by the immune system.
[37] Impact of the HPV Vaccine | HPV | CDC — HPV vaccination prevents cancer-causing infections & precancers HPV infections and cervical precancers have dropped since 2006, when HPV vaccines were first used in the United States. Among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 88 percent. Among young adult women, infections with HPV types that cause most HPV cancers and genital warts
[39] Impact of HPV vaccination and cervical screening on cervical cancer ... — This is because even if HPV vaccination were to eradicate HPV types 16, 18, 31, 33, 45, 52, and 58, a proportion of LMICs (mainly in sub-Saharan Africa) would still have cervical cancer incidence greater than the threshold of four cases per 100 000 women-years; about 10% of cervical cancers are due to HPV types that are not in the currently
[41] Global distribution, risk factors, and recent trends for cervical ... — In addition, we found an overall decreasing trend in incidence and mortality of cervical cancer for the recent past decade. Previous studies have also identified similar decreasing trends in the burden of cervical cancer .
[42] Trends of cervical cancer at global, regional, and national level: data ... — In conclusion, cervical cancer epidemiological patterns have changed dramatically over recent decades, emphasizing the importance of tracking changing trends in this context.
[46] 70 years of progress in cervical cancer research — 1958 We pioneered one of the earliest UK cervical screening studies . Our first step takes us back around 70 years. In the 1950s, researcher Erica Wachtel analysed smear tests - samples of cells from the cervix - from 165 patients following treatment for gynaecological cancers (such as endometrial, ovarian and cervical).. She discovered that measuring oestrogen activity helped predict if these
[47] A Brief History of Cervical Cancer - ScienceDirect — Cervical cancer is not a new disease. The history of how it was experienced, viewed, and managed in the past has been studied as a part of women's history and the history of medicine and gynecology. The story is important for understanding how current knowledge developed and provides a link to how it is still seen in some societies outside
[48] A Brief History of Cervical Cancer - ScienceDirect — This picture of cervical cancer began to change with the development of morbid anatomy in the 18th century. The first drawing of a cancerous uterus appeared in Matthew Baillie's The Morbid Anatomy of Some of the Most Important Parts of the Human Body in 1793, but whether this was cervical cancer is unclear. Doctors were interested in this new
[49] An Overview of Cervical Cancer History for Cervical Cancer Awareness ... — In 2019, approximately 13,170 new cases of invasive cervical cancer will be diagnosed. From these cases, nearly 4,300 women will die from the disease. Once the most common cause of cancer death for American women, cervical cancer now ranks 14th in frequency due to the increased use of the Pap test. Most cases of cervical […]
[54] Cervical Cancer Detection Techniques: A Chronological Review — As artificial intelligence (AI) and image processing technology advance, we have reviewed progressively intelligent diagnosis tools that are being applied in cervical cancer screening. In this section, we offer a brief review of some methods available in the literature, starting with the year 2019 and progressing to the current cervical screening.
[55] Cervical Cancer Screening: Past, Present, and Future — This article will review the history of cervical cancer screening and will describe these new screening technologies, which have the potential to greatly lower the cervical cancer incidence in the developing world. ... Recent advances in digital optical technology have allowed for the development of highly portable digital colposcopes. DC has
[56] About the Data: Overview | HPV-IMPACT | CDC - Centers for Disease ... — HPV-IMPACT enables CDC to monitor trends in cervical lesions that could progress to cancer and the reduction of cancer-causing HPV types that can be prevented by HPV vaccine. Started in 2008, the Human Papillomavirus (HPV) Vaccine Impact Monitoring Project (HPV-IMPACT) monitors rates of high-grade cervical lesions in the United States. CDC uses the data from HPV-IMPACT to describe trends in high-grade cervical lesions and the reduction of cancer-causing HPV types (such as HPV16 and HPV18) in people diagnosed with these cervical lesions. Monitoring high-grade cervical lesions and the reduction of the HPV types that are prevented by vaccination are ways to measure the impact of the HPV vaccine. Since 2008, HPV-IMPACT has monitored pre-invasive cervical lesions that could progress to invasive cancer if left untreated as early indicators of population vaccine impact.
[57] Impact of the HPV Vaccine | HPV | CDC — Impact of the HPV Vaccine | HPV | CDC Impact of the HPV Vaccine Impact of the HPV Vaccine Impact of the HPV Vaccine HPV vaccination provides safe, effective, and long-lasting protection against cancers caused by HPV. HPV vaccination is very safe As with all approved vaccines, CDC and FDA closely monitor the safety of HPV vaccines. HPV vaccination prevents cancer-causing infections & precancers HPV infections and cervical precancers have dropped since 2006, when HPV vaccines were first used in the United States. Among vaccinated women, the percentage of cervical precancers caused by the HPV types most often linked to cervical cancer has dropped by 40 percent. HPV Vaccine Safety for Parents HPV vaccination is very safe HPV vaccination prevents cancer-causing infections & precancers Impact of the HPV Vaccine
[58] Attitude and Perceived Barriers Among Highly Educated Women Towards ... — In addition, the women's age, marital status, and education were found to be significantly associated with women's attitudes towards screening. Conclusion. The study revealed that educated women do possess a favorable attitude towards cervical cancer screening. However, a major gap is still a hindrance between women's perception and practice.
[60] Assessing the interrelationship between stigma, social influence, and ... — Abstract. In the US, incidence and mortality from cervical cancer disproportionately affects racial/ethnic minorities and low-income women. Despite affordable access to primary and secondary prevention measures at Federally Qualified Health Centers (FQHCs), Human Papillomavirus (HPV) vaccination and screening rates are low, suggesting the presence of non-financial barriers to uptake in this
[75] The Global Fund, Cervical Cancer, and HPV infections: what can low- and ... — The footprint of cervical cancer mirrors the impact of global inequity and inequality on the right to health for girls and women. While today, cervical cancer is a relatively rare cause of death in Europe, North America, and Australia, almost 94% of deaths in 2022 occurred in low- and middle-income countries (LMICs). Governments adopted the WHO global strategy to eliminate cervical cancer
[76] Cervical Cancer Forum Brings New Wave of Commitments — Cervical cancer is the fourth most common cancer in women worldwide, and continues to disproportionately impact women and their families in low- and middle-income countries (LMICs). In an important shift, the World Health Organization (WHO)'s 2022 global recommendation for one-dose HPV vaccine schedules significantly reduced barriers to
[88] Cervical Cancer Causes, Risk Factors, and Prevention — Cervical Cancer Causes, Risk Factors, and Prevention - NCI HPV infection causes cervical cancer Long-lasting (persistent) infection with high-risk types of human papillomavirus (HPV) causes virtually all cervical cancers. Two high-risk types, HPV 16 and HPV 18, cause 70% of cervical cancers worldwide. Factors that increase the risk that an HPV infection will cause cancer Some risk factors make it more likely for a person who has a high-risk HPV infection of the cervix to develop cervical cancer. Nearly all cervical cancers could be prevented by HPV vaccination, routine cervical cancer screening, and appropriate follow-up treatment when needed. Because HPV vaccination doesn’t protect against all HPV types that can cause cervical cancer, getting screened at regular intervals is still important. Sign up for email updates
[89] Cervical Cancer Risk Factors | Cervical Cancer | CDC — Conditions that can increase risk. Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on your cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.
[90] Risk Factors for Cervical Cancer — All About Cancer What Is Cancer? All About Cancer All About Cancer What Is Cancer? All About Cancer All About Cancer Cervical Cancer Cervical Cancer About Cervical Cancer * What Is Cervical Cancer? * Risk Factors for Cervical Cancer * If You Have Cervical Cancer Risk Factors for Cervical Cancer Infection by the human papillomavirus (HPV) is the most important risk factor for cervical cancer. Several factors related to your sexual history can increase the risk of cervical cancer. Certain studies show that the Chlamydia bacteria may help HPV grow and live on in the cervix which may increase the risk of cervical cancer. cervical infection with human papillomavirus, and risk of cervical cancer: A Cervical cancer. More in Cervical Cancer About Cervical Cancer Cancer
[91] Cervical Cancer Risk Factors | Cervical Cancer | CDC — Cervical Cancer Risk Factors | Cervical Cancer | CDC Official websites use .govA .gov website belongs to an official government organization in the United States. Cervical Cancer View All Cervical Cancer Basics Symptoms Screening Risk Factors Preventing Treatment Statistics AMIGAS View All Cervical Cancer Risk Factors Almost all cervical cancers are caused by human papillomavirus (HPV). Other things can increase your risk of cervical cancer. Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. If it doesn't, it can cause cervical cancer over time. Other things can increase your risk of cervical cancer: Cervical Cancer Screening tests and the HPV vaccine can help prevent cervical cancer.
[92] Overview: Cervical cancer - InformedHealth.org - NCBI Bookshelf — It usually takes years, if not decades, for abnormal cells to develop into cervical cancer. Most cervical cancer tumors develop from abnormal cells at the opening of the cervix. A woman’s risk of cervical cancer mainly depends on whether she goes for screening, whether she has had an HPV vaccine, and how old she is. The following table shows estimates of how many women of different ages will develop cervical cancer if they don’t go for screening and don’t have an HPV vaccine. to get cervical cancer within the next ten years (if they don't have screening or an HPV vaccine): | Screening allows abnormal (precancerous) tissue to be discovered and removed before it can develop into cervical cancer.
[98] Cervical Cancer Causes, Risk Factors, and Prevention — Cervical Cancer Causes, Risk Factors, and Prevention - NCI HPV infection causes cervical cancer Long-lasting (persistent) infection with high-risk types of human papillomavirus (HPV) causes virtually all cervical cancers. Two high-risk types, HPV 16 and HPV 18, cause 70% of cervical cancers worldwide. Factors that increase the risk that an HPV infection will cause cancer Some risk factors make it more likely for a person who has a high-risk HPV infection of the cervix to develop cervical cancer. Nearly all cervical cancers could be prevented by HPV vaccination, routine cervical cancer screening, and appropriate follow-up treatment when needed. Because HPV vaccination doesn’t protect against all HPV types that can cause cervical cancer, getting screened at regular intervals is still important. Sign up for email updates
[99] HPV and Cancer - NCI - National Cancer Institute — What cancers are caused by HPV Infection? How does HPV cause cancer? What cancers are caused by HPV Infection? HPV infections that persist can cause precancers (moderate dysplasia and high-grade dysplasia) that need to be treated to prevent them from becoming cancer. How does HPV cause cancer? The Division of Cancer Epidemiology and Genetics conducts research into cervical and other HPV-related cancers to advance our understanding of how HPV causes cancer, evaluates screening practices to determine the most effective methods to detect precancerous changes early, develops and tests new approaches to screening that may be easier to use in low-resource settings, and refines tools for risk assessment in the clinic to help health care providers follow up on abnormal screening test results.
[129] 8 common early signs of cervical cancer | HealthShots — However, these 8 early signs of cervical cancer may appear as the disease progresses. To prevent severe complications, it is important to be aware of the early signs of cervical cancer so you can seek timely medical attention and begin treatment. Early signs of cervical cancer Here is a list of early signs of cervical cancer you should know: One of the early signs of cervical cancer is abnormal vaginal bleeding. Pain during sexual intercourse, also known as dyspareunia, or other sexual health problems can also be in the list of early signs of cervical cancer, states Women’s Health. Knowing these early signs of cervical cancer can help you diagnose the condition early!
[131] Cervical Cancer: Early Signs and Staging - Healthline — Cervical Cancer: Early Signs and Staging Cervical cancer rarely presents with evident symptoms in its early stages. Cervical cancer often causes no symptoms in the early stages. Cervical cancer staging Healthcare professionals use pap tests to screen for cervical cancer even in the absence of symptoms. Treatment of cervical cancer depends on the size and shape of the tumor, the cancer stage, and personal factors such as your age, overall health, and future reproductive goals. You may not notice evident symptoms and signs of stage 1 cervical cancer. For many people, the first symptom of cervical cancer is unusual bleeding or spotting. Cervical cancer doesn’t typically cause symptoms in its early stages. Cervical cancer. Cervical cancer. https://www.acog.org/womens-health/faqs/cervical-cancer-screening Stage 3 Cervical Cancer: Symptoms, Treatment, and Outlook
[132] 10 Common Cervical Cancer Symptoms & Signs, According to OBGYNs — “Symptoms of cervical cancer are vague, and can mean many things, but bleeding in between periods, bleeding after intercourse, or after menopause can all be signs of cervical cancer,” she explains. If you get abnormal pap test results, don’t freak out that it’s cervical cancer right away. This symptom on its own does not mean cervical cancer, if you’re experience a wide array of these warning signs, in addition to a loss of appetite or weight loss, talk to your doctor. Leg pain or swelling is a sign of cervical cancer, though it might not show up until later stages of the disease, says Christine Horner, MD, FACS, author of Radiant Health, Ageless Beauty.
[134] What Are the Early Signs of Cervical Cancer? - US News Health — If cervical cancer is found early, most women do well with surgical treatment. Having awareness of symptoms is crucial. But don't rely on physical symptoms alone as cancer warning signs.
[135] Signs and Symptoms of Cervical Cancer - American Cancer Society — Learn about some of the most common signs & symptoms of cervical cancer including abnormal vaginal bleeding, unusual discharge, and pain during sex. ... Women with early cervical cancers and pre-cancers usually have no symptoms. Symptoms often do not begin until the cancer becomes larger and grows into nearby tissue. When this happens, the most
[136] 8 common early signs of cervical cancer | HealthShots — However, these 8 early signs of cervical cancer may appear as the disease progresses. To prevent severe complications, it is important to be aware of the early signs of cervical cancer so you can seek timely medical attention and begin treatment. Early signs of cervical cancer Here is a list of early signs of cervical cancer you should know: One of the early signs of cervical cancer is abnormal vaginal bleeding. Pain during sexual intercourse, also known as dyspareunia, or other sexual health problems can also be in the list of early signs of cervical cancer, states Women’s Health. Knowing these early signs of cervical cancer can help you diagnose the condition early!
[146] Precancerous conditions of the cervix - Canadian Cancer Society — Precancerous conditions of the cervix are changes to cervical cells that make them more likely to develop into cancer.
[147] Precancerous Changes to the Cervix - Texas Oncology — A range of cervical abnormalities can be detected by screening. In some cases, the changes are suggestive of precancerous or cancerous lesions. These cases are often further evaluated by colposcopy and, depending on the findings, may warrant treatment.
[148] Precancerous Changes to the Cervix - Virginia Cancer Institute — Overview A range of cervical abnormalities can be detected by screening. In some cases, the changes to the cervix are minimal or of uncertain significance. These cases may be managed with repeated screening, HPV testing, or colposcopy. In other cases, the changes are suggestive of potentially important precancerous or cancerous lesions. These cases are often
[149] Identification of Core Genes Involved in the Progression of Cervical ... — EMT is a key biological process that is involved in the activation of invasion and the metastasis of cancer cells, including those of CC [ 7, 8, 9 ]. Oncogenic human papillomavirus (HPV) represents an important but not a sufficient risk factor involved in the process of promoting cervical carcinogenesis [ 4 ], particularly of high-risk (HR) HPV
[151] Understanding Cervical Cancer: The Role of Pap Smears and Pelvic Exams — The Relationship Between Pap Smears and Pelvic Exams. While distinct, Pap smears and pelvic exams are often performed together during a single visit. The pelvic exam provides a broader context, while the Pap smear specifically targets cervical cell abnormalities. The combination offers a more comprehensive assessment of women's reproductive health.
[152] Cervical Cancer Screenings: Pap Tests, HPV Tests and Pelvic Exams — This discovery has led to changes in how women are screened for cervical cancer. Women now get HPV tests in addition to Pap smears. Both tests can be conducted as part of a pelvic exam. Your gynecologist collects cells from the cervix, which are then analyzed in a laboratory. The pelvic exam itself is also an important cancer detection tool.
[154] Pap Smear: Importance and Procedure for Cervical Cancer Screening — The importance of a Pap smear lies in its ability to detect cervical abnormalities at an early stage, often before any symptoms appear. Early detection is crucial because cervical cancer is highly treatable when identified in its initial stages.
[155] Screening for Cervical Cancer | Cervical Cancer | CDC — The HPV test and the Pap test can help prevent cervical cancer or find it early. The HPV test and the Pap test can help prevent cervical cancer or find it early. The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. Her cervical cancer screening test found precancerous cells. If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may tell you that you can wait several years for your next cervical cancer screening test. Next Steps after an Abnormal Cervical Cancer Screening Test: Understanding HPV and Pap Test Results (National Cancer Institute) Screening tests and the HPV vaccine can help prevent cervical cancer.
[177] New Cervical Cancer Treatment Approach Offers Hope for Longer Survival — A new approach to treating cervical cancer could help people with locally advanced cervical cancer live longer. This includes cancers that have spread beyond the cervix, but have not yet spread to distant parts of the body. The treatment approach involves giving chemotherapy (chemo) before chemoradiation.
[178] Beyond the Microscope: A Technological Overture for Cervical Cancer ... — Cheng and colleagues developed an innovative system for cervical cancer screening that utilizes deep learning techniques on WSIs. This computer-aided approach has the potential to significantly improve the accuracy and efficiency of cervical cancer screening, offering a promising new avenue for early detection and treatment.
[179] The future of cervical cancer prevention: advances in research and ... — Emerging technologies for cervical cancer prevention include novel screening techniques such as HPV DNA testing, thermal ablation for treating precancerous lesions, and digital health interventions. In conclusion, cervical cancer research and technology offer significant potential for progress in treatment, prevention, and screening strategies. The exploration of genetic editing techniques, particularly CRISPR/Cas9-based methods, holds significant promise for treating cervical cancer by targeting HPV and its associated oncogenes. The Abbott RealTime High Risk HPV test is a clinically validated human papillomavirus assay for triage in the referral population and use in primary cervical cancer screening in women 30 years and older: a review of validation studies. Molecular tests potentially improving HPV screening and genotyping for cervical cancer prevention.
[180] The Future of Cervical Cancer Screening - Taylor & Francis Online — Cervical cancer remains a significant health concern, particularly in developing countries, where it is a leading cause of cancer-related deaths among women. Innovative technologies have emerged to improve the efficiency, cost-effectiveness, and sensitivity of cervical cancer screening and treatment methods.
[181] New Technologies for Cervical Cancer Screening - PMC — New technologies for cervical cancer screening seek to provide an accurate, efficient, and cost-effective way of identifying women at risk for cervical cancer. Current screening uses HPV DNA testing combined with cytology and requires multiple visits at a great cost to the patient and the society.
[183] Promising new treatment approaches for locally advanced cervical cancer — In another study presented at ESMO Congress 2023, investigators reported on the first interim analysis of the KEYNOTE-A18 study of 1060 patients with high-risk locally advanced cervical cancer who were randomized to concurrent treatment with pembrolizumab and chemoradiation (n = 529) or chemoradiation (n = 531). 5 At 24 months, a significant
[185] Biotech's most promising new treatments for cervical cancer — Tivdak wins FDA approval for the treatment of cervical cancer . The go-ahead from the U.S. Food and Drug Administration (FDA) came after the antibody drug conjugate showed overall survival (OS) benefit in patients who had previously been treated for cervical cancer. A 30% reduction in the risk of death compared to chemotherapy was also observed. Tivdak contains a monoclonal antibody directed
[186] New cervical cancer treatment method 'biggest step forward in two ... — Short burst of chemotherapy before main treatment could lead to better outcomes for women with cervical cancer. ... intensive bursts of chemotherapy shows promising results not only for cervical cancer, but across various cancer types. ... New cervical cancer treatment method 'biggest step forward in two decades' Short burst of chemotherapy
[193] PDF — The integration of AI technologies into existing screening frameworks, including the use of automated systems for image interpretation, decision support tools for healthcare providers, and mobile health applications for patient education and engagement and the regulatory and ethical considerations surrounding the deployment of AI in cervical cancer detection are discussed. 4 − ©Oncology and Radiotherapy 18(4) 2024: 001-007 The integration of AI technologies into existing screening frameworks The integration of AI technologies into existing screening frameworks for cervical cancer involves leveraging automated systems for image interpretation, decision support tools for healthcare providers, and mobile health applications for patient education and engagement.
[194] Artificial Intelligence in Cervical Cancer Screening and Diagnosis — In recent years, artificial intelligence (AI)-based medical diagnostic applications have been on the rise and have excellent applicability in the screening and diagnosis of cervical cancer. Their benefits include reduced time consumption, reduced need for professional and technical personnel, and no bias owing to subjective factors.
[196] Artificial intelligence strengthens cervical cancer screening - present ... — An AI-assisted system analyzes cytologic images, develop mathematical models based on deep learning or other AI techniques, and screen digital smear images to identify normal and abnormal cells and facilitate cervical cancer screening. | Wentzensen N42 | Detection on dual-stain+ cells and performance of AI cytology in cervical cancer screening | Based on 3 epidemiologic studies, > 4,000 cases Aside from AI research on cervical cytology images, AI-based digital microscopes have also been developed, providing new opportunities to address the challenges of cervical cancer screening in LMICs. Tang et al.48 utilized the augmented reality (AR) technique with an AI microscope to provide real-time assistance for cervical cytology diagnosis.
[197] Artificial Intelligence in Cervical Cancer Screening ... - MDPI — In this context, the advent of artificial intelligence and digital algorithms could represent new directions available to gynecologists and pathologists for the following: (i) the standardization of screening procedures, (ii) the identification of increasingly early lesions, and (iii) heightening the diagnostic accuracy of targeted biopsies and
[198] The growing role of precision and personalized medicine for cancer ... — Companion diagnostics (CDx) help identify which treatments will be most effective for a specific patient’s tumor, and novel cell therapies are used to target the cancer with minimal damage to healthy tissues, making the PPM model more effective and safer. Recent work has focused on the development of more accurate tumor models (organoids) and harnessing the specificity of the immune system to develop effective cancer vaccines or mAbs. The personalized treatment approach has resulted in improved patient outcomes in terms of response rate and progression-free survival in Phase I clinical trials that selected patients using a specific biomarker versus those that did not174.
[200] Emerging biomarkers and molecular targets for precision medicine in ... — Cervical cancer remains a significant global health burden, necessitating innovative approaches for improved diagnostics and personalized treatment strategies. Precision medicine has emerged as a promising paradigm, leveraging biomarkers and molecular targets to tailor therapy to individual patients.
[216] Background - Comprehensive Cervical Cancer Control - NCBI Bookshelf — A minority of HPV infections persist; in women this may lead to cervical pre-cancer, which, if not treated, may progress to cancer 10 to 20 years later. The majority of these deaths can be prevented through universal access to comprehensive cervical cancer prevention and control programmes, which have the potential to reach all girls with human papillomavirus (HPV) vaccination and all women who are at risk with screening and treatment for pre-cancer. Cervical pre-cancer is a distinct change in the epithelial cells of the transformation zone of the cervix; the cells begin developing in an abnormal fashion in the presence of persistent or long-term HPV infection.
[218] Importance of Education about Cervical Cancer and Its Preventive ... — Importance of Education about Cervical Cancer and Its Preventive Measures for the Promotion of HPV Vaccine According to the WHO Strategies - PMC Importance of Education about Cervical Cancer and Its Preventive Measures for the Promotion of HPV Vaccine According to the WHO Strategies The World Health Organization (WHO) has officially declared a global strategy regarding the Elimination of Cervical Cancer in November 2020, which focuses on preventing cervical cancer through HPV vaccination, screening precancerous lesions and managing and treating invasive cervical cancer . A simulation model study predicted that the high HPV vaccination coverage of girls can lead to cervical cancer elimination in most lower–middle-income countries by the end of the century. In Japan, subsidies from local and national governments for the HPV vaccination program for girls aged 13–16 years commenced in 2010.
[220] Cervical cancer - World Health Organization (WHO) — Being vaccinated at age 9–14 years is a highly effective way to prevent HPV infection, cervical cancer and other HPV-related cancers. Screening from the age of 30 (25 years in women living with HIV) can detect cervical disease, which when treated, also prevents cervical cancer. All protect against the high-risk HPV types 16 and 18, which cause most cervical cancers and have been shown to be safe and effective in preventing HPV infection and cervical cancer.As a priority, HPV vaccines should be given to all girls aged 9–14 years, before they become sexually active. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries
[222] Can Cervical Cancer Be Prevented | Ways to Prevent Cervical Cancer — A well-proven way to prevent cervical cancer is to have screening tests. Screening is having tests to find conditions that may lead to cancers and can find pre-cancers before they can turn into invasive cancer. The Pap test (or Pap smear) and the human papillomavirus (HPV) test are specific tests used during screening for cervical cancer.
[231] Co-designed, culturally tailored cervical screening education with ... — Participation of culturally and linguistically diverse (CALD) women from migrant and refugee backgrounds in cervical screening is crucial to eliminate cervical cancer as a public health problem within the next 20 years. Co-designed, culturally tailored cervical screening health promotion forums are feasible and acceptable to CALD women, in both face-to-face and online formats. This study evaluated the process, feasibility and effectiveness of co-designed, culturally tailored health promotion forums to address lack of understanding of changes to the Australian cervical screening program and limited health literacy around cervical screening within CALD communities. Our research questions: Are co-designed, culturally tailored cervical screening health promotion forums feasible and acceptable to CALD women?
[232] A systematic review of the cost-effectiveness of interventions to ... — This study systematically reviewed published studies on the cost-effectiveness of interventions to increase cervical cancer screening uptake rates in underserved women in Europe. Self-sampling and reminder interventions were generally shown to be cost-effective to increase uptake rates among underscreened women.
[237] Benefits, harms and cost-effectiveness of cervical screening, triage ... — Screening with VIA or cytology every 3 years was less effective and less cost-effective than HPV screening every 5 years. Furthermore, VIA generated more than double the number of pre-cancer treatments compared to HPV. In conclusion, primary HPV screening is the most effective, cost-effective and efficient cervical screening option in LMICs.
[238] Cervical Cancer Screening (PDQ®) - NCI - National Cancer Institute — Screening by Pap testing with associated diagnostic testing and treatment is effective in reducing the incidence of all histologies and stages of invasive cervical cancer. The benefit increases with age. ... Choice in methods of screening for cervical cancer in resource-limited countries or underserved populations has prompted the evaluation of
[239] Screening for Cervical Cancer | Cervical Cancer | CDC — The HPV test and the Pap test can help prevent cervical cancer or find it early. The HPV test and the Pap test can help prevent cervical cancer or find it early. The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. Her cervical cancer screening test found precancerous cells. If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may tell you that you can wait several years for your next cervical cancer screening test. Next Steps after an Abnormal Cervical Cancer Screening Test: Understanding HPV and Pap Test Results (National Cancer Institute) Screening tests and the HPV vaccine can help prevent cervical cancer.
[240] Cervical Cancer Screening - NCI — The goal of screening for cervical cancer is to find precancerous cervical cell changes, when treatment can prevent cervical cancer from developing. Sometimes, cancer is found during cervical screening. Cervical cancer found at an early stage is usually easier to treat. By the time symptoms appear, cervical cancer may have begun to spread, making treatment more difficult.
[241] Cervical Screening - StatPearls - NCBI Bookshelf — Cervical cancer is a significant women's health problem worldwide. Most cases of cervical cancer occur in developing countries that have ineffective screening programs. The incidence and mortality of cervical cancer in the United States have been decreasing in the past 30 years due to widespread screening. In the United States, cervical cancer diagnosis is usually in women who have never
[262] Global landscape of cervical cancer incidence and mortality in 2022 and ... — If 2022 rates remain unchanged, the global burden of cervical cancer was predicted to increase to 760,082 new cases (a 14.8% increase) and 411,035 deaths (a 17.8% increase) by 2030. Our findings highlight the persistent and widening geographic and socioeconomic inequalities in the burden of cervical cancer. There is an urgent need for tailored
[263] Global burden of cervical cancer: current estimates, temporal trend and ... — Global burden of cervical cancer: current estimates, temporal trend and future projections based on the GLOBOCAN 2022 - ScienceDirect Global burden of cervical cancer: current estimates, temporal trend and future projections based on the GLOBOCAN 2022 Age-standardized incidence rate (ASIR) and mortality rates (ASMR) of cervical cancer were compared and linked to human development index (HDI) between populations. Globally, an estimated 662,044 cases (ASIR: 14.12/100,000) and 348,709 deaths (ASMR: 7.08/100,000) from cervical cancer occurred in 2022, corresponding to the fourth cause of cancer morbidity and mortality in women worldwide. If national rates in 2022 remain stable, the estimated cases and deaths from cervical cancer are projected to increase by 56.8% and 80.7% up to 2050.
[264] Global estimates of incidence and mortality of cervical cancer in 2020 ... — In 2020, WHO launched the global Cervical Cancer Elimination Initiative to accelerate the elimination of cervical cancer, 8 aiming to reduce incidence below a threshold of 4 cases per 100 000 women-years in every country and thus narrow international disparities associated with this disease. The 90-70-90 target set by the initiative to be
[265] Cervical Cancer Leads Cancer Deaths for Women in 37 Countries — An accompanying article from a collaboration with IARC researchers, "Global Cancer Statistics, 2022," was published in the ACS flagship journal CA: Cancer Journal for Clinicians. Most countries aren't on track to meet the World Health Organization's (WHO) Cervical Cancer Elimination target to end cervical cancer by 2030.
[266] Cervical cancer - World Health Organization (WHO) — Being vaccinated at age 9–14 years is a highly effective way to prevent HPV infection, cervical cancer and other HPV-related cancers. Screening from the age of 30 (25 years in women living with HIV) can detect cervical disease, which when treated, also prevents cervical cancer. All protect against the high-risk HPV types 16 and 18, which cause most cervical cancers and have been shown to be safe and effective in preventing HPV infection and cervical cancer.As a priority, HPV vaccines should be given to all girls aged 9–14 years, before they become sexually active. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries
[273] Public Education and Targeted Outreach to Underserved Women Through the ... — This article provides an overview of the importance of public education and targeted outreach activities for cancer screening through community-based programs including examples from NBCCEDP grantees that highlight successes, challenges, and solutions, encountered when conducting these types of interventions. The Guide to Community Preventive Services provides recommendations on evidence-based interventions (EBIs) that are effective strategies to increase breast and cervical cancer screening.16 Recommendations include educational and outreach activities that inform and motivate women to receive the recommended cancer screening. Ideally, a comprehensive approach combining multiple evidence-based strategies is employed, which has been shown to be successful in increasing cancer screening.18 NBCCEDP grantees use these EBIs in collaboration with their communities and partners to increase breast and cervical cancer screening by conducting public education and targeted outreach activities that focus on raising awareness, providing public and provider education, addressing barriers to screening, and motivating women to complete cancer screenings.
[274] Evaluating the implementation of cervical cancer screening programs in ... — The 2011 WHO Prioritized Research Agenda for Prevention and Control of Non-communicable Disease notes that while cancer screening services have been shown to be effective in high-income countries (HICs) [9–12] and HPV screening has been shown to reduce cervical cancer deaths in resource-limited settings such as rural India , there are few reports describing the implementation of successful and sustained cervical cancer screening programs in LMICs. Research that examines cervical cancer screening program barriers and facilitators within specific contexts and informs the adaptation of evidence-based interventions within these contexts is needed to ensure the successful implementation and sustainment of programs across various settings .
[275] How Healthcare Providers Can Improve Cervical Cancer Screening Rates in ... — Cervical cancer is preventable, yet many women in underserved communities face barriers to screening, including lack of access, financial constraints, and cultural stigma. Healthcare providers can bridge this gap by implementing mobile screenings, education initiatives, self-testing options, and financial assistance programs to increase participation.
[276] Cervical Cancer: Community Health Workers | The Community Guide — Evidence shows these interventions increase cervical cancer screening rates when community health workers deliver them independently or as part of an implementation team. The following list of included studies is for interventions engaging community health workers to increase breast, cervical, or colorectal cancer screening. Addressing multilevel barriers to cervical cancer screening in Korean American women: a randomized trial of a community-based intervention. Breast and cervical cancer screening literacy among Korean American women: a community health worker led intervention. Increasing cervical cancer screening among Vietnamese Americans: a community-based intervention trial. Effective lay health worker outreach and media-based education for promoting cervical cancer screening among Vietnamese American women. A cluster randomized controlled trial to increase breast cancer screening among African American women: the black cosmetologists promoting health program.
[281] Global landscape of cervical cancer incidence and mortality in 2022 and ... — Age-standardized rates of incidence and mortality were presented according to countries, 20 United Nations-defined world regions, and four-tier Human Development Index (HDI) levels. The predicted burden of cervical cancer for 2030 was calculated based on global demographic projections.
[286] New recommendations for screening and treatment to prevent cervical cancer — WHO’s global strategy for cervical cancer elimination– endorsed by the World Health Assembly in 2020 – calls for 70% of women globally to be screened regularly for cervical disease with a high-performance test, and for 90% of those needing it to receive appropriate treatment. “With these new guidelines, we must leverage the platforms already developed for HIV care and treatment to better integrate cervical cancer screening and treatment to meet the health needs and rights of the diverse group of women living with HIV to increase access, improve coverage, and save lives” Dr. Meg Doherty, Director, WHO Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.
[289] Wave of new commitments marks historic step towards the elimination of ... — Governments, donors, multilateral institutions, and partners today announced major new policy, programmatic and financial commitments, including nearly US$ 600 million in new funding, to eliminate cervical cancer. If these ambitions to expand vaccine coverage and strengthen screening and treatment programs are fully realized, the world could eliminate a cancer for the first time.
[290] Global cervical cancer elimination forum commitments — In terms of working with our partners, Spanish Cooperation is committed to collaborating with them to eliminate cervical cancer, applying the WHO strategy: increasing equitable and sustainable access to vaccines against the human papillomavirus (HPV), supporting the formulation and implementation of screening and early treatment programs, and treating invasive lesions in low- and middle-income countries, making available to our partner countries the experience gained in the fight against this cancer, as well as working in alliance with actors such as WHO-OPS, as well as other key allies in vaccination and innovation in screening programs such as Gavi, UNICEF and UNITAID.