Use of Risk-Based Cervical Screening Programs in Resource-Limited Settings
Obstetrics and Gynecology
Cervical cancer screening and management in the U.S. has adopted a risk-based approach. However, the majority of cervical cancer cases and deaths occur in resource-limited settings, where screening and management are not widely available. We describe a conceptual model that optimizes cervical cancer screening and management in resource-limited settings by utilizing a risk-based approach. The principles of risk-based screening and management in resource limited settings include (1) ensure that the screening method effectively separates low-risk from high-risk patients; (2) directing resources to populations at the highest cancer risk; (3) screen using HPV testing via self-sampling; (4) utilize HPV genotyping to improve risk stratification and better determine who will benefit from treatment, and (5) automated visual evaluation with artificial intelligence may further improve risk stratification. Risk-based screening and management in resource limited settings can optimize prevention by focusing triage and treatment resources on the highest risk patients while minimizing interventions in lower risk patients.
Perkins, R. B., Smith, D. L., Jeronimo, J., Campos, N. G., Gage, J. C., Hansen, N., Rodriguez, A. C., Cheung, L. C., Egemen, D., Befano, B., Novetsky, A. P., Martins, S., Kalpathy-Cramer, J., Inturrisi, F., Ahmed, S. R., Marcus, J., Wentzensen, N., de Sanjose, S., & Schiffman, M. (2023). Use of Risk-Based Cervical Screening Programs in Resource-Limited Settings. https://doi.org/10.1016/j.canep.2023.102369