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Use of risk-based cervical screening programs in resource-limited settings

by Jeronimo, Jose , Cheung, Li C. , Smith, Debi L. , Gage, Julia C. , Egemen, Didem , de Sanjose, Silvia , Ahmed, Syed Rakin , Kalpathy-Cramer, Jayashree , Schiffman, Mark , Befano, Brian , Martins, Sandro , Wentzensen, Nicolas , Inturrisi, Federica , Hansen, Natasha , Perkins, Rebecca B. , Novetsky, Akiva P , Marcus, Jenna , Rodriguez, Ana Cecilia , Campos, Nicole G.

in Ablation / Artificial Intelligence / Automated visual. evaluation / Cancer screening / Cervical cancer / Cervical cancer prevention / Disease prevention / Early Detection of Cancer - methods / Epidemiology / Female / Genotyping / HPV testing / Human papillomavirus / Humans / Immunization / Infections / Management / Mass Screening - methods / Medical screening / Papillomaviridae / Papillomavirus Infections - diagnosis / Principles / Resource-Limited Settings / Risk groups / Risk-based screening / Surveillance / Uterine Cervical Neoplasms

2023

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2023

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2023

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Journal Article

Use of risk-based cervical screening programs in resource-limited settings

Jeronimo, Jose,

Cheung, Li C.,

Smith, Debi L.,

Gage, Julia C.,

Egemen, Didem,

de Sanjose, Silvia,

Ahmed, Syed Rakin,

Kalpathy-Cramer, Jayashree,

Schiffman, Mark,

Befano, Brian,

Martins, Sandro,

Wentzensen, Nicolas,

Inturrisi, Federica,

Hansen, Natasha,

Perkins, Rebecca B.,

Novetsky, Akiva P,

Marcus, Jenna,

Rodriguez, Ana Cecilia,

Campos, Nicole G.

2023

Overview

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.

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Publisher

Elsevier Ltd,Elsevier Limited

Subject

Ablation

/ Artificial Intelligence

/ Automated visual. evaluation

/ Cancer screening

/ Cervical cancer

/ Cervical cancer prevention

/ Disease prevention