Analysis of strategies of the screening, diagnosis and prevention of cervical cancer: a systematic review

Authors

DOI:

https://doi.org/10.59464/2359-4632.2023.3163

Keywords:

Uterine cervical neoplasms, Early detection of cancer, Technology

Abstract

Objective: to analyze the best strategies used in screening, diagnosis and/or prevention of cervical cancer. Methods: systematic review, conducted in September 2023, using the guiding question “What are the best strategies used in screening, diagnosing and/or preventing cervical cancer?”. For the search, the databases and libraries Google Scholar, Biblioteca Virtual em Saúde, MEDLINE (via PubMed), EMBASE, Scopus and Web of Science were used. Studies were limited to clinical trials, longitudinal studies, implementation research and quasi-experimental studies, published between January 2018 and August 2023, in Portuguese, English or Spanish. After applying the specific search strategy in each database, 334 studies were identified, of which 11 were selected to compose the sample. Results: the main strategies identified were the association of HPV tests with cytology or colposcopy, the use of mHealth and artificial intelligence. Furthermore, emphasis was also given to the offer of kits for self-sampling to identify HPV and neoplastic lesions. Conclusion: the combination of screening tests seems to have been the best strategy found by clinicians and researchers around the world. Additionally, it is expected that diagnostic accuracy technologies will be implemented and adapted to different socioeconomic contexts. Further investigations are still needed that consider the cost-effectiveness and association of the tests surveyed.

Author Biography

Thais de Arruda Reinehr, Universidade Federal do Amazonas

Médica, residente em Ginecologia e Obstetrícia pela Universidade Federal do Amazonas (UFAM). 

References

Aasbø G, Tropè A, Nygård M, Christiansen IK, Baasland I, Iversen GA, Munk AC, Christiansen MH, Presthus GK, Undem K, Bjørge T, Castle PE, Hansen BT. HPV self-sampling among long-term non-attenders to cervical cancer screening in Norway: a pragmatic randomised controlled trial. Br J Cancer. 2022 Nov;127(10):1816-1826. doi: 10.1038/s41416-022-01954-9.

Alfaro K, Maza M, Cremer M, Masch R, Soler M. Removing global barriers to cervical cancer prevention and moving towards elimination. Nat Rev Cancer. 2021 Oct;21(10):607-608. doi: 10.1038/s41568-021-00396-4.

Allahqoli L, Laganà AS, Mazidimoradi A, Salehiniya H, Günther V, Chiantera V, Karimi Goghari S, Ghiasvand MM, Rahmani A, Momenimovahed Z, Alkatout I. Diagnosis of Cervical Cancer and Pre-Cancerous Lesions by Artificial Intelligence: A Systematic Review. Diagnostics (Basel). 2022 Nov 13;12(11):2771. doi: 10.3390/diagnostics12112771.

Bebis H, Reis N, Yavan T, Bayrak D, Unal A, Bodur S. Effect of health education about cervical cancer and papanicolaou testing on the behavior, knowledge, and beliefs of Turkish women. Int J Gynecol Cancer. 2012 Oct;22(8):1407-12. doi: 10.1097/IGC.0b013e318263f04c.

Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, et al. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health. 2016;4(7):e453–63. 10.1016/S2214-109X(16)30099-7

Cobucci R, Maisonnette M, Macêdo E, Santos Filho FC, Rodovalho P, Nóbrega MM, Goncalves A. Pap test accuracy and severity of squamous intraepithelial lesion. Indian J Cancer. 2016 Jan-Mar;53(1):74-6. doi: 10.4103/0019-509X.180825.

Cuzick J, Adcock R, Carozzi F, Gillio-Tos A, De Marco L, Del Mistro A, Frayle H, Girlando S, Sani C, Confortini M, Zorzi M, Giorgi-Rossi P, Rizzolo R, Ronco G; New Technologies for Cervical Cancer Screening Working Group. Combined use of cytology, p16 immunostaining and genotyping for triage of women positive for high-risk human papillomavirus at primary screening. Int J Cancer. 2020 Oct 1;147(7):1864-1873. doi: 10.1002/ijc.32973.

Dang L, Kong L, Zhao Y, Dai Y, Ma L, Wei L, Zhang S, Liu J, Xi M, Chen L, Duan X, Xiao Q, Abulizi G, Zhang G, Hong Y, Zhou Q, Xie X, Li L, Niyazi M, Zhang Z, Tuo J, Ding Y, Qiao Y, Lang J. Evaluation of triage strategies for high-risk human papillomavirus-positive women in cervical cancer screening: A multicenter randomized controlled trial in different resource settings in China. Chin J Cancer Res. 2022 Oct 30;34(5):496-509. doi: 10.21147/j.issn.1000-9604.2022.05.09.

Denninghoff V, von Petery F, Fresno C, Galarza M, Torres F, Avagnina A, Fishkel V, Krupitzki H, Fiorillo A, Monge F. Clinical implementation of a cervical cancer screening program via co-testing at a university hospital. PLoS One. 2022 Dec 1;17(12):e0278476. doi: 10.1371/journal.pone.0278476.

Elfström KM, Eklund C, Lamin H, Öhman D, Hortlund M, Elfgren K, Sundström K, Dillner J. Organized primary human papillomavirus-based cervical screening: A randomized healthcare policy trial. PLoS Med. 2021 Aug 23;18(8):e1003748. doi: 10.1371/journal.pmed.1003748.

Gilham C, Sargent A, Kitchener HC, Peto J. HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT. Health Technol Assess. 2019 Jun;23(28):1-44. doi: 10.3310/hta23280.

Holmström O, Linder N, Kaingu H, Mbuuko N, Mbete J, Kinyua F, Törnquist S, Muinde M, Krogerus L, Lundin M, Diwan V, Lundin J. Point-of-Care Digital Cytology With Artificial Intelligence for Cervical Cancer Screening in a Resource-Limited Setting. JAMA Netw Open. 2021 Mar 1;4(3):e211740. doi: 10.1001/jamanetworkopen.2021.1740.

Hou X, Shen G, Zhou L, Li Y, Wang T, Ma X. Artificial Intelligence in Cervical Cancer Screening and Diagnosis. Front Oncol. 2022 Mar 11;12:851367. doi: 10.3389/fonc.2022.851367.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2023: incidência do Câncer no Brasil. Rio de Janeiro: INCA, 2022. Disponível em: https://www.gov.br/inca/pt-br/assuntos/cancer/numeros/estimativa Acesso em: 25 nov 2022

Ito Y, Miyoshi A, Ueda Y, Tanaka Y, Nakae R, Morimoto A, Shiomi M, Enomoto T, Sekine M, Sasagawa T, Yoshino K, Harada H, Nakamura T, Murata T, Hiramatsu K, Saito J, Yagi J, Tanaka Y, Kimura T. An artificial intelligence-assisted diagnostic system improves the accuracy of image diagnosis of uterine cervical lesions. Mol Clin Oncol. 2022 Feb;16(2):27. doi: 10.3892/mco.2021.2460.

Koliopoulos G, Nyaga VN, Santesso N, Bryant A, Martin-Hirsch PP, Mustafa RA, Schünemann H, Paraskevaidis E, Arbyn M. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst Rev. 2017 Aug 10;8(8):CD008587. doi: 10.1002/14651858.CD008587.pub2.

Lam JU, Rebolj M, Ejegod DM, Pedersen H, Rygaard C, Lynge E, et al. Human papillomavirus self-sampling for screening nonattenders: opt-in pilot implementation with electronic communication platforms. Int J Cancer. 2017;140:2212–9

Makadzange EE, Peeters A, Joore MA, Kimman ML. The effectiveness of health education interventions on cervical cancer prevention in Africa: A systematic review. Prev Med. 2022 Nov;164:107219. doi: 10.1016/j.ypmed.2022.107219.

Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS. Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018 Aug 21;320(7):687-705. doi: 10.1001/jama.2018.10400.

Okunade KS, Soibi-Harry A, John-Olabode S, Adejimi AA, Allsop MJ, Onyeka TC, Akaba GO, Oshodi YA, Salako O, Ugwu AO, Adefemi A, Anorlu RI, Berek JS. Impact of Mobile Technologies on Cervical Cancer Screening Practices in Lagos, Nigeria (mHealth-Cervix): A Randomized Controlled Trial. JCO Glob Oncol. 2021 Aug;7:1418-1425. doi: 10.1200/GO.21.00258.

Olubodun T, Balogun MR, Odeyemi KA, Osibogun A, Odukoya OO, Banjo AA, Sonusi SE, Olubodun AB, Ogundele OOP, Dolapo DC. Effect of social marketing on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos, Nigeria. BMC Womens Health. 2022 Feb 14;22(1):42. doi: 10.1186/s12905-022-01620-5.

Osei EA. Innovations in healthcare delivery: Human papilloma virus self sampling diagnostics and participatory innovations for CCS. Cancer Med. 2023 Jul;12(14):15544-15551. doi: 10.1002/cam4.6201.

Rebolj M, Rimmer J, Denton K, Tidy J, Mathews C, Ellis K, Smith J, Evans C, Giles T, Frew V, Tyler X, Sargent A, Parker J, Holbrook M, Hunt K, Tidbury P, Levine T, Smith D, Patnick J, Stubbs R, Moss S, Kitchener H. Primary cervical screening with high risk human papillomavirus testing: observational study. BMJ. 2019 Feb 6;364:l240. doi: 10.1136/bmj.l240.

Schliemann D, Tan MM, Hoe WMK, Mohan D, Taib NA, Donnelly M, Su TT. mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews. J Med Internet Res. 2022 Aug 15;24(8):e36316. doi: 10.2196/36316.

Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, Arbyn M, Basu P, Bray F, Vaccarella S. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023 Feb;11(2):e197-e206. doi: 10.1016/S2214-109X(22)00501-0.

Xue P, Gao LL, Yin J, Han LL, Zhao J, Li L, Seery S, Han XY, Li TY, Jiang Y, Chen W, Shen J. A direct comparison of four high-risk human papillomavirus tests versus the cobas test: Detecting CIN2+ in low-resource settings. J Med Virol. 2019 Jul;91(7):1342-1350. doi: 10.1002/jmv.25451.

Yu K, Hyun N, Fetterman B, Lorey T, Raine-Bennett TR, Zhang H, Stamps RE, Poitras NE, Wheeler W, Befano B, Gage JC, Castle PE, Wentzensen N, Schiffman M. Automated Cervical Screening and Triage, Based on HPV Testing and Computer-Interpreted Cytology. J Natl Cancer Inst. 2018 Nov 1;110(11):1222-1228. doi: 10.1093/jnci/djy044.

Zhang J, Zhao Y, Dai Y, Dang L, Ma L, Yang C, Li Y, Kong L, Wei L, Zhang S, Liu J, Xi M, Chen L, Duan X, Xiao Q, Abulizi G, Zhang G, Hong Y, Gao X, Zhou Q, Xie X, Li L, Niyazi M, Zhang Z, Tuo J, Ding Y, Si M, Chen F, Song L, Qiao Y, Lang J. Effectiveness of High-risk Human Papillomavirus Testing for Cervical Cancer Screening in China: A Multicenter, Open-label, Randomized Clinical Trial. JAMA Oncol. 2021 Feb 1;7(2):263-270. doi: 10.1001/jamaoncol.2020.6575.

Zhang SK, Luo XP, Li ZF, Su Z, Xia JC, Hu GY, Zhu YJ, Xie LX, Feng XX, Sun XB, Chen W, Qiao YL. [Performance of human papillomavirus typing test in cervical precancer lesions and cervical cancer screening]. Zhonghua Zhong Liu Za Zhi. 2020 Mar 23;42(3):252-256. Chinese. doi: 10.3760/cma.j.cn112152-20190603-00346.

Published

2023-10-31

How to Cite

de Arruda Reinehr, T., & Cardoso Pinheiro, C. (2023). Analysis of strategies of the screening, diagnosis and prevention of cervical cancer: a systematic review. Revista Científica Integrada, 6(1), e–202324. https://doi.org/10.59464/2359-4632.2023.3163