scholarly journals State of the Science: Screening, Surveillance, and Epidemiology of HPV-Related Malignancies

2021 ◽  
pp. 1-12
Author(s):  
Rahel Ghebre ◽  
J. Michael Berry-Lawhorn ◽  
Gypsyamber D’Souza
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
High Resolution ◽  
Cervical Cancer Screening ◽  
Task Force ◽  
Hpv Vaccination ◽  
Cancer Society ◽  
Screening Guidelines ◽  
Cancer Precursors ◽  
The U.S

Oropharyngeal, cervical, vulvar, and anal cancers share a common risk factor of HPV infection. HPV vaccination is currently recommended at age 11 or 12 to prevent new HPV infections for all genders with catch-up vaccination recommened up to age 26. Despite the known effectiveness of HPV vaccination to prevent HPV-related cancer, there is continued low uptake in the United States; only 40% of eligible persons were vaccinated in 2018, though rates are 70% among teenagers. Current American Cancer Society cancer screening guidelines recommend cervical cancer screening, but do not have specific recommendations for screening for other HPV-related cancers. Oropharyngeal cancer precursors have yet to be identified, and there are currently no routine screening tests for oropharyngeal cancer recommended by the U.S. Preventive Services Task Force. The U.S. Preventive Services Task Force and American Cancer Society recommend cervical cancer screening for women at average risk up to age 65, and screening guidelines do not currently differ by HPV vaccination status. Primary HPV DNA testing was first approved for cervical cancer screening in 2016 and was shown to be superior for cervical cancer prevention. Vulvar and anal cancer precursors have been identified, but optimal screening remains unclear. Examination of the anal canal and perianus is best performed by trained clinicians using high-resolution anoscopy, and effectiveness of using high-resolution anoscopy to detect and treat anal high-grade squamous intraepithelial lesions to prevent cancer is actively being researched. Current multistep approaches to control HPV-related malignancies include HPV vaccination coupled with cervical cancer screening or surveillance for oropharyngeal, vulvar, and anal cancers.

scholarly journals Cervical Cancer Screening Guidelines in the Postvaccination Era: Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Carlo A. Liverani ◽  
Jacopo Di Giuseppe ◽  
Luca Giannella ◽  
Giovanni Delli Carpini ◽  
Andrea Ciavattini
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Screening Strategy ◽  
Cervical Cancer Prevention ◽  
Dna Test ◽  
Hpv Dna ◽  
Screening Guidelines ◽  
Screening Programs

Cervical cancer is relatively rare in high-income countries, where organized screening programs are in place, as well as opportunistic ones. As the human papillomavirus (HPV) vaccination rates increase, the prevalence of cervical precancers and cancers is going to decrease rapidly very soon, even if, in the most optimistic scenario, it is unlikely that optimal vaccination coverage will be achieved. Then, the optimal screening paradigm for cervical cancer prevention in the postvaccination era is still debated. Screening guidelines are being developed with the aim of reducing the number of tests a woman needs during her lifetime, in order to receive the maximum benefit from screening, while decreasing potential harms that may result with the use of a screening strategy (overdiagnosis, overtreatment, anxiety, and costs). With this purpose in mind, new management guidelines for cervical cancer screening abnormalities are recommendations based on risks, not on results. This review aims to summarize the process that led to the introduction of the HPV DNA test in screening programs and the different screening strategies. Moreover, it aims to introduce the new risk-based guidelines for the future, where full HPV genotyping can resize the risk on the basis of specific high-risk genotypes. In the same way, the data regarding HPV vaccination could be introduced as soon as women vaccinated with the nonavalent vaccine reach the screening age, with the recommendation of a prolonged screening interval.

scholarly journals The impact of medical tourism on cervical cancer screening among immigrant women in the U.S.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sou Hyun Jang ◽  
Hendrika Meischke ◽  
Linda K. Ko
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Medical Tourism ◽  
Immigrant Women ◽  
Screening Guidelines ◽  
Permanent Resident ◽  
The Impact ◽  
The U.S

Abstract Background Research on the relationship between medical tourism—traveling abroad for healthcare and cervical cancer screening is lacking. This study examines (1) the association between medical tourism and cervical cancer screening among immigrant women and (2) whether the association varies across years in the U.S. Methods We analyzed the New Immigrant Survey data of immigrant women aged 21–65 (n = 999). The outcome was having had a Pap smear since becoming a permanent resident, and the main predictor was medical tourism. Logistic regressions were conducted. Results Immigrant women who engaged in medical tourism had higher cervical cancer screening rates compared to those who did not engage in medical tourism (84.09% vs. 71.68%). This relationship was statistically significant only among women who have recently immigrated, after controlling for covariates. Conclusions Immigrant women who engaged in medical tourism had 2.18 higher odds of receiving a Pap smear than immigrant women who did not, after controlling for other covariates. Health educators should be aware of the practice of medical tourism and consider providing education on adherence to cancer screening guidelines and follow up abnormal results to ensure that immigrant women receive continuous cancer care.

scholarly journals Age and Cervical Cancer Screening Recommendations

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Elliot Levine ◽  
Norman Ginsberg ◽  
Carlos Fernandez
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Task Force ◽  
Current Data ◽  
Cancer Society ◽  
Age Related ◽  
The Us ◽  
American Society ◽  
Preventative Services

Recommendations for cervical cancer screening have had remarkable agreement from a number of medical societies, including the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), American Society of Cervical Colposcopy and Pathology (ASCCP), and the US Preventative Services Task Force (USPSTF). Reference to the recommended age for screening may need to be re-examined, in light of current data regarding the comparative age-related incidence of cervical malignancy, especially when recognizing the past utility of screening with exfoliative cytology in reducing subsequent mortality.

Risk Factors and Other Epidemiologic Considerations for Cervical Cancer Screening: A Narrative Review for the U.S. Preventive Services Task Force

2011 ◽  
Vol 155 (10) ◽  
pp. 698 ◽  
Author(s):  
Kimberly K. Vesco ◽  
Evelyn P. Whitlock ◽  
Michelle Eder ◽  
Brittany U. Burda ◽  
Caitlyn A. Senger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Task Force ◽  
Preventive Services ◽  
Narrative Review ◽  
The U.S

scholarly journals Cost effectiveness analysis of cervical cancer screening in women until age 70

2018 ◽  
Vol 7 (10) ◽  
pp. 3899
Author(s):  
James C. Quon
Keyword(s):  
Cervical Cancer ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Task Force ◽  
Cost Benefit ◽  
Cost Effective ◽  
The United States ◽  
Screening Guidelines

Background: 2017 US Preventive Services Task Force guidelines for screening cervical cancer and pre-malignant lesions advise that screenings cease for women over age 65, with qualifications. Recent literature has identified significant discrepancies in rates of cervical cancer in older women – if hysterectomies in this patient population is accounted for, cervical cancer incidence does not decline with age as previously established. This adjusted incidence of cervical cancer necessitates a re-examination of current practice.Methods: This study seeks to demonstrate the utility of extending the cervical cancer screening age recommendations to age 70. Cost effectiveness will be estimated, from a payer perspective, of extending screening to age 70 for the United States women’s population in those who have not undergone hysterectomy or otherwise been treated for past cervical cancer or premalignancy. A Markov model was constructed to project outcomes in a hypothetical cohort of 10 000 women aged 65 to 70, with a time horizon of lifetime. A Probability Sensitivity Analysis determined the robustness of the result, and the Incremental Cost-effectiveness Ratio (ICER) is charted.Results: The economic evaluation of screening compared to none in this population was determined to be cost effective, with an ICER demonstrating a cost benefit, and Quality Adjusted Life Year (QALY) benefit, to extended screening.Conclusions: The sensitivity analysis confirms the robustness of this result. Implementing extended screening guidelines could potentially be a significant gain for both patients and society.

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