Cervical cancer prevention is focused on the screening and detection of high-grade pre-cancerous lesions as opposed to diagnosing cancer.
The overarching goal is to detect, with the highest possible sensitivity, high-grade cervical intraepithelial neoplasia (CIN) (eg ≥CIN2). These pre-cancerous lesions are most strongly associated with the development of invasive carcinoma.1
Numerous approaches are used, most of them based on conventional or liquid-based Pap cytology and, increasingly, incorporating adjunct testing for high-risk human papillomavirus (hrHPV).
Global cervical cancer screening: wide disparity in coverage and opportunity for improvement
Snapshot: screening coverage worldwide, women age 25-64
The search continues for improved testing that can return the majority of women to routine screening while identifying women who could benefit most from further intervention. Biomarkers for cervical pre-cancer may meet this unmet need.Discussions about cervical cancer screening often focus on the availability of the laboratory services and technologies needed to identify and diagnose disease.
But coverage – the number of women in a given population who avail themselves of or participate in screening services – is a key to effective screening. Even in developed countries with established infrastructures, coverage varies widely and could be improved for subpopulations of women, such as women over 45 years of age.2
Women reporting pelvic/Pap exam in past 3 years.
Women reporting pelvic/Pap exam at any time.
Women reporting never had a pelvic/Pap exam.
In developing countries, coverage generally is low. Many women have never had a pelvic exam, and many who have been examined have not had the benefit of laboratory testing.2
The chart above illustrates the variability in cervical cancer screening across 57 counties. It reflects differences in socioeconomics, and inconsistencies in access, technologies, and formalized versus opportunistic screening approaches.