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<p>Secondary prevention of cervical cancer is based on population-based screening followed by triage of risk factors, colposcopy, biopsy, and treatment of precancerous lesions. Currently, co-testing of human papillomavirus (HPV) status and cytology is performed for women aged 35&#xa0;years and older and cytology alone for women aged 20–34. Due to the lower specificity of HPV testing compared with cytology, effective triage of HPV-positive women is essential, particularly in populations with mixed status regarding HPV vaccination introduced as primary prevention. Current algorithms that consider only HPV status and cytology lack sufficient specificity and require adaptation: HPV genotyping improves risk stratification by identifying high-risk cases. Dual-stain cytology shows higher sensitivity and specificity than Pap (Papanicolaou) cytology alone. DNA methylation represents another promising biomarker. Optimized triage algorithms aim to maximize the detection of CIN 3+ (cervical intraepithelial neoplasia grade&#xa0;3 or worse) while minimizing overdiagnosis.</p>

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Neue Abklärungsdiagnostik bei der Zervixkarzinom-Vorsorge

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Peter Hillemanns,
  • Agnieszka Denecke,
  • Jens Hachenberg,
  • Lena Steinkasserer,
  • Anna Viktoria Stassek

摘要

Secondary prevention of cervical cancer is based on population-based screening followed by triage of risk factors, colposcopy, biopsy, and treatment of precancerous lesions. Currently, co-testing of human papillomavirus (HPV) status and cytology is performed for women aged 35 years and older and cytology alone for women aged 20–34. Due to the lower specificity of HPV testing compared with cytology, effective triage of HPV-positive women is essential, particularly in populations with mixed status regarding HPV vaccination introduced as primary prevention. Current algorithms that consider only HPV status and cytology lack sufficient specificity and require adaptation: HPV genotyping improves risk stratification by identifying high-risk cases. Dual-stain cytology shows higher sensitivity and specificity than Pap (Papanicolaou) cytology alone. DNA methylation represents another promising biomarker. Optimized triage algorithms aim to maximize the detection of CIN 3+ (cervical intraepithelial neoplasia grade 3 or worse) while minimizing overdiagnosis.