The main goal of cervical cancer screening is to prevent cancers, which is achieved by identifying cervical precancers that can be treated to prevent progression to invasive cancer. On the population level, cervical cancer screening needs to identify the small group of women at increased risk of cervical cancer, who need further workup and possibly treatment, while reassuring the majority of women that their cancer risk is very low. Recent guidelines efforts have adopted a risk-based approach to develop guidelines for screening, triage, management and treatment. Different risk estimates are only relevant when they translate to different clinical management. There are four relevant groups of risk of cervical precancer: At the lowest risk, women return for screening after regular screening intervals. In the intermediate risk group (below a colposcopy referral threshold and above a regular screening threshold), additional testing or increased surveillance is required. The next level is the colposcopy referral threshold, and at the highest risk level, immediate treatment may be an option. p16/Ki-67 dual stain cytology has been evaluated as a biomarker for primary screening and for triage of cytology and HPV screening and will be used to illustrate the risk-based screening and triage approach, a paradigm for precision prevention.
n/a
n/a