New Aspects and an Artificial Intelligence Approach for the Detection of Cervical Abnormalities

Abstract

The COVID-19 pandemic has challenged health systems worldwide by decreasing their reserves and effectiveness. In this changing landscape, the urge for reallocation of financial and human resources represents a top priority. In screening, effectiveness and efficiency are most relevant. In the quest against cervical cancer, numerous molecular ancillary techniques detecting HPV DNA or mRNA or other related biomarkers complement morphological assessment by the Papanicolaou test. However, no technique is perfect as sensitivity increases at the cost of specificity. Various approaches try to resolve this issue by incorporating several examination results, such as artificial intelligence are proposed. In this study, 1,258 cases with a complete result dataset for cytology, HPV DNA, HPV mRNA, and p16 were used to evaluate the performance of a self-organizing map (SOM), an unsupervised artificial neural network. The results of the SOM application were encouraging since it is capable of producing maps discriminating the necessary tests and has improved performance.

Effect of Condom Use after CIN Treatment on Cervical HPV Biomarkers Positivity: Prolonged Follow Up Study

“…An equally ambitious yet feasible project could be the further validation of a Cervical Pathology Scoring system, a concept which was initially introduced in published form by Paraskevaidis et al, several years before the introduction of commercially available colposcopy mobile apps [ 17 , 18 , 20 , 33 ]. Together with information such as vaccination status, age at onset of sexual intercourse, number of sexual partners and smoking habits, frequency of condom use represents an integral part of a Lifestyle Cervical Pathology Risk Assessment Tool during history taking at the colposcopy clinic [ 19 , 24 , 35 ]. When validated and combined with cytology and HPV-biomarker data, this user-friendly algorithm would represent an invaluable tool for the clinician, predicting accurately the likely clinical course of every new colposcopy referral.…”

“…Inadequate technique, residual HPV infection, re-infection with (other) high-risk oncogenic HPV or crypt involvement might all represent the underlying plausible mechanism [ 15 ]. Cytology, colposcopy, HPV DNA test and more recently, established or novel HPV related biomarkers have been proposed and used successfully in the post-treatment surveillance period giving excellent results [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. HPV DNA test, in particular, seems to further improve accuracy and has been established as a ‘test of cure’ (TOC) which allows women to return back to community recall [ 23 ].…”

HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature

“…With comparable clinical accuracy for hrHPV testing in self-samples as clinician-collected material and flexibility for use both in primary cervical screening as well as triage of abnormal samples, advocacy for incorporating self-sampling into organized screening programs is strong, especially after the disruption due to the SARS-CoV-2 pandemic [ 5 , 17 , 20 , 21 , 57 , 58 , 59 , 60 ]. With an ever-growing number of countries considering self-collection for cervical screening, issues to be determined are how to best offer the service, whom to offer it to, adhering to f-u, triage of HPV-positive cases and how to best prepare the public and health systems for this transition [ 14 , 61 ]…”