CERVICAL DYSPLASIA: CURRENT INSIGHTS IN PATHOGENESIS, DIAGNOSIS, PROGNOSIS, PREVENTION AND MANAGEMENT
DOI:
https://doi.org/10.32689/2663-0672-2025-1-12Keywords:
cervical dysplasia, pathogenesis, human papillomavirus (HPV), cervical cancer, screening strategies, treatment, preventionAbstract
The aim of the study. To conduct a systematic analysis of current knowledge about the pathogenesis, diagnosis, prognosis, prevention and clinical management of cervical dysplasia; to identify key risk factors, the role of oncogenic types of human papillomavirus (HPV), the diagnostic value of molecular markers, as well as the cost-effectiveness of screening and treatment strategies based on current clinical guidelines. Methodology. The study was based on a systematic review of the literature for 2010-2024, including the results of randomized controlled trials, meta-analyses, and FIGO, ESGO, WHO guidelines on the diagnosis, risk stratification, and treatment of cervical dysplasia. The evidence was summarized with a focus on the clinical and economic effectiveness of biomarker support, screening programs, and tactical approaches to the management of patients with CIN1-3. Scientific novelty. It has been established that the integration of highly specific biomarkers (p16INK4a, Ki-67), HPV genotyping and modified screening strategies (HPV testing in combination with cytology) can improve diagnostic accuracy and individualize treatment approaches. The high clinical and cost-effectiveness of excisional treatments for HSIL, as well as the potential for using thermal ablation in patients with limited access to health care services, were revealed. Conclusions. A comprehensive strategy to combat cervical dysplasia should include early vaccination, the introduction of high-precision molecular diagnostic methods, and algorithmic management of patients according to the degree of dysplasia and associated risk factors. Early diagnosis, risk stratification using biomarkers, and the use of cost-effective therapeutic interventions can significantly reduce cervical cancer morbidity and mortality and ensure the preservation of women's reproductive health.
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