Use of risk-based cervical screening programs in resource-limited settings

Rebecca B. Perkins, Debi L. Smith, Jose Jeronimo, Nicole G. Campos, Julia C. Gage, Natasha Hansen, Ana Cecilia Rodriguez, Li C. Cheung, Didem Egemen, Brian Befano, Akiva P. Novetsky, Sandro Martins, Jayashree Kalpathy-Cramer, Federica Inturrisi, Syed Rakin Ahmed, Jenna Marcus, Nicolas Wentzensen, Silvia de Sanjose, Mark Schiffman

Research output: Contribution to journalComment/Letter to the editorAcademic

5 Citations (Scopus)


Cervical cancer screening and management in the U.S. has adopted a risk-based approach. However, the majority of cervical cancer cases and deaths occur in resource-limited settings, where screening and management are not widely available. We describe a conceptual model that optimizes cervical cancer screening and management in resource-limited settings by utilizing a risk-based approach. The principles of risk-based screening and management in resource limited settings include (1) ensure that the screening method effectively separates low-risk from high-risk patients; (2) directing resources to populations at the highest cancer risk; (3) screen using HPV testing via self-sampling; (4) utilize HPV genotyping to improve risk stratification and better determine who will benefit from treatment, and (5) automated visual evaluation with artificial intelligence may further improve risk stratification. Risk-based screening and management in resource limited settings can optimize prevention by focusing triage and treatment resources on the highest risk patients while minimizing interventions in lower risk patients.
Original languageEnglish
Article number102369
JournalCancer epidemiology
Publication statusPublished - 1 Jun 2023


  • Automated visual. evaluation
  • Cervical cancer prevention
  • HPV testing
  • Resource-limited settings
  • Risk-based screening

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