[The preferential strategies of programs of cervical virologic screening (publications review)].

Nowadays, the screening programs underwent global alterations due to low sensitivity and specificity against the background of significant increase of cervical oncopathology. The HPV testing became a major strategy of primary screening in many developed countries. The studies of organizational technologies of successful implementation of virologic screening are to bear on scientific justification of test choosing. To review scientific base of organizational technologies of primary virologic screening of cervical cancer with study of preferred criteria of selecting HPV test in world practice. The selection from scientific database PubMed and Google Scholar relevant publications over the past 15 years on organizational technologies of implementing methodologically validated virologic screening for cervical cancer was carried out. The world publications present evidence base of success in modifying organizational structure of cervical screening from PAP smear cytological screening to HPV testing. The necessary condition of efficiency was the organized screening covering at least 70% of female population of reproductive age, applying validated HPV assays as primary screening. The results of randomized clinical trials were the preferred strategies of selecting tests and primary screening programs. Currently, HPV testing is the preferred technology of primary cervical screening. The choice of specific HPV test is based on Mayer's criteria, including validation, information content, availability, identification of main HPV types of high oncogenic risk with typing, groups ranking for personalization of therapy and rehabilitation. To decrease subjectivity in organization of laboratory component in screening methodology, automation and standardization were applied in isolation of HPV DNA with cutting-off clinically insignificant results. The preferred strategies of selecting cervical virologic screening programs were results of multicenter randomized clinical trials, with significant evidence base of detection of cervical precancerous pathology and decrease of corresponding morbidity.

[EPIDEMIOLOGICAL FEATURES OF PAPILLOMAVIRUS INFECTIONS AND CERVICAL CANCER IN THE REPUBLIC OF BASHKORTOSTAN AND THE KALININGRAD REGION].

In the context of improving cancer prevention programs, it becomes relevant to justify the introduction of regional HPV cervical cancer screening programs based on a study of the prevalence of human papillomavirus infection and cervical cancer. Aim: to identify the main patterns of the prevalence of human papillomavirus infection and cervical cancer in Bashkortostan and the Kaliningrad region for the scientific substantiation of the criteria for the adoption of regional screening programs. A prospective analytical cohort single-stage observational examination of 3428 women of the Republic of Bashkortostan and 1246 women of the Kaliningrad region was carried out, as well as a retrospective observational analytical study of cervical cancer incidence in Bashkiria and the Kaliningrad region according to the official statistics from 2011 to 2020 compared to Russian indicators. In Bashkortostan and the Kaliningrad region, HPV DNA was detected in 48.7% and 54.2% of women of reproductive age, respectively, of which HPV of high oncogenic risk (HPV HR) was 51.7 ± 6.2%, and 23.4% were found to have PCM . In the Kaliningrad region, HPV DNA was detected in 47.2% of the women under study, HPV VR - 31.1%, in 25.5% accompanied by cervix uteri diseases. An increase in the incidence is noted in the Kaliningrad region by 38.6% over 10 years, with an annual increase of 3.8%. In Bashkortostan, the growth is demonstrated by 31.8% with an annual increase of 3%, which is significantly higher than in the Russian Federation (13.3%, р=0.001). For 10 years, the prevalence of cervical cancer has increased in the Kaliningrad region by 10.1%, with an average annual increase of 1.1%. In Bashkortostan, the prevalence of CSM increased by 4.7% with an annual increase of 0.3%. The high prevalence of HPV infection among women of reproductive age, the unfavorable dynamics of indicators of cervical HPV-associated oncopathology in remote regions of the Russian Federation (Bashkiria and the Kaliningrad region) is a scientifically based criterion for the reorganization of regional cervical screening programs. The implementation of Organized screening with primary HPV examination with mandatory separate genotyping of types 16 and 18 and the remaining 12 types of HPV HRC in a complex will enhance the effectiveness of ongoing preventive measures and meet international standards.