IMR Press / CEOG / Volume 50 / Issue 8 / DOI: 10.31083/j.ceog5008160
Open Access Review
Prevention, Screening, Treatment and Follow-Up of Gynecological Cancers: State of Art and Future Perspectives
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1 Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
2 Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in ''Translational Medicine and Oncology'', Sapienza University, 00185 Rome, Italy
3 Department of Gynecologic Oncology, IRCCS National Cancer Institute, 20133 Milan, Italy
4 Unit of Gynecologic Oncology, ARNAS ''Civico – Di Cristina – Benfratelli'', Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
5 Department of Woman’s and Child’s Health, Obstetrics and Gynecological Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy
6 Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy
7 Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Unit Institute, 00128 Rome, Italy
*Correspondence: ottavia.doria@uniroma1.it (Ottavia D'Oria)
Clin. Exp. Obstet. Gynecol. 2023, 50(8), 160; https://doi.org/10.31083/j.ceog5008160
Submitted: 24 February 2023 | Revised: 28 March 2023 | Accepted: 17 April 2023 | Published: 2 August 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objective: This study aims to analyze the available data on prevention and early diagnosis in gynecological cancers. Mechanism: A comprehensive search was performed in the PubMed (MEDLINE), EMBASE, SCOPUS and Web of Science databases. Findings in Brief: To date the prevention programmes of all degrees exist exclusively for cervical cancer. Human Papilloma Virus (HPV) vaccination prevents from infection and development of precancerous lesions and contributes significantly to the deflection of the incidence of cervical cancer. Screening for HPV-related lesions is worldwide performed by cervical smear (Pap-test) and HPV test. Finally, tertiary prevention is aimed at the treatment of previously diagnosticated lesions with the aid of surgery, chemotherapy, radiotherapy and immunotherapy. Unfortunately, to date the prevention programmes of other gynecological tumors have not reached a good performance; indeed, the primum movens that leads to the development of such neoplasms has not been identified yet. Actually, no screening programs for the early diagnosis of endometrial cancer are available, however, it is recommended the adoption of a healthy lifestyle and a balanced diet. Diagnostic biomarkers would be helpful for screening asymptomatic high-risk women, but histopatological examinations remain the gold standard for diagnosis of endometrial cancer. Similarly, there are no screening tests for the diagnosis of ovarian cancer. In recent years many steps forward have been made in this field and new perspectives have been presented, however, additional investigation is needed to optimize the duration and timing of treatment, examine its cost-effectiveness, and identify potential tumor or host biologic factors predictive of the efficacy and adverse events. Finally, there are no primary and secondary prevention for vulvar cancer so patients should be invited to self-examination and pay attention to the presence of symptoms. Conclusions: Are the available screening programs for the diagnosis of gynecological carcinomas sufficient? The prevention and the diagnosis of precancerous lesions is the goal to be achieved for all gynecological cancers in order to improve patient outcomes, reduce the costs for managing the disease and prolonged follow up.

Keywords
gynecologic oncology
cancer prevention
gynecological cancers
HPV vaccination
screening programs
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