Cervical cancer is diagnosed in more than 13 000 women, of whom 30% will die in the United States each year (1). Worldwide, more than 3% of both the global burden of cancer incidence and death is attributable to this preventable disease with an annual estimated 570 000 cases and 311 400 deaths (2). Prevention of cervical cancer can be primary through human papillomavirus (HPV) vaccination or secondary through repetitive screening during a woman’s reproductive years. The challenge of screening has been to capture true positives and reduce the false positives that lead to over-testing and increased medical costs. The current recommendation of combined cytology with HPV testing of high-risk subtypes at 5-year intervals has improved the positive predictive value of screening but still leads to over-referrals for colposcopy because of the high prevalence of transient HPV infections (3). An additional challenge for resource-limited regions is the need for a sophisticated infrastructure requiring materials for cytology and HPV testing; processing instruments; highly trained cytopathologists; systems for reporting, tracking, and follow-up; and the lack of health-care insurance in many regions requiring out-of-pocket pay by patients.

中文翻译：

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基于深度学习的双染色细胞学评估宫颈癌筛查：一种新范式

超过 13 000 名女性被诊断出宫颈癌，其中 30% 的女性每年将在美国死亡 (1)。在全球范围内，超过 3% 的全球癌症发病率和死亡负担可归因于这种可预防的疾病，每年估计有 570 000 例病例和 311 400 例死亡 (2)。宫颈癌的预防可以通过人乳头瘤病毒 (HPV) 疫苗接种进行初级预防，也可以通过女性生育年龄期间的重复筛查来预防。筛查的挑战在于捕获真阳性并减少导致过度检测和增加医疗成本的假阳性。目前建议每隔 5 年对高危亚型进行细胞学检查和 HPV 检测，这提高了筛查的阳性预测值，但由于一过性 HPV 感染的高患病率，仍然导致过度推荐阴道镜检查 (3)。资源有限地区的另一个挑战是需要复杂的基础设施，需要用于细胞学和 HPV 检测的材料；加工仪器；训练有素的细胞病理学家；报告、跟踪和跟进系统；许多地区缺乏需要患者自付费用的医疗保险。训练有素的细胞病理学家；报告、跟踪和跟进系统；许多地区缺乏需要患者自付费用的医疗保险。训练有素的细胞病理学家；报告、跟踪和跟进系统；许多地区缺乏需要患者自付费用的医疗保险。