New Trends in the Detection of Gynecological Precancerous Lesions and Early-Stage Cancers

Abstract

The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.

Keywords: cervical cancer; endometrial cancer; liquid biopsy; ovarian cancer; precancer.

Figure 1

Application of liquid biopsies and liquid-based cytology (LBC) for diagnostics in clinical practice and/or research.

Figure 2

Various sources of body fluids are used for detection of circulating biomarkers in non-invasive format to identify women at high risk of cervical, endometrial and ovarian (pre)cancer.