Conference "Cervical pathology at the crossroads of medical specialties"

 

A scientific and medical conference "Cervical pathology at the crossroads of medical specialties" for obstetrician/gynecologists, gynecologic oncologists, cytologists, and oncologists of the Lviv oblast was held on November 23, 2016 at the conference hall of the Suputnyk hotel (116 Knyahynia Olha St., Lviv). Unexpectedly for us, there were many attendees - 105 persons registered.

 

For your attention, please find the abstracts of the moderator's report and those of the speaker - deputy head physician for the medical work in the Lviv State Oblast-level Cancer Treatment and Diagnostics Centre, surgical oncologist, Dr. Orest Tril:

 

The state of diagnostics associated with cervical cancer in the Lviv oblast in accordance with data provided by the National cancer registry (V.Yu.Ludchak)

 

Dry figures associated with terrible statistics reflect the tragic female destiny with respect to the diagnosis of cervical cancer; however, optimistic curves associated with the drop in the mortality rate from this disease on the background of a positive increase in the diagnosis, as resembled in the diagrams related to Ca in situ in the implementation of screening, were clearly demonstrated using examples of the countries where screening is successfully implemented, specifically Great Britain and South Korea. Ukrainian realities stay behind the increasingly growing curve associated with invasive cancer on the background of the limited insufficient increase in the level of the pre-invasive diagnosis of cervical cancer at the 0 stage. For the Lviv oblast, the latter curve is significantly higher, which suggests the possibility of a positive intersection of these lines, - in particular, high-quality screening provides hope of being able to improve the stage 0 diagnosis rate, compared to cervical cancer cases where symptoms are already more evident.

 

Experience in establishing screening programs and their effectiveness in the developed countries (N.A.Volodko)

 

Evaluation of the Ukrainian potential with its qualified personnel of cytologists, extensive and disciplined obstetrician/gynecological service, emphasizes inadequacy of the screening model of the "reveal - treat - undertake diagnosis in case of failure" type, as proposed for the countries with very scarce resources. Instead, cytological cervical cancer screening is quite feasible for our realities. Its modern transformations into the liquid-based cytology and HPV testing can be considered as preferences for the future, especially after the introduction of optimal monitoring of women and high rate of the follow-up activities associated with the target groups. Analysis of the screening programs applied in Europe and the US shows heterogeneity in terms of multiplicity of approaches to the target groups of women in screening, which is certainly due to the resources and the national cultural characteristics of each country. Ukrainian approach to the population-based screening is manifested through improved coverage by cytological screening, high-quality monitoring of the contingents of the unexamined women, standardization, and quality control of such procedures, as smear sampling, colposcopy protocol, cytological staining, and upgrade of the classifications related to cytological descriptions, IT solutions in terms of data exchange and processing data sets.

 

Pathogenetic mechanisms associated with cytological changes in the cervix uteri caused by HPV; Comorbidity and antiviral asthenia during cervical cancer (Kh.O.Lishchuk-Yakymovych)

 

The issue of frequent HPV infection is not proportional with the incidence rate associated with cervical cancer, which, probably, correlates with additional significant effects on the immune competence - comorbidity associated with other infections (herpes viruses, such as Epstein-Bar, and other diseases). The relation between the HPV and poor immunogenicity, locus morbi localization in the transforming area where there is a minimum of immunocompetent cells, leads to chronic HPV infection. Incorporation of the viral genome into the DNA of a woman with disabling interferon antiviral mechanisms of cell transformation results in the danger of transforming into cytological abnormalities - dysplasia, atypical cells, and cancer. Nowadays, current approaches to HPV prevention in the form of vaccination provides great hopes for the formation of the resistant barrier in girls vaccinated against HPV. Regarding the treatment of existing HPV, there is no consensus among the experts with respect to the unified efficient approach (interferon therapy may only be effective in the early stages of infection; however, in the course of the incorporation in the human genome, more advanced approaches are developed).

 

Organization of the population-based screening involving the opportunities offered by the “Preventive oncology” project (O.V.Tril)