Prevention of cervical dysplasia as a strategic medical and social resource for preserving the reproductive potential and security of the nation

Introduction

Ensuring women’s reproductive health is one of the most important strategic tasks in the health care system, which directly affects demographic indicators, socio-economic development of the state and its security [1]. Cervical dysplasia (intraepithelial neoplasia) is one of the most common pathologies that, in the absence of timely diagnosis and treatment, leads to the development of invasive cervical cancer, the second most common malignancy among women of reproductive age in the world [2].

According to the World Health Organization, cervical cancer kills more than 311,000 women annually, with most deaths occurring in low- and middle-income countries [3]. In Ukraine, cervical cancer incidence remains consistently high, which necessitates the development and implementation of effective prevention strategies aimed at early detection of precancerous changes and prevention of their progression [4].

The development of screening systems based on cervical cytology, human papillomavirus (HPV) testing, and mass vaccination against oncogenic HPV types are considered by the global medical community to be key tools in the fight against this disease [5]. However, the effectiveness of these measures directly depends on the level of organization of medical care, availability of preventive services, public awareness, and social mobilization [6].

At the same time, cervical dysplasia, as a medical and social phenomenon, is an indicator of the general health of the female population, the level of access to medical innovations, and the effectiveness of health care management [7]. Timely detection and treatment of precancerous conditions preserves the reproductive potential of women, improves their quality of life, and contributes to the formation of a healthy gene pool of the nation [8].

In this context, prevention of cervical dysplasia is of strategic importance as a resource for long-term preservation of public health, ensuring sustainable development of society and ensuring national security [9]. Formation of a national prevention strategy should be based on a systematic analysis of existing approaches, evaluation of the effectiveness of international experience and implementation of innovative models of medical and social care [10].

Given the above, conducting a comprehensive study to assess the effectiveness of preventive measures for cervical dysplasia and substantiate ways to improve them is an urgent scientific and practical task of modern medicine and public health policy.

The aim of the study is to substantiate the prevention of cervical dysplasia as an integrated medical and social resource to ensure reproductive safety and long-term stability of the nation’s health.

Object and methods of the study

The object of the study is organizational models of prevention and early detection of cervical dysplasia, their impact on reproductive health indicators and general demographic indicators. The research methods included a systematic analysis of scientific literature over the past 10 years, an analytical review of the effectiveness of screening and vaccination programs, a summary of the results of medical and statistical studies on cervical cancer morbidity and mortality, and the use of methods for comparative assessment of the impact of preventive measures on public health.

Results

An analysis of scientific literature, national and international databases on the epidemiology of cervical dysplasia found that more than 570 thousand new cases of cervical cancer are diagnosed annually worldwide, which in 85% of cases is associated with preexisting dysplastic changes. In Ukraine, the incidence of cervical cancer in 2021 was 16.8 per 100 thousand women, and the mortality rate was 9.7 per 100 thousand, which is significantly higher than the European average.

A comparative analysis of screening programs has shown that in countries with organized cervical screening (Sweden, the United Kingdom, Australia), the rate of invasive cancer has been reduced by 60-80% over the past 30 years. In countries with unorganized or low-coverage programs (including Ukraine), there is stagnation or even growth in invasive cervical cancer rates.

Studies of the impact of preventive measures have shown that the introduction of HPV vaccination among adolescents leads to an 80–90% reduction in severe dysplasia in the 20–25 age group 10 years after the start of the program. In countries with wide vaccination coverage (e.g., Australia, Denmark), the actual elimination of cervical cancer is predicted to occur within the next 20–30 years.

The analysis of the factors of access to preventive measures in Ukraine revealed a number of barriers:

• insufficient level of public awareness (up to 40% of women of reproductive age are unaware of the importance of regular screening);
• uneven access to quality services between urban and rural areas;
• limited availability of vaccination due to lack of state funding in some regions.

A systematic analysis of the cost-effectiveness of prevention programs has shown that investments in screening and vaccination are highly effective: every dollar spent on prevention provides from 3 to 7 dollars in savings on the treatment of invasive forms of cancer.

It was also noted that the use of innovative approaches to self-sampling for HPV testing can increase screening coverage by 15–20% among women who have not previously participated in prevention programs, especially in remote regions.

A comprehensive assessment of organizational models of prevention shows the need to create a unified national registry of screening examinations and vaccinations to improve monitoring, accounting and control of the effectiveness of measures.

Discussion

The results obtained confirm the extreme relevance of cervical dysplasia prevention as a multidisciplinary medical and social strategy aimed not only at reducing cancer incidence but also at maintaining the overall level of public health, ensuring reproductive safety and demographic stability of the state.

The availability of organized national screening programs is a critical success factor in the fight against cervical dysplastic diseases. International experience demonstrates that only a comprehensive, standardized approach with centralized data recording, clear referral and treatment algorithms, and guaranteed access to quality diagnostics can lead to a significant reduction in the incidence. A retrospective analysis of programs in Sweden, the Netherlands, and the UK shows that a high level of screening organization ensures coverage of more than 75% of the target population, which is the key to the effectiveness of preventive measures.

Another key task is to integrate HPV vaccination into national vaccination schedules. Global experience shows that countries that have introduced free vaccination among adolescent girls have achieved an 88% reduction in oncogenic HPV infections in 10 years. For Ukraine, it is necessary to implement mass communication campaigns to promote vaccination among parents and adolescents, as well as to ensure equal access to vaccines regardless of the region of residence.

Special attention should be paid to overcoming the social determinants of inequality of access to preventive services. Studies show that socially disadvantaged groups (low-income women, rural women, migrants) have 2–3 times higher risks of developing dysplasia and progression to cancer due to lower participation in screening. To overcome these challenges, it is proposed to use mobile screening units, telemedicine consultations, simplify access to self-testing, and actively engage NGOs.

Innovative approaches to cervical screening include automated cytology analysis (artificial intelligence for primary sampling), molecular tests for high-risk HPV, and the use of biomarkers for risk stratification. The introduction of such technologies can significantly increase the sensitivity and specificity of screening, reduce the number of unnecessary interventions, and optimize patient routing.

An additional way to improve dysplasia prevention is to increase the level of public health education through the integration of health knowledge into school and university curricula, the development of specialized educational platforms for healthcare professionals, and mass media and social media campaigns.

Thus, prevention of cervical dysplasia should become a priority of the state health policy, and its effectiveness will be determined by the level of integration of innovative technologies, cross-sectoral cooperation and focus on the needs of the most vulnerable groups.

Conclusion

Prevention of cervical dysplasia is a priority in ensuring women’s reproductive health and maintaining the demographic stability of society. It has been established that a systematic approach to the organization of primary and secondary prevention can significantly reduce the level of morbidity and mortality from cervical pathology. The results of the study emphasize the importance of integrating modern screening methods, including human papillomavirus testing and cytology programs, as well as the widespread introduction of HPV vaccination into public health programs. Ensuring accessibility of preventive services, especially for socially vulnerable groups, should be one of the key objectives of the national health strategy.

Raising public awareness through active health education is an integral part of increasing the effectiveness of preventive measures. Improving medical standards, regular monitoring of health indicators, and the introduction of a personalized approach to screening can improve the quality of medical care and the timeliness of detecting pathological changes.

Further developments should be aimed at improving organizational models of prevention, introducing the latest technologies for diagnosing and treating precancerous conditions, and developing innovative mechanisms for managing health care resources. Comprehensive prevention of cervical dysplasia should be viewed not only as a clinical task, but as an important element of ensuring reproductive safety and strategic health of the nation.

References

Надійшла до редакції/Received: 27.04.2025
Прийнято до друку/Accepted: 29.04.2025