The premalignant and malignant lesions of the female lower genital tract (cervix, vagina, vulva) and the perianal region are lined with stratified squamous epithelium. They are highly related to the human papillomavirus (HPV) infection which is widespread in women of childbearing age. Perianal premalignant and malignant lesions (such as squamous cell anal cancer) can be visualized entirely without buttock traction within a 5 cm radius of the anal opening. The transformation zones of the anal canal and the cervix are characterized by high turnover epithelium that is particularly vulnerable to malignancy-inducing genetic alterations. There are many similarities between perianal and cervical cancer, with similar biological characteristics of tumorigenesis and their precursors early in the disease process. The screening modalities for female lower genital tract cancers are mainly based on cervical cancer screening settings, including high-risk HPV (hr-HPV) DNA test, cytology test, visual inspection with acetic acid (VIA), and colposcopy. With the success of secondary prevention practices for cervical cancer and other HPV-associated malignancies, screening strategies may similarly decrease rates of perianal region cancer.
It is important to reduce missed diagnoses and avoid overtreatment that affects fertility with current screening methods. Diagnosis and treatment based on new principles have become the recent advances in precision medicine. Newer tests and techniques have been developed recently, including molecular tests such as HPV mRNA, oncoprotein detection, DNA methylation, cytological p16/Ki-67 dual staining, and artificial intelligence/machine learning platforms. The methods of treatment could be ablative (destroying abnormal tissue by heating it with thermal coagulation or freezing it with cryotherapy) or excision, including surgery, large-loop excision of the transformation zone (LLETZ), or cold knife conization (CKC) recommended by World Health Organization (WHO). The latest treatments are immunotherapy, photodynamic therapy, new drugs, vaccination, and surgical technology and equipment advances.
The mechanism and clinical evidence of new diagnostic and therapeutic techniques are significant for future clinical application and guidance. Therefore, our team launched this Research Topic, aiming to strengthen the in-depth research on the primary and clinical aspects of the premalignant and malignant lesions of the female lower genital tract and the perianal region. This Research Topic welcomes manuscripts related to basic and clinical research that can be submitted for publication. Studies primarily bioinformatics and in silico based without clinical and fundal validation in vitro will not be considered per journal policy.
The premalignant and malignant lesions of the female lower genital tract (cervix, vagina, vulva) and the perianal region are lined with stratified squamous epithelium. They are highly related to the human papillomavirus (HPV) infection which is widespread in women of childbearing age. Perianal premalignant and malignant lesions (such as squamous cell anal cancer) can be visualized entirely without buttock traction within a 5 cm radius of the anal opening. The transformation zones of the anal canal and the cervix are characterized by high turnover epithelium that is particularly vulnerable to malignancy-inducing genetic alterations. There are many similarities between perianal and cervical cancer, with similar biological characteristics of tumorigenesis and their precursors early in the disease process. The screening modalities for female lower genital tract cancers are mainly based on cervical cancer screening settings, including high-risk HPV (hr-HPV) DNA test, cytology test, visual inspection with acetic acid (VIA), and colposcopy. With the success of secondary prevention practices for cervical cancer and other HPV-associated malignancies, screening strategies may similarly decrease rates of perianal region cancer.
It is important to reduce missed diagnoses and avoid overtreatment that affects fertility with current screening methods. Diagnosis and treatment based on new principles have become the recent advances in precision medicine. Newer tests and techniques have been developed recently, including molecular tests such as HPV mRNA, oncoprotein detection, DNA methylation, cytological p16/Ki-67 dual staining, and artificial intelligence/machine learning platforms. The methods of treatment could be ablative (destroying abnormal tissue by heating it with thermal coagulation or freezing it with cryotherapy) or excision, including surgery, large-loop excision of the transformation zone (LLETZ), or cold knife conization (CKC) recommended by World Health Organization (WHO). The latest treatments are immunotherapy, photodynamic therapy, new drugs, vaccination, and surgical technology and equipment advances.
The mechanism and clinical evidence of new diagnostic and therapeutic techniques are significant for future clinical application and guidance. Therefore, our team launched this Research Topic, aiming to strengthen the in-depth research on the primary and clinical aspects of the premalignant and malignant lesions of the female lower genital tract and the perianal region. This Research Topic welcomes manuscripts related to basic and clinical research that can be submitted for publication. Studies primarily bioinformatics and in silico based without clinical and fundal validation in vitro will not be considered per journal policy.
