Cervical cancer: a realistic approach to the evolutionary development of radiation therapy, intellectual and technical capabilities. An expert's perspective

Due to low rates of early diagnosis of stage 0-I cancers and unsatisfactory results of treatment of stage II-Iva cancers, I discuss the expediency of digitization and registration of newly diagnosed patients with morphologically confirmed cancers by disease stage, tumor spread variant, degree of squamous cell cancer differentiation, HPV infection. There is a need for PET-CT diagnosis of patients with invasive cervical cancer with recurrent symptoms of viral infection. There is an opportunity to use diagnostic/therapeutic telemedicine centers (city, regional) for express selection of clarifying diagnostic tests for patients with cervical cancer, eliminating repeated diagnostic procedures and determining the actual route of patients and institutions to implement diagnostic and therapeutic algorithms in accordance with Russian Ministry of Health local standards. It is necessary to formulate protocols for extra-class radiotherapeutic technologies (proton irradiation, MR/LT, etc.) based on updated standards of the Russian Ministry of Health and recommend medical institutions for their implementation within the compulsory health insurance. It is also necessary to evaluate the treatment of cervical cancer with an independent examination of the results of recurrence-free and overall survival of patients during the 1-year, 3-year and 5-year follow-up with data entered into the protocol of the cancer registry of the medical institution and through the structures of the Ministry of Healthcare of the Russian Federation in the population cancer registry.